Women Heart Patients Have Better Survival Odds with Women Doctors
Women having a heart attack are less likely to die if their doctor is also female, a new study shows.
How much less likely? When treated for a heart attack by men, the risk for women goes up 1.5 percent. That means roughly one in 66 women has a better chance of leaving the hospital alive if their doctor is also a woman, the study published this month in the Proceedings of the National Academy of Sciences shows.
Researchers looked at about 582,000 census records of patients admitted to Florida emergency rooms from 1991 to 2010 for acute myocardial infarctions or AMI, commonly called a heart attack. Of those, between 1,500 to 3,000 fewer women may have died if their doctor had been female, Laura Huang, a study co-author and Harvard Business School associate professor, said in an interview.
The research mirrors bias found in studies elsewhere, like in the workplace where women face prospects of lower pay or fewer chances at promotionthan men. In the medical world, recent studies show doctors are less alert to symptoms in older adults when a patient is female.
Heart attacks are the leading cause of death in the United States for both men and women, according to the Centers for Disease Control. In the emergency room as a business, the customer lives or dies.
“This is really like a glass ceiling on life,” said Huang, whose research often involves bias and gut feelings when it comes to risk. “All of the effects that we're finding in other organizations should not be happening in this context, but yet we still see this glass ceiling.”
Another finding: the more frequently male doctors treated women, the better the female patient’s chance of survival became. Male doctors performance also improved when emergency rooms had more female doctors. For Huang, the price of that learning curve seems too high for women.
“There's lots of these scenarios where people have to advocate, have to perform on our behalf,” Huang said. “The question is, does it really matter who that person is? And yes, it sort of does. Here we find that who you are and who is advocating for you, who is treating you, is making a difference.”
Results don’t show exactly why male physicians don’t do as well with women, in part because the study is based on observation only, rather than experiments. But Huang and her co-authors, Brad N. Greenwood, of the University of Minnesota-Twin Cities, and Seth Carnahan, of the Washington University in St. Louis, offer a few suggestions.
One reason may be that training is traditionally based on male experience as a baseline when evaluating symptoms. And women present with different symptoms than men when it comes to heart attacks. They may also may also wait longer to be treated than men, the study’s authors noted.
“It's not that these male physicians are not amazing physicians—they are,” Huang said. “But we do see a notable difference based on what type of patients they're seeing.”
So, if you’re a hospital administrator or involved in training doctors, look at ways to combat the traditional assumption that heart disease, and heart attacks in particular, are male-centric.
To promote change, more studies might include "experimental interventions, or tests of more targeted training, to examine how exposing male physicians more thoroughly” to what female symptoms look like, the researchers wrote.