Female physicians demonstrated better patient outcomes compared with their male counterparts due to the lower likelihood of male physicians providing guideline-recommended care to female patients, researchers reported.

Since 2019, women comprised most medical students in the U.S.; the percentage of female medical students rose from 46.9% in 2015 to 50.5% in 2019. Despite this trend, some subspecialties such as cardiology, cardiothoracic surgery and vascular surgery have lower number of female physicians, with women representing only 12.6% of cardiologists, the researchers wrote.

Demographic concordance

“We did this study to support our hypothesis that, at the present time, gender concordance may lead to improved outcomes,” Malissa J. Wood, MD, cardiologist in the cardiovascular division in the department of medicine at Massachusetts General Hospital, told Healio. “Our group firmly believes that the demographics of the cardiology team need to better match with the demographics of our patients.”

Researchers conducted a systemic review published in the Journal of the American College of Cardiology evaluating eight studies assessing the patient-physician gender relationship and patient outcomes based on physician gender across various medical specialties and the role in the care received by patients.

In one study of adult patients with diabetes treated by primary care physicians from the Kaiser Permanente Northern California system, researchers found female patients to be less likely to receive treatment intensification than male patients, especially when treated by male physicians. In the same study, female physicians were more likely to intensify therapy for hyperlipidemia and hypertension compared with male physicians.

In a study of patients admitted to Florida hospitals from 1991 to 2010, researchers found higher mortality among female patients treated by male physicians compared with similar mortality rates between men and women when treated by female physicians. This study found patient-provider gender concordance was associated with a 5.4% reduction in death probability compared with a baseline of 11.9%. This study also found that male physicians with more exposure to female patients and physicians had more success in treating female patients compared with those with less exposure.

Although data are limited, these findings highlight the urgent need for further investigation into the magnitude of patient-provider gender concordance and its potential influence on patient outcomes, Wood and colleagues wrote.

Increasing diversity

The researchers suggested the following to increase gender diversity in the physician workforce:

• increasing the number of women in CV medicine through comprehensive interventions;
• changing the culture of cardiology to be more female- and family-friendly; and
• increasing women representation in leadership positions in CV medicine.

To improve sex- and gender-specific medical training, the researchers suggested:

• increasing sex- and gender-specific education in medical training;
• including more comprehensive behavioral health curriculums in medical schools addressing increasing levels of stress, depression and anxiety faced by women and men with CVD;
• teaching patient-centered communication styles; and
• introducing implicit bias training into medical education.

According to the researchers, nonrandomized experimental designs incorporating economic approaches with medical research may aid in understanding the role of gender in patient-physician relationships and patient outcomes.

“We hope the findings of this study will emphasize the importance of expanding diversity within the cardiology workforce, improved attention to taking care of the patient and their unique situation instead of taking care of a ‘condition’ — this approach should be taught in medical school, residency and fellowship,” Wood said in an interview. “Finally, we need to understand why women and underrepresented minorities are not entering the field of cardiology and address these reasons directly.”