I think in general women are at ease with a female doctor rather than a male doctor because they can easily open up whereas with a male doctor they would hesitate to communicate. It’s true in the case of male patients even. So being comfortable is the most important factor as far as doctor patient relationship and the treatment progress is concerned.
I don’t agree with the notion that women doctors listen more when compared with their male counterparts. It all boils down to the individual ultimately irrespective of the gender and also the work pressure exerted by the hospitals concerned plays important role in this regard. I do agree that if the doctors can spend a little bit more time and listen patiently, it surely will help them treat the patients better.
2
This article would be better if it more explicitly noted that the study is correlational and therefore it is possible that the population of patients seen by female doctors is different from those seen by male doctors (this could be due to patient choice, referring practitioner choice, doctor specialty, doctor experience, the amount to which advanced/high mortality cases are given to male vs female doctors, etc). I assune the original study controlled for some of these and other confounding factors, and perhaps the article could have mentioned that.
It would also be good to put the effect size in context. How does the effect size of doctor gender compare to the effect sizes, for example, of doctor experience (years in practice), practice setting, doctor pay, etc.
My biggest concern is that this article subtly promotes the idea that doctor gender is causally related to quality of care. It's true the article does quote an author of the original study cautioning patients against choosing a female doctor on the basis of the study -- however, that paragraph is halfway down in the article. Should it not have been in the first paragraph ("authors caution that the study is correlational, and there is no evidence as of yet that patients who switch to female doctors will have better health outcomes")?
Readers should not be presumed to be experts in science and policy who can put a single correlational study in context. Responsible writing would, instead, provide that contex.
4
I live in the Tucson, AZ area. I'm having a hard enough time finding a qualified, competent, caring doctor who graduated from a truly reputable medical school. While I might have had a preference for a female doctor when I moved here, I gave up on that criteria after being treated by as many callous and indifferent women as men. Also, women doctors here tend to be part-time or leave the area if their spouses get a better opportunity elsewhere. A lose-lose choice for me.
1
As a woman doctor, I can only hope that this kind of research will serve as a corrective for health systems that define physician "productivity" as how fast the physician sees patients. The physician who spends a little extra time may be adding value to patients that is not measured by the clock. When you consider that women are by and large the primary caregivers at home as well, the extra hour a day speaks volumes about the dedication of women in primary care. It is dangerous to stereotype women as " the listeners", though, because then rather than help those physicians could become better listeners, everyone from receptionists to administrators directs patients with greater social needs to women.
5
I've had only BAD experiences with female doctors. I made a very conscious decision to select a female primary care doctor, with an excellent academic and clinical background, only to spend 80% of every visit listening to her complaining about her schedule, her kids, her shoes, etc. She was always friendly, but after a few years I realized that she was only using me as her "listener" and I was paying for the privilege.
My ophthalmologist was even worse. Not only did she talk nonstop about her professional problems, she complained about her boyfriends too. Twice she was so involved with herself and her own issues that she wrote down the wrong numbers from the tests and gave me the wrong prescription. When I had to call the office to tell her that my glasses were unusable and the eyeglass store said the prescription was wrong she went into a screaming rage.
Now I'm back to male doctors who ask me questions about myself and listen to my answers. They never discuss their personal lives with me - my visits are only about me and my health.
2
The best doctor I ever had was a man who, he eventually told me, has the same chronic autoimmune disease I do and as a teen had gone through the same experience I'd had of doctors finding nothing (yet) and saying it must all be in his head. He was the most empathetic doctor I could ever have hoped for, and when I was close to death he willed me to live. I could not let him down: I pulled through.
The worst doctor I ever had was an older specialist twenty-five years ago who, having seen me knitting in the waiting room, told me out of the blue that I was denigrating the cause of women by staying home to raise my children--and *knitting*! I offended her to the core. Wait, what? Where did that come from? I was completely blindsided. We'd barely met. We were done.
I think today's women doctors are a lot more balanced than she was. If for nothing else, they didn't go through medical school nearly alone in their gender.
I have always preferred women doctors if I can possibly get them, but I notice that referrals that I get from other doctors, or my insurance company, rarely include women doctors. I have problems with my hands and I consulted a orthopedic surgeon (male), who barely looked at my scans and then handed me over to a woman P.A. she was wonderful, caring, attentive and professional in every way. but the practice she was working with wanted her to do more administrative work, declined to buy the topical anesthetic she used (causing my treatment to become very painful) and just caused her to decide to switch practices. her former practice refused to tell me where she went, I refused to return to that practice and have had to find another orthopedic surgeon. unfortunately, my referrals were for all men. I have had very very good male doctors but would prefer to have more of a choice.
1
For all those who are running a victory lap, I would be interested to hear what you think about James Damore's infamous Google memo.
The best doctors I’ve had, including my current male PCP, are the ones who take the time to ask “What’s new in your life?” and “How is your family?” in addition to discussing health issues. They know who you are, treat you like a whole person, and are better able to recognize symptoms that are out of the ordinary for you and stressors that may impact your health. On a sick visit to my primary doctor last year, he took the extra time to diagnose a heart problem which was not immediately apparent, for which I was very grateful. I believe a caring attitude and ability to listen are vitally important attributes in any doctor, and I've found them equally in men and women physicians. (I am an older female.)
5
What an indictment of male doctors and men in general.
3
If your doc doesn't listen, find another. My current doc listens, she's always late.
I saw a specialist who made a quick dx, dismissed everything I tried to say, just wanted me on terrible meds for rest of life for an acute problem. Worst doc I'd ever seen. But can be worse, thousands die from unaware docs.
4
When there is Medicare for all, and medicine ceases to be practiced like a business, THAT’s when doctors will universally be able to take the time to really listen to their patients. Doctors cannot afford to practice on their own as they used to do traditionally. They are required to work for large hospital based practices, if they want to have a couple of minutes left over at the end of their day to see their families; and take a breath from a very stressful job. We are all constantly being squeezed to do more and more, with less and less, And that translates into seeing as many patients in a day as management has squeezed into your schedule for you to see, or risk losing your job.
It’s not always as straightforward as it appears.
8
I live in Canada, where we have universal healthcare, and although I wish that your sentiment was accurate, unfortunately I have not found it to be so. Doctors in Canada are incredibly busy, struggle with the work/life balance and to provide enough time for their patients. I have some serious health issues and therefore have had to be a frequent consumer of our healthcare system. I have, at times, been very concerned about the health and well-being of my doctors as I see them rushing around, working while ill themselves, and in general taking on too much. I am intensely grateful for my physicians, who are smart, caring, capable people and I sincerely hope that there will be positive changes within the medical field to support physicians to have healthier lifestyle practices, which will also hopefully ensure better patient outcomes.
6
@Maria Malott I had a wonderful male doctor who I went to see for an emergency and wound up being his patient for almost 25 years. he always started by asking what was happening in your personal life... what had changed, what was good, what was bad. his waiting time was long and forever but I wouldn't have thought of complaining, as he gave every patient the same amount of attention. he had a lovely wife, his nurse, and two children who both became doctors. his attention and schedule took its toll on him and he died suddenly of a heart attack after playing a game of tennis. he was 58. I miss him every time I need help -- I've had 3 doctors since then and none of them paid the care and attention he did. of course, they have all managed to live be older than 60...
@Betsy I can only guess you are not on Medicare.
My daughter is a radiation oncologist. Her hospital asks patients to rate their doctor in various categories. She scores very high on friendliness,explanation, concern, inclusion of patient in treatment, understanding, enough time, comforting, likelihood of recommendation, (on all of these she gets 4.9 or 5 out of 5) . Her wait time score is 4.2 because she gives her patients as much time as they require.
5
Thank you for this article. I’m a 62 year old man who has seen mostly male physicians. Not intentionally, but that’s just how it’s been.
My PCP just retired. He was/is a great D.O. and spent lots of time with me on every visit, usually about 2-3 times a year, always doing a physical exam which involved touching my neck, throat, and ankles, tapping my knees, taking my pulse and temperature, and listening to my heart. He would talk to me for at least 10 minutes. He did blood tests to verify things. A great doc named Sam Fern. I will miss him and I think most of his patients feel the same way.
Because of this article, I am going to ask my wife which of her doctors listen the best. I will be more conscious about considering female physicians.
I get the impression from some docs that since they know their profession well, be it diagnosis, surgery, or other treatment, that they needn’t spend time listening to, or getting to know their patients. I recently had shoulder repair by an orthopedic surgeon with a great reputation. He was as charming as a prince before the surgery but now, a year afterward, I can’t get 3 minutes of his time to discuss issues with my shoulder. Instead I get his extenders who were not involved in the surgery. I know the surgery is where the money is, but I think less of him now because of this fact.
5
The reliability of these research findings is likely to be limited by numerous other variables which affect outcomes. These include the doctor's training, other team member's expertise, patient and organisation factors.
I do agree that in general male and female doctors have some differences in style. Patients will vary as to what they prefer. Personally, I opted for a male general practitioner as I prefer a slightly more business like approach.
1
There's an important co-factor that some of the responses suggest, but that isn't noted in the article, and that's how the medical practice is run. I've been treated by males at our small local hospital, and with only a couple of exceptions, they've been as caring and diligent as the stereotypical female doctors are.
Switch to the mega-hospital complex that seems to be all about big data, and the women are as brusque and superficial as the stereotypical male doctors are. After having been treated by several GPs and over a dozen specialists, I'm afraid I'll have to believe my own experience over the conclusions of this study.
2
The UCLA Women's Cardiovascular Center has more than 25 female physicians and researchers. With offices throughout greater Los Angeles, these dedicated professionals focus primarily on care for women, by women, and they understand our unique physiological needs at all stages of life https://www.uclahealth.org/heart/women. Since 80% of heart disease is preventable, it's important that women of all ages understand the warning signs of a heart attack, and make sure to tell their physicians about any history of cardiovascular disease in their families.
3
“It’s not practical to spend that much time with every patient.” And there’s the problem with modern medicine (one of many).
7
A friend of mine was referred to a male specialist whose practice was 30 minutes drive from her home. That was one hour of her time.
She saw this physician three times following surgery. Each 5-10 minute visit required a wait time of at least three hours, among a dozen or so other patients.
She finally quit this inane situation and wrote a letter to the physician, saying, “I could at any time drop dead of a heart attack or other ailment. But I choose not to do it in your waiting room!”
2
It is nice to see that women are a little more successful than men. But, the things that need to be improved for male doctors is their listening skills and the amount of time they spend with a patient? This feels kind of like “click bait.” Yes, the evidence is there. But women are naturally more genuine and nurturing. So, of course they are going to succeed more than men, in that area. It just does not seem as if this article truly shared how women are successful.
3
I enjoyed Tara Pope's article suggesting that female doctors account for 32,000 fewer deaths in cardiac patients. However the exact explanation of why this is true seems elusive. Tara's article seems to suggest that spending more time with the patient and being a better listener is the explanation. I would question that. Perhaps there are differences in prescribing practices, or referral practices, or differences in the practice of medicine which explains the 32,000 fewer deaths. Do we seek a doctor because of their personality? or because of their skill and expertise, even though they have no personality? Is the best doctor the one who uses less, or the doctor who uses more of conventional medicine ? Deborah Grady MD says less health care is better than more health care in her editorial in the May 10, 2010 Archives of Internal Medicine . For more see: http://www.bioidenticalhormones101.com/Less_Is_More_Jeffrey_Dach.html
6
Interesting question, meaningless data.
There are multiple issues with these retrospective studies that make the NYT statements baseless. Both physician populations and patient populations treated were not equal. In the Harvard study, the male physicians were avg 5 yrs older. Maybe they had out-dated practices that led to poorer outcomes. Female physicians treated 2% more female patients, so maybe treating same sex patients leads to better outcomes. Female physician patients also had a 10% higher income than pts treated by male physicians. Sure a multivariate analysis was done, but that never accounts for all the issues.
Finally the part about listening I think is also a very narrow view of the situation. If a female physician spent 30 more minutes listening and treating one pt in the ER that results in delays for other pts which get dumped on overworked male colleagues leading to decreased overall quality of care, who is really at fault here? Hard answer right? For the patient that got the extra 30 minutes the female physician is in the right. For those that got delayed care, not so much. On top of that, the typical response to allow physicians to see fewer patients would result in higher health care costs leading to large population deficits in quality, so maybe also not the best answer. Would you pay double the copay to have your physician spend an extra 15 minutes listening to you?
7
@sprouts1If those extra 15 minutes improves the therapeutic relationship and increases the probability a patient will be adherent to treatment recommendations, then yes, paying double copay might lead to better outcomes. I have talked to multiple patients who said they disengaged from care or refused to take medications prescribed because they felt "talked at" and their concerns brushed off. If a patient won't follow treatment recommendations, it doesn't matter what we do or say, or how long or short the appointments are.
Improving productivity and seeing as many people as possible might increase revenue and get more people in, but are there any studies indicating this somehow improves quality outcomes? I'm sure there are multiple confounding variables in the research, but it appears more than one study concluded with similar findings. You imply that women physicians who spend too much time with one patient cause patients to be "dumped on overworked male colleagues leading to decreased overall quality of care, who is really at fault here?"; this is defensively deflecting blame onto female physicians for their male colleagues poorer quality of care (if a difference even exists). Speculating on who is to blame or at fault only contributes to missing an opportunity to improve the practice of all health care providers, despite gender.
13
@sprouts1 Thank you for pointing out that there are lots of confounding factors here that blithely overlooked in the simplistic headline. Interesting that in the anecdote about the woman who just needed to talk for 22 minutes, the physician was male and the presumably female nurse was trying to hurry him up to keep him on schedule. I'm not going to defend all the imperious behavior of a lot of male physicians but the ramifications of having all physicians spending a lot more time listening makes the conclusion that 32,000 lives will be saved probably invalid. If the increased costs leads to longer wait times and decreased spending elsewhere then more lives will be lost in other areas.
1
@Liz
I agree, I used the male/female situation here in light of the article but the gender is not the root of that argument.
The point I was trying to make is that just increasing provider-patient time alone can have far reaching outcomes beyond the single patient experience. Another example of this is the argument that doctors get paid too much. So say we ask doctors to double the time they spend with each patient, and decrease their pay by half or more. Subsequently many doctors close shop and patients have to drive 2-3 hours to be seen and often spend an hour waiting. Medicine becomes less competitive as a whole and becomes a field filled with C-grade college grads which leads to diminished quality of care.
All conjecture of course but I add these possibilities to highlight the issues with simplistic generalizations, many of which were made by this article.
The ability to see a doctor is so privileged, why are we even debating male v. female? I mean, it's like asking which is better, beluga or osetra caviar?
5
You want the doctor to spend longer talking to you, but you're not willing to pay for the first 10 minutes either.
3
I’m not questioning the results of this study but imagine for a moment if the study said men were better doctors. Would that article/study be published?
8
@JB The author would get the James Damore treatment.
Same goes for Dentists. My current Dentist is a woman, and it is the best dental care I have ever experienced.
So true- about the male Doctor trying to refocus the discussion even when the patient has relevant medical questions.
Physicians beholden to the bean counters are not practicing medicine at its best.
3
A few male doctors have been so rude and dismissive toward me, I am actually afraid of them. A condescending doctor who doesn't listen is one of the worst interactions a person can have, especially when struggling through a health issue.
I've had a strict rule for only female doctors for over a decade now, and have never once had an experience like that. I'm sure there are good male doctors out there, but I'll probably never find out because I'm too scared to ever tell one my personal health issues ever again.
17
Yes. Get a female doctor. She has had to work 5x harder to get where she is and will be the one who can read your body language. As to delicate surgeries such as eyes, I for one did no t want ham fisted hands working around my eyes when I had lens replaced.
9
You should choose a doctor whose religious beliefs won’t affect your care. There was a recent article about this (and men should be concerned about their care too, not just women).
6
Whether it is true or not that, on average, female doctors listen more, it is sexist to treat individuals based on such averages. Research can undoubtedly show that male doctors are, on average, more “something” than female colleagues. Treating an individual Dr. (or any person) based on stereotypes, even if derived from true averages, is pre-judging, and wrong. The left is fond of quoting notions of female superiority in certain categories while condemning supposed average sex differences they dislike. Sexually stereotyping individuals is wrong factually (their is usually more variation within sexual categories than between them) and morally, whatever the motives.
5
From my 30’s I sought out female doctors...my gynecologist, dermatologist, and holistic MD. For me it was just logical.
3
I had trouble sleeping, up every two hours every night, it was exhausting. I was treating it with Ambien and natural remedies. I went to an internist in my medical group - a young male Dr - who told me I was depressed and needed a psychiatrist. I was certainly depressed because i could NOT sleep. I finally found a sleep Dr, a woman, and went to see her. I spent about 20 minutes with her explaining what I was experiencing and she listened to my symptoms. Immediately she said I had sleep apnea, and I did!! I received the proper care and I sleep much better now. I NEVER went back to the intern I saw at my group and I complained about his diagnosis to another Dr. I do believe women need to be their own advocate in their heath care process.
10
This article raises several really important findings that hopefully will drive further inquiry and action. First the observation that survival is better for patients cared for by female doctors means we really need to figure out quickly what the females are doing that men are not. Second we need to have specific diagnostic algorithms for female cardiac patients; yes, we are not “little men.” Third, all health care workers should think of listening as a critical skill. We should be tested and cleared by our boards for how well we listen.
10
I wish the article told us the absolute differences between the two genders. It probably is slight and certainly not enough to make any blanket statement of superiority. There are many excellent physicians on both sides.
9
Short answer: that depends.
General answer: that depends.
Best answer: be an informed patient.
7
Hmmm......must be something odd about me. I've had two superb surgeons. excellent internist and on and on....and they've all been male. Experience, quality and genuine interest in the patient are what count and selections should be made (and retained) on that score.
6
I just find it sad that 22 minutes out of the life of a terminally ill patient (or any patient) is thought of as "not practical". We need to make it practical (profitable) for a doctor to listen to a patient for longer. You could give 20 patients 20 minutes each in a 7 hour day. (This is an issue with primary care physicians in Canada, too.)
Also, re: "Dr. Goldberg knew the patient had been concerned enough to see a doctor". I feel like that often gets forgotten by doctors and their receptionists.
9
22 minutes was just answering one question!
Then you actually have to get real information from the patient, examine the patient, explain what is going on, explain your plan of treatment, send in the prescription, get consent for a possible procedure, talk to the insurance company, talk to the woman’s children, review or order blood or radiologic studies,finish the electronic medical record, code the billing for the visit...you get the picture.
Maybe you don’t.
The 7 (try10) hour day gets sucked up pretty fast.
6
@DLP - From my perspective, I don't think patients realize how much other work goes into their care. They only see the time we spend during the clinical encounter and not the time spent before the encounter reviewing the chart or the time spent after dealing with paperwork like insurance forms, referral forms, talking to other doctors etc.
5
I've had dismissive female doctors, and very caring male ones,and vice-versa. It's about the level of caring a physician brings to the profession, not his or her gender, that makes the difference.
15
Twenty-five years ago, I stopped seeing one of the doctors in the practice my family went to when that doctor could never remember that although I had 2 young children, I also worked. Thus suggestions about how or what I did for them during the day, which completely ignored the role of my working spouse (also his patient), became an annoyance and led me to think he didn't listen to me. I switched to a woman in the same practice - and have stayed with female practitioners ever since. Anecdotal, I know, but it squares with the conclusions of this study.
9
It took women a long time to be accepted as physicians. Perhaps, when they finally attained the status they sought, it was through harder study, longer hours, and stronger determination to make it. Through all that, they had to listen to their guts, because they were used to having to to rely on themselves when the men shoved them in a corner. Women have honed the art of listening throughout centuries of being told to stay in their place. Women listen to their children, to their husbands, to each other, to what's going on in the world, to what's going on around them, and they draw their conclusions based on those observations. Men tend to listen quickly; they hear the last thing said or the first thing said and dismiss all else, so they can move on to their next obligation.
11
Women are good listeners I think (but I'm biased). Younger physicians are doing much better than the older docs used to do. But people also need to help facilitate the communication by being as succinct as possible. It works well for me being a nurse.
@MKP
i totally disagree. younger docs are awful...i even had one say "if you want to talk about this further, you'll need to schedule a longer appointment time". never saw that one again. they even treat their staff worse. (i have been a medical assistant, labor and delivery technician, and pharmacy technician.)
1
As a retired family physician and former medical director for a large health care system, I am not surprised by these findings. I often found female physicians to be better listeners, a key to good patient care. As with so many things, however, gender is not an absolute predictor. I knew many male physicians who displayed this quality and female physicians who did not. But one thing I know for sure. The trend in primary care over the last 40 years to demand physicians see more patients more quickly has resulted in physicians being worse providers despite their best efforts. This trend was obvious early in my career and one of the main reasons I decided initially to split my time between primary care practice and administrative medicine. I wanted to push back against this movement which demeaned the value of the time physicians spent with patients. Claiming the value of time physicians spent with their patients couldn't be measured, it was seen to be of lesser value than money making tests and procedures. Most ten minute surgeries still pay surgeons more than a primary care physician gets for a one hour physical exam. Ultimately, I went back to full time primary care as it became clear primary care physicians and their patients would lose the battle. Though the idea of gender being a driver in care outcomes is interesting, as my wife said recently after several visits with her female physician, "I don't think she would recognize me without my chart in her hand."
15
First one hopes for a really good effective doctor male or female. Second, why in the world would a women see a male GYN?
2
Because it may be the best doctor for her condition! It’s fallacy to think that the doctor must experience the ailments, be the same gender to understand and relate to the patient. Full disclosure I am a male ObGyn and I have the highest patient satisfaction scores in a department of 19 women and 2 male physicians.
11
@The Iconoclast
Why in the world would a man see a female urologist for a prostate condition?
4
The male gynecologists I've seen have been more gentle than the women! See a woman, if you prefer, but don't assume that male doctors choose that specialty for the wrong reasons, or that all women are too embarrassed to be examined "down there" by a man.
Any woman who'd prefer to do so, may ask for the presence of a female nurse while being examined by a male gyno. But I've never felt the need.
2
As I read the comments, I'm struck by how many readers focus on their own micro experiences with physicians as evidence that these macro studies are skewed, unreliable or just silly. How could it be? You can quibble with interpretations of exactly what human gendered dimension drives these data points and I guess that's what's being debated here.
My hope is that research like this drives better outcomes for patients, not hurt feelings. We should all remember how hard it's been to get medical professionals to adopt and follow the hand-washing protocols and surgical safety checklists which demonstrably save lives. It seemed so simple.
Are we forever colliding with our biases about what we think we know?
11
We all have anecdotes. Fewer of us know how to read medical studies, and the Times writers don't do a great job of explaining them.
(I know how to evaluate studies, but that's not a common skill to possess in our society, apparently.)
1
If a study showed better outcomes by the race of the doctor, it would be considered racist. Why is a study that compares outcomes by the gender of doctors not considered sexist? Or is this the old Liberal trope men bad, women good?
13
@Rick
Well. I guess because men and women have actual physiological differences that may affect their practice of medicine while have different colored skin would not.
7
"Does gender matter when choosing a doctor?"
Who knows? My white female osteopath was excellent. So was my black male medical doctor. For that matter, so were one of my white female dentists and my black male dentist.
I chose them because they were good at what they did, not because of their race or sex.
18
I suppose one might argue as a take away from this article that women make better people than men. Of course that is rubbish. My experience of over 40 years in practice is regardless of sex is the best physician Is the one who listens best. Consequently I am always behind because I enjoy talking with the patients and finding out really what the issue is that they’ve come in for. It is basically elementary psychology.
12
How about publishing the statistics on the number of male doctors who’ve been convicted of molesting their patients vs the number of female doctors who’ve been convicted of molesting patients. Then ask readers who they’d choose for medical treatment.
6
@Kind Of Blue
So what cannot be greater than 1% of male physicians, if that, accounts for your recommendation?
1
The KEY is that the doctor take the time to listen! TWO more minutes can make a world of difference.
Glad to see Tara is still reporting for the NYT. She is terrific!
3
I fired a female doctor because she knew I had an autoimmune disease of the thyroid but never told me. I learned it from a nutritionist.
3
Almost everyone could learn many important facts about their conditions from a nutritionists! I have had good and questionable doctors, male and female. Now I just avoid going to the doctor at almost all costs, literally. Terrible health insurance costs as a retired 63 year old and barely adequate care at huge expense. However, whether male or female, being listened to would be a pleasant surprise!
4
I don't care about gender, color, ethnicity, etc. when choosing a doctor. I do care about qualifications, competence, willingness to listen to me, etc. I have had both male and female doctors in my 69 years. But the worst experience I had with a doctor was with a female doctor. I was 17 and had to undergo a physical as part of the process of enrolling in the university I would attend in the fall. (They used to require those.) It turned out this female doctor was very involved in issues involving teen pregnancy. This was certain laudable, but I was mortally embarrassed when she lectured me on the dangers of premarital sex (and my Mom was in the room!). I was not sexually active and already knew the dangers. If she had asked me--without my Mom listening to every word--if I was sexually active, that would have been fine. But she she treated me as if I was having sex with every guy in my class!
2
My female primary care doctor was once a perfect example of everything noted in the article. She listened intently, did not interrupt me, was never dismissive. She followed up on everything, often on her own time. Since her medical group was absorbed by a health care conglomerate, though, she has changed her demeanor. She is now as cold and dismissive as any male doctor. Her sole concern is to get you out of the office within your allotted eight minutes. I hate being in her office so much that I avoid medical appointments, which is exactly what insurers want.
4
Joe went into the medical clinic and the receptionist asked him why he was there. Joe said, "I have shingles". The receptionist gave him a clip board,told him to fill it out, and to take a seat until they call his name. After twenty minutes, a nursing assistant came out, called Joe and took him down the hall to measure his height, weigh him, take his clip board, and put him in an exam room. 15 minutes later the nurse came in and asked Joe what he was there for. Joe said," I have shingles". So the nurse took his blood pressure, took a blood sample, and gave Joe an ecg, told him to take his clothes off and wait for the doctor. 10 minutes later the doctor came in and asked Joe what he was there for? Joe replied, "I have shingles". The doctor asked where? Joe said, "on the truck in the alley, where do want them"?
17
Here's a quick lesson in association vs. causation, from HealthNewsReviews, a web site that evaluates news stories on health. This review evaluates another story with a big data base.
https://www.healthnewsreview.org/2018/08/exercise-improves-mental-health...
Exercise improves mental health? What you need to know
August 14, 2018
"Even though the data set had 1.2 million people, observational findings like these–that can only detect patterns–are reversed all the time when a true experimental, randomized controlled trial (RCT) is conducted."
5
I care more about capabilities than sex. I’ve had male and female docs, and for me it comes down to trust. My primary care physician, a woman, is someone I’ve seen for 20 years. She respects me, knows my history inside and out, and cares about me. I’ve jokingly told her she isn’t allowed to retire while I’m still alive!
On the other hand, the last female ob/gyn I had mistreated me and almost killed me. Long story short, I had a uterine fibroid that caused me so much pain and blood loss I ended up in the hospital. For months I had complained about the pain I was in, and she kept telling me it was normal premenopausal symptoms. A basic ultrasound would have shown the tumor, but she never did one. A male ob/gyn saved my life in the ER after I had lost so much blood I couldn’t sit up without passing out.
My takeaway: I don’t care so much about your bedside manner or your gender, just be good at what you do.
10
If that's the case, why not demand that men spend more time in medical school, residency and fellowships to remedy their abrupt, unfeeling attitudes towards patients? Why not add a surcharge to men's license renewal fees? Also, a surcharge to any (men's) malpractice settlements? Also, demand that local Medical Boards of Registration have a majority of women? Also, why not have a requirement that a pre-written apology statement be afforded to ALL patients, before their visit to a male clinician? Keeping in mind customs observed in Chairman Mao's Cultural Revolution, why not demand that male physicians wear dunce caps in any patient-interaction?
5
Most of my experiences with doctors, whether male or female, have been abysmal.
6
Statistically, it seems unlikely one would have an abysmal experience with four different doctors in a row. Some introspection may be warranted.
I've had good doctors who were men and good doctors who were women. I've also had questions blown off by both a man and a women: "You shouldn't believe everything you read on the internet."
The thing I hate is how they keep typing and looking at the screen instead of looking at me and listening to me.
8
Your government has required your doctor to use that computer. Really, it is true. There is no way around clicking on that thing while you are in the room. The only people who have consistently benefited from electronic medical records are the people who sell them (funded somewhat by your tax dollars), not the patient nor the doctor.
3
Yeah, maybe. And as women continue to flood into the profession the prestige and compensation plummet.
6
Should I use a female doctor? I'm not sure - which sex is more likely to have received their training through affirmative action?
5
You realize that whatever your definition of affirmative action is (assuming you are using that in the pejorative) it would only be considered at time of application. Medical students still have too pass medical boards and pass all of there residency skills before they can practice. So, who cares how they got in?
9
@neal In 2016, for the first time in history, the incoming class of medical students was majority female. That's not affirmative action. So, the answer to your question, within the next decade, will be male ;)
10
After my horrid male ob gyn fat shamed and told me for 3 month that my infected c-section incision was just that “fat takes a long time to heal” I will never let a male doctor touch me. A simple swap would have saved me 3 months of a constantly weeping gut wound while caring for an infant. My female family doctor finally got fed up and did the swab, prescribed the antibiotics and it cleared up in days.
8
I’ve always gone out of my way to take my daughters to female doctors and dentists (and other professional service providers) whenever possible so that they would see the medical profession as dominated by women and not feel discouraged discouraged from entering it or any other field when they’re older.
This article just reaffirms that.
Thank you.
7
Back in the pre-Internet, paper chart days, I had a professor who would say that “90% of the diagnosis is found in the patient’s telling of her history”. This from one of the Grand Old MEN of internal medicine and advice I’ve never forgotten. Even when I’m an hour behind and facing 3 hours of e-charting after dinner.
12
Yes! What's true in medical diagnosis holds true through out life - teaching. mediation, counseling, child rearing, marriage, research, engineering and design, and on and on. Take the time to hear what patients. and clients, students and disputants , lovers and friends are saying. Our industrialized medicine and production line human services, our flittering profit and time obsessed culture consistently devalues taking the time to listen, engage, and understand the problem and each other. Nowhere is this more apparent and detrimental than in the world of patient care - more aptly called patient processing. I have had some excellent doctors, both men and women, who really listen, engage, and want to solve the problem. They are terrific.
3
Specifically depends on what the person is concerned about. My gynecologist is a physician. However, other specialties like oncology, etc. are best treated with perhaps a man if he has more experience. I do not select my physicians on gender but medical schools, experience, etc. If they are experts in their field they get my vote. You do not see most women in orthopedic surgery; I rest my case.
2
Maybe between 1991 and 2010 the better Florida hospitals were hiring more female physicians? Maybe the difference in outcomes was due to a difference in the treating hospital, and a higher concentration of female and other diverse doctors is a marker of higher status among hospital systems.
1
So it is time for the insurers and widget counters to put this into financial practice. Stop making PCP’s see a patient every 10 or 12 or 15 minutes in order to pay the bills of the practice. Let PCP’s spend the time that is needed and then bill for that time accordingly. Current billing practices do NOT allow for billing for time just to listen long enough to allow get the patient to get to his or her point.(there are all kinds of caveats to billing for time spent in the current system).
11
Meanwhile, I am still paid less as a female physician with 20 years of experience than my less-experienced male colleagues. Despite research like this which continues to show not just equal but BETTER outcomes for patients of female physicians. Absolutely not okay.
46
I am a French medical doctor graduate in 1982. Women doctors were better students. in France we had a "numerosus clausus" (limited number) anonymous exam. In my generation, women were 17% to start and 38% to be graduate. Girls presenting medical school were issued from upper social class. The exam to be an academic doctor is extremely selective, again the women were succeeding better, it was said to avoid the risk to go to private practice. In my practie, I was asking the planner to have only 1 new patient by consultation. I wanted to be sure to take the time to listen to the story and understand what was possible to do best for the patient. The following consultations were accurate and taking less time. My patients loved me and I was rewarded for the efforts I spent to learn sciences and medicine to cure people. The relationship patient-doctor in America is very different and is a part responsible for the epidemic obesity. A MD does not know about the lifestyle of his patients, IBS, atrhritis and most of so-called "autoimmune" diseases are consequences of lifestyle. I discovered the surprise of some American acquaintance when I explained how to eat to be healthy and age graciously, my attorney shortened the discussion " she is so French". Knowledge is power, women are not translating it into a money making but in satisfaction of giving a piece of life with the consultation. We will see with the parity of gender now, how the quality of life and the expectancy may improve.
14
This may be true in aggregate but when it comes to the particular, I will never forget that one of the most hurtful experiences I ever had with a doctor was with a female doctor. On the other hand, one of the most smugly self-satisfied, least sympathetic and slightly superior doctors I ever had was a man. And one of the most thoughtful and best listeners was a man. So while gender might play a role in helping you choose a doctor, it really boils down to the individual and how they treat you.
22
@L
One of my patients, an attractive heterosexual male, went to a female dermatologist who called in a female PA chaperone when he undressed down to his underwear.
After the “modeling session”, her PA was introduced as a potential date!
I tried to get him to report her misconduct, but as is true with most males he didn’t take it seriously.
I am a male physician and a patient and can’t even estimate the times doors have been left open for one female para-pro after another to intrusively bust in and ask my physicians stupid questions.
Now imagine that an undressed female patient had male chaperones saunter in and out at will.
4
I can only base my opinion on my personal doctors, I have had good female doctors and not so good female doctors (same mixed reviews for male doctors). So I don't know if gender has anything to do with it. If a doctor is dismissive of a woman's symptoms, it's time to find another doctor. But I don't think only males fall into this category. I had a female doctor who dismissed my symptoms which turned out to be a thyroid disease (later diagnosed by a male doctor). I know others with similar stories - some women doctors don't take women seriously either.
17
While I have no issue with data confirming the superior listening skills of female over male physicians and while I have no reason to doubt the mortality data discussed, I must question this arrticle's implication that the data confirms the superiority of female physicians over male physicians.
I assume that patients were able to select their doctors and therefore the data on patient outcome is associative, not causal.
Patients who select female phycicians over male physicians are different than those who do not and they may have different mortality outcomes for reasons other than the gender of their physician.
20
Except that the article states that some studies looked at ER admitted patients. I don't think you have much of a choice if you are admitted to the ER.
7
@Mona Sobel MD the study subjects did not choose their female physicians, however. The study in question examined treatment outcomes related to encounters in emergency departments, where one does not choose one's doctor.
1
It may well turn out that male physicians' relative deficit in listening (communication) skills not only means less favorable patient outcomes but also higher malpractice costs. Was years ago, don't remember the study, that suggested one of the major factors in a patient's decision to sue for malpractice was the patient's belief that the physician failed to adequately communicate with him/her.
9
This is a bit like the women-make-better-bosses trope. I have to yield to the data here, but in my own experience I have learned this: female bosses are every bit as bad, or good, as male bosses. They seem to have no gender-based magic. I’ve had male and female doctors. Dentists too. They’ve all been good, some less good, some listeners, some talkative, some neither. The females seem to lack any special gender-based advantage or disadvantage.
18
@MWR
In fact I contend that for every woman who works for a woman who likes that arrangement,, as a psychiatrist I’ ve treated at least one who doesn’t.
Men who don’t like working for women never comment on the value of the boss’s “ listening skills” but prototypically comment on lack of consensus building for employees of both genders when working for female bosses.
That issue will fade when female doctors and bosses in general try to SHED their belief in the premise that their gender, rather than their innate skills and diplomacy will make or break all bosses, and will always rule the day.
5
Once again, another example of poor science reporting by the media. An underpowered study shows a tiny absolute difference. So much possible bias in the study. Perhaps male doctors tend to be the household breadwinners and take on contracts with higher patient load requirements, leading to less time with the patients and consequently a higher risk of medical mismanagement due to being pushed to work "in the red" all the time. Who knows? The point is we won't find out from this study nor from Ms. Parker-Pope's science writing.
It's interesting that patients commenters are mostly concerned with a "good experience" with women physicians- and I'm assuming they were physicians and not midlevel providers, as often patients don't understand the difference. And what seems to make their experience good is "being listened to." When physicians are contractually obligated to see a patient every 15 minutes, with likely only 7.5-10 minutes of face-to-face time, they don't have the luxury of "listening to" the patient for long. Vital questions will not be asked and documentation requirements not done and then when the patient sues because of a problem that wasn't fully assessed because the patient wanted to talk about something irrelevant, the court will not understand the physician's POV. So the physician interrupts to get to the point and the patient feels their "experience" was not good. Interestingly, physicians with the highest patient satisfaction scores have worse health outcomes.
12
Their sample sizes were well over half a million in one study and 1.5 million in the other. So the difference between female and male doctors, even if small, is meaningful given the very large sample size. When applied to the large number of patients, this results in a significant difference in deaths.
11
@Commenter Man
Yes, the sample sizes were large, but they were retrospective studies. Retrospective studies can never establish causation.
A surgeon once told me, "I could very easily improve my outcome statistics -- just pick healthier patients."
If for some reason the women doctors had healthier patients, that would explain the difference.
If male doctors tended to have more patients who smoked cigarettes, for example, then they would have worse outcomes.
Of course, epidemiological studies try to correct for risk factors, but that's ultimately impossible. There are some factors, like socioeconomic status, that aren't recorded in medical records.
If epidemiological studies were reliable, we wouldn't need randomized, controlled trials. But they're not.
Look in the NEJM. Every randomized, controlled trial was preceded by epidemiological studies. Roughly half the time, the epidemiological study got one result, and the randomized controlled trial got another.
@Norman
Very well said.
Prospective studies would have to match the same disease data plus outcomes, in identical settings, to even come close.
As my pulmonary professor used to say, “the best doctors are the ones that cure me”.
As a woman, I always have and always will require a female primary care physician. Same goes for gynecology and dermatology. Recently I found a female gastroenterologist that I'm very happy with. And next month I have my first appointment with a female ophthalmologist.
Frankly, I'd prefer that all my doctors be women. But at a certain point, experience and track record override gender. If I'm having surgery, I want the best doctor I can get. If I can't find a female surgeon with a comparable resume to the best available male surgeon, he gets the job.
9
Patients want a doctor who is competent, compassionate. good listener, and effective communicator, regardless of gender. Patients want to be taken care of seriously, not serially...
26
@Nelson Turcios No one is disagreeing with that statement. The article in question is about a study that suggests that female physicians more frequently have those attributes than male physicians.
While TNYT readers debate the pros and cons of female v. male physicians relating to "listening skills," many Americans, even with the ACA, don't have adequate access to affordable care -- and I imagine those 46 percent of Americans with private insurance who earn below 200 percent of the federal poverty level have experienced some cost-related access problem at some point in recent months. Perhaps they've skipped doses, failed to fill a prescription, or neglected to visit a GP/PCP or specialist when needed because they can't afford to!
I daresay, they wouldn't be nitpicking and debating the perceived listening deficiencies of otherwise good doctors -- they'd be happy to see any doctor, of either gender.
12
This study should be checked for cross-cultural variations. I am a man who had a Jewish woman doctor who was fabulous. She was conversational, genuinely showed interest in my health and said so. She moved and was replaced with an Asian woman doctor who is as cold as a fish. The Asian doctor is much younger, to be fair, but nothing about being a woman doctor makes me feel that she is at all interested in my well-being.
11
I agree and have a female primary care doctor. But what if the assertion were that male doctors were associated with better outcomes? Males and females are different and both have, on average, positive and negative characteristics.
5
This article is understating women doctors. Male doctors are not that much insterested or they have their opinion and they do not go beyond that. I had a sleeping problem that I would wake up in the middle of the night and did not let me go to sleep. I've had male gastrologists and they did two endoscopies and one colonoscopy. I said to one of them that I still have the problem of waking up at nigth with a stinging feeling around the stomach area. He shrugged and could not help. So I gave up. However I was getting worse after 3-4 years and my neurosurgeon told me to go to Cleaveland Clinic and it was a women that saw me. She put me on fodmap diet while she did some tests. After the tests and diets were done she came to the room and directly said you have gut nerve disorder and I'll give Elavil 25mg. That was right on as this drug saved my life. I am so grateful to her. My primary care doctor is also a wome and she is great. I think women doctors not only listen but they want to help so much to fix the problem. Male doctors are more like, hey toughen up, that is the way it is kind of thinking.
20
As a female MD, my thoughts:
1) I can't tell you the number of times I have been called by my first name as a female physician, by men and women. Pause and reflect if this would occur to male physicians.
2) Female primary care physicians often have more women in their patient panel. These visits are often lengthier and more involved; as an example: physical for a women often involves a full breast exam and pelvic exam. It simply takes more time due to these factors and also I think we tend to spend more time talking with patients, connecting.
3) Meanwhile physician compensation for women is markedly less then men. I know this does not come as a surprise to the women reading this.
4) I consider the physician-patient relationship to be one that is worth safeguarding. Unfortunately few medical students choose primary care compared to specialities. In an effort to save money, primary care is moving to replace MD and DO's with NP and PA's. There are many stories emerging of physicians being completely replaced by someone who has a fraction of the training. We must defend the noble profession of medicine so highly-trained primary care physicians are not a thing of the past. It likely will get harder and harder to find a primary care physician.
103
I always call all my doctors by their first names. Why not. Plus I instruct my students to call me by my first name (even if I am a "doctor", not a real one, just a lowly Ph.D.).
1
@ED
#3 in nonsense. IF compensation for women were markedly less, health systems and medical groups would be hiring only woman, to make a bigger profit.
1
@ED I've heard the argument that NPs and PAs are replacing physicians in order to save money, a lot. I have a really hard time believing this. I think the increased utilization of NPs and PAs in primary care and in other organizations is directly proportional to the dwindling supply of primary care physicians.
I do agree with the argument that NPs need residencies, more clinical practice, and supervision upon completion of our programs. I also think the explosion of online programs and accelerated paths from RN to NP schools delegitimize our practice and gives people who are looking for an easy path to a profession with a good income and power while being able to bypass training and education essential to being a good provider.
That being said, I don't think the current collaborative practice requirements improve patient care and give unscrupulous physicians a lot of power to demand astronomically high fees disproportionate to the work/supervision they actually provide, and does not improve patient care. I think this is why a lot of NPs feel they are used as a clandestine way to restrict our practice and limit competition. I would be completely onboard with more stringent regulations on school requirements and residential programs for NPs, but there should be independent oversight on how it is implemented to prevent too much power being allotted to one profession who is trying to regulate another profession with obvious conflicts of interest.
My husband had multiple, long standing, chronic illnesses. In his later years, most of his docs were women because they were the newest and so "less desirable" and therfore available to see him. He didn't care one way or the other, but quickly found that he liked them much better than his male doctors, and considered himself fortunate to be in their care. And because he trusted them (something that was pretty uncommon for him), so did I.
11
I’m 65 and haven’t seen a doctor in 15 years. So now that I’m eligible for Medicare I might try to find a doctor. But I ain’t taking no medications. My diet is my medicine. And I will heed this article’s inference and try to catch a female doctor. Why not.
3
And are female doctors compensated fairly for their better outcomes?
According to this data, it would make sense for female doctors to be paid more.
Or are females just going to do more work, better work, earn less and have less recognition, like in virtually every other field except for fashion modeling...
102
@Vstrwbery
And be paid fully during maternity leave?
2
@Vstrwbery as more women become primary care doctors, they’ll be paid even less. It’s a trend in other professions. You know it’s becuase they don’t need to support a family. It’s a hobby job. :(
2
@Vstrwbery
Actually, from the Harvard study, the female internists in the study do significantly less work than their male counterparts (131.9 vs. 180.5 patients per year on average).
2
Family doctor here, 29 years in the game.
The doctor let the pt talk for 22 minutes.
So, 25 pts per day at 22 minutes each plus 3 hours of charting = 12.16 hours per day. Do that 5 days per week 48 weeks per year and you're divorced by age 45. And dead by age 50.
How would that help with the primary care physician shortage?
The solution is to train up cheaper doc knock-offs (nurse practitioners and physician assistants) and have docs focus on procedures. The market is pushing us that way now.
15
@vbering
No, the answer to the primary care shortage is not more mid-levels with minimal training being put in primary care settings. The answer is to remove the Medicare cap on residency funding, put money into new family medicine programs and in the shorter term invite the thousands of MDs who have been unmatched so far to work as assistant physicians. Instead, hospital CEOs and top administrators have been consolidating hospitals and closing down residency programs, hiring mid-levels to replace the doctors, paying themselves huge salaries out of their winnings. Mid-levels are fighting against assistant physician laws that would get these new doctors out into the community, even though they have thousands of more hours training by the end of medical school than do the mid-levels. We have mid-levels with 500 hours of shadowing, less training than a dog groomer, seeing patients with serious illness. People are dying. I just saw a man today who had had a massive PE and prior PE hx that an NP at urgent care thought was an asthma attack and sent him home with an inhaler despite no wheezing or asthma. He later collapsed and amazingly survived due to some great emergency room physicians. I'm seeing serious mismanagement on a regular basis and wonder how many don't survive that I'm just not seeing because they're dead and no one is tracking mid-level mismanagement and most doctors are unfortunately drinking the Kool aid. It's just too lucrative for the healthcare administrators.
30
@vbering. There are studies showing that nurse practitioners and physician assistants order more tests and procedures than physicians because they sometimes don’t know what they don’t know. This is not cheaper healthcare. It’s more dangerous healthcare. There are many nurse practitioners and PAs who have degrees from online schools where they didn’t get enough hands-on clinical experience.
As for gender, I’ve been to good and bad regardless of gender. I’m not appreciative of MDs who take family leave and leave their patients hanging for months at a time. I’ve not yet had a male physician who took family leave.
MDs, I realize that your degree was hard earned but does it really matter what your patients call you. Maybe it’s better to park your ego before entering your office. My new physicians introduce themselves to me by their full names minus “doctor”, unless their parents gave them Doctor as their first name.
4
@vbering Not every patient needs 22 minutes...some only need an "extra" 60 seconds.
As a female physician, I enjoy listening to my patients and find that I understand them much better when I give them a chance to talk. On the other hand, some patients take my listening as license to talk, and talk, and talk, and talk, then get irritated if I remind them that there are other patients waiting to be seen, no matter how polite I am in reminding them. Like everything else, it’s a balancing act.
20
I'm a man, I switched to a female doctor more than a decade ago, and never looked back. I've had two different female doctors since then and both have been excellent, and in fact I am more comfortable with them than male doctors.
My most recent primary care physician is an outstanding listener and compassionate as well. She always apologizes if she keeps you waiting, but it is never a problem because you know she's only kept you waiting because she was talking with other patients and addressing all of their questions, etc.
She has an MD as well as a PhD which doesn't hurt either; what an excellent person and outstanding physician.
26
This is interesting, but as others have said, the important thing is to find a patient doctor who really listens and who is not arrogant. I've had both male and female doctors who possess these qualities. And I've had both male and female doctors who do not.
12
I have chosen female physicians since 1979.
I was born in 1950. I was late making the change because the small little town in which I lived in California didn't have a female. I will be honest here. I had never worked with a female doctor before 1974; then I did. From that point onward I have chosen a female physician whenever I can.
I cannot say that the all the female physicians I have worked with or have had as my PCP have been the right choices for me. One refused to listen to anything I had to say about how I felt, what I thought might be the problems. She is one of those 10 minute docs. The second was simply a breast specialist/surgeon. How could I go to a breast doctor for a sore throat?
I especially admire a woman who has worked her way up from being as an ambulance attendant, a NA or LVN. Those women are driven to care and seem to have an empathy with their patients that physicians who are what I call 'inherited educated physician status'; who are only physicians because their fathers were and daddy is paying for the college.
I've known a male surgeon who had a master's degree in English Literature. He ended up supporting his young family on an off-shore drilling rig. He thought biology might be as interesting as literature. He took the leap and found his calling. This stuff really does happen! He went on to become a general surgeon and achieved higher goals. I would have trusted, and did trust that man, for my son's medical care.
Empathy matters, not gender.
11
I have not read the Florida study other than the abstract, but I bet you didn't either Ms Parker-Pope. If a patient goes to the hospital with a heart attack they will likely be treated by numerous physicians. The ER doc may be female, the cardiologist may be gay, and the cardiothoracic surgeon may be male. I have been a practicing physician for over 20 years and have learned that experience brings a lot to the table. You learn to ask better questions and identify unusual signs of disease. In my field each race and gender is more prone to certain conditions and those conditions may manifest themselves in atypical ways.
A good physician shows empathy and listens, but most of all, he or she has the clinical experience to be suspicious of rare conditions or unusual presentations of conditions. I find the title and a great deal of the content of this article to be misleading. I do not have a uterus and don't feel it has made me any less of a physician.
16
I used to have a preference for female doctors, believing that they would be at least better listeners.
Now, after years of primarily seeing female doctors, and having had poor to mixed satisfaction with them, I only maintain such a preference for a doctor who might practice gynecological exams.
Instead I have found that age, rather than gender, may play a bigger role:
- some of the oldest, and thus most experienced (and often male) doctors have been the best and kindest of all. Perhaps it is a generational distinction - the model of the doctor who made house calls; or perhaps time has made them more empathetic. Unfortunately most have or will soon be retired.
- some of the youngest, just out of school, idealistic and possibly aware of the latest research,and thus more likely to resolve your problem (nothing ruins a doctor's ego and attitude, I've found, as a MD who is unable to help you, even though I am ok with it). They may also have picked up some of the recent emphasis on bedside manner in med school.
10
My daughters go to a male pediatrician. He was recommended by a friend and has been great with the girls.
My wife and I go to the same female GP (who doubles as my wife's OB). She was recommended by a friend and is great with both of us.
Studies are all well and good (more knowledge = better), but on a practical level you should go to a doc that is well respected in your area and who treats you well. Gender, race, age, shoe size, eye color... doesn't matter.
14
I feel as if this may relate to genetics. Because women tend to be more motherly, it does not surprise me that they listen closely to their patients. However, I also think that some of this has to do with experience. As Dr. Goldberg did his experiment, he noticed himself to be more attentive to patients. Every situation is unique, and so I feel like the title is almost clickbait. I'm glad advantages and disadvantages of both female and male doctors were compared. I have always preferred female doctors but that is only because I am also female, I hope that this is not biasing my opinion too much. This article is very interesting though. I wish there were more time for each individual patient, but there are just too few doctors and too many patients.
2
My primary care physician is a female. She also happens to be the best doctor I’ve ever been under the care of. I think what makes her good at this job is who she is as a person. She is tough, smart, patient, experienced, and caring. I think her eyes would roll if I suggested her gender played an outsized roll in any of those.
8
My husband and I would say the same thing about our primary care physician and friend!
The current system doesn't permit either male or female practitioners adequate time with their patients. The brief treatment time allotted, coupled with the task of real time charting, means that only the most emotionally skilled practitioners "get" their patients and have them feel "heard". Many just don't have the time and attentional resources to integrate all of the information. My advice is to see practitioners who appear to be most able to read and connect to people quickly. This is based on 30 years as a psychologist in a medical setting.
16
@Cass
Good point . I too ask myself, who manages or developed the so called Medical system model, of Physicians never having enough time to be with patients. If I treated my clients like that, they would fire me and find a new consultant.
4
I have five doctors, cardio,ortho,gastro,endo,internal, 3 women and 2 men. Most specialty Drs have been men. I have found that the older the doctor is, the more likely they are to listen. An older doctor is more sure footed. An older Dr. has experience of having seen so much. True, each person is different. Anatomy and Physiology is the same for all of us. Parts are parts. The experienced Dr. has a great well from which to draw.I have not found gender to play much of a roll. Experienced Drs. just seem calmer and to listen more than they talk regardless of gender. There are some things you cant teach to anyone. Those things that pass between people, not found in books, empathy, listening, concern, caring, etc. All the things that really matter to us all.
5
I choose doctors -- I have a doctor for each medical specialization -- according to recommendations, insurance acceptance, and location. Then I stick with that doctor or look for another one, depending on my personal experience with him or her. Attentiveness (not necessarily length of time) is high on my list. The category of medical discipline doesn't seem to matter much. In caring for elderly parents, I found that except for geriatricians, most doctors didn't take seniors as seriously as they did younger patients, so seniors need strong advocacy.
5
@Nativetex "I found that except for geriatricians, most doctors didn't take seniors as seriously as they did younger patients"
I have found that since I turned 60, I apparently have suddenly become deaf, my symptoms have become inconsequential, and I'm evidently not capable of understanding explanations and terms I was capable of understanding the day before my 60th birthday.
I find this attitude most prevalent among male physicians, whereas before I received equal and respectful treatment from practitioners of both sexes.
Although there was that one surgical oncologist who told me to let him worry about everything when I started asking questions. I left his office and found another, who just coincidentally happened to be a woman, who had no problem with questions saying, "It's your body. You deserve to know."
12
@Marcy
Who said “ before you’re sixty you have a problem and doctors say they can help it—after you’re sixty you have a problem and doctors say that just happens”?
A doctor who speaks American English.
7
The issue is not so much gender as white male privilege. If a doctor has this status, generally best to avoid them.
3
Depends. I’ve found male doctors cut through the chase faster, at least when dealing with cancer!
1
After a male doctor sexually assaulted me during an employment physical, I tried four times to report. I was told I was making it up and besides it was my fault. I was labeled a trouble maker and fired. After that I said no male doctors, ever, not for anything, so at least I will never "make up" anything like that again. I've had some female doctors I did not care for but I never had to fear them.
8
@Carol
Too late, but I would report something like that to your state's licensing board. It would have gotten their attention.
2
Every state has a licensing board to which you can report your complaint
1
Like you, Carol, I once received a job offer that required general medical screening. The doctor assigned to me performed a painful, unnecessary, unwitnessed, and unprofessional breast examination. This occurred on the campus of a medical school! At the time, I was so shocked that I didn't react defensively, and also, I needed the job. It still makes me mad 29 years later. I learned a lesson and would NEVER put up with such abuse again.
1
So . . . you mean you have never had a doctor shrug his shoulders when you described a physical problem? Then, you didn't leave the office thinking evil thoughts. My complaint about the medical profession is that no one connects the dots, but how could you connect the dots when do don't perceive the dots and you don't perceive the dots because all you want to do is get that appointment over with? My primary physician for the last 30 years has been a woman. When she retires, I will look for another female doctor.
2
Interesting that a study demonstrating that women are better doctors than men was published in PNAS.
3
Generalization doesn’t seem to be a smart way to evaluate doctors. I have had incredibly insightful male doctors who take the time to listen thoroughly. Conversely, I just left a highly regarded female physician who wanted to run through her “checklist” of questions and wouldn’t listen to my description of what took me to her office. Just like anything else in life, you have to do your research to get the best (if you are lucky enough to have good health insurance and have a choice).
8
In my experience, male doctors are more confident (maybe overconfident) then women, and order fewer tests. Female doctors are less confident and order more tests or send me to a specialist "just to be sure". I generally have a more pleasant experience with male doctors because they are more reassuring -- but maybe they miss things. My female doctors are more annoying because of the tests and referrals -- but maybe they catch things that the male doctors don't. So who knows?
5
Half a percentage point is rarely statistically significant. Ideally, it would require about 350,000 patients to be significant at the "three-standard deviation" level. Were there that many?
Actually, it's worse---because the comparison is only of those who died, only patients who died should be counted. They were a small fraction of the total patients in the study.
It is also notorious that "half of all three-standard deviation results are wrong" because of unappreciated systematic biases in the data. No wonder so many medical studies are not reproducible.
5
@Jonathan Katz
And was an attempt made to differentiate between female doctors' success with female patients and with male patients?
3
If you take the extra time to listen to patients then you fall behind in your charting and do it out of your personal time. You then get exhausted want to work less and indirectly take a pay cut. May be one reason why many female physicians work less ??
May be you want to tell your politicians to turn the tide against the extra-ordinary charting burden being imposed on physicians?
I wonder what the ratio of administrators to clinicians (not only doctors but also others involved in direct patient care) is in 2018?
More rules more regulations (some of them really contribute to the care and safety of patients and many don't) do mean more administrative dollars.
More money on unwieldy EMRs mean less money to pay your doctors and nurses and physical therapists who will then be forced to see more patients with less time to spend with each.
More money spent upfront on years of education to get through med school means more pressure on clinicians to make ends meet and less control on ability to work the way they want to -which is to really sit down with patients and do the best by each one of them. After all the reason that medicine is so alluring to most is that it is respected profession with immediately tangible results in making things better for fellow humans.
More money spent worrying and guarding against litigation means less money in the pot to pay for clinical time.
Fellow citizens, pay closer attention to where your money goes in present day health care.
15
I’ve had both female and male doctors and have been treated wonderfully and poorly by both. I also have a very complex medical history which requires paying attention and heeding my side of the story. Meeting new doctors is always a challenge, years of experience created an intuition I trust.
My worst experience was with a world renowned neurosurgeon who did not talk to me but dictated into his hand held recorder detailing his findings “life threatening...only when you lose the ability to control your bladder and bowels would we consider doing the surgery...it is very necessary...brain stem and tip of spinal cord...”. He then turned off his recorder and told me, that because I had sustained a severe brain injury, there are any questions, I should have my daughter (aged 17) call him. I immediately contacted my neurologist and told him, “I don’t care if he’s the best in the world, he’s not touching me.” It’s now 25 years later and I’m still waiting on needing the surgery.
My best experience was with a physiatrist, African, educated in America’s top schools, who had an earth bound sensitivity that allowed me to trust her, her treatments and suggestions with no fear of consequence, understanding innately she would be there if things went wrong.
Excellence is not gender based - it’s empathy based. When my physician assures me that I am more important than his or her relationship with an insurance/corporate entity, I tend to have a more fulfilling experieence.
11
Although listening may be a part of it, as a physician myself, I find that male doctors tend to want to "fix things" rather than sit back and allow the patient time to heal. Aggressive care is good in some scenarios but these scenarios are the minority of patient encounters. The worse outcomes may be the consequence of too much ineffective, and perhaps even detrimental care, rather than too little attention.
10
But too little attention can cause ineffective or detrimental care.
I am very happy with my current female doctor, who has been seeing me and my family for fifteen years now. I pay extra directly to her office just so that I can continue to see her.
The one time I left a practice though, it was because of the female doctor there who clearly didn't want my husband in the examination room with me when I was afraid I was having a miscarriage, wouldn't tell me if I was having one or not, and sent us to the ER where a miscarriage was confirmed. I called to ask if I could never see her again and was told that I had to take her if it was her turn. I immediately left that practice. I won't have a doctor who won't tell me what's happening with my body, or who won't welcome my spouse when I'm going through something so frightening.
13
"Should You Choose a Female Doctor "?!
"Studies show that female doctors tend to listen more, and their patients tend to fare better."
Did these studies include specialists such as surgeons ,anesthesiologists, and radiologists?
I find it unlikely that surgical patients of female doctors fare
better than those of male surgeons, that female anesthesiologists are more likely to keep patients who are under the knife alive, or that female radiologists are better equipped to read scans than are male doctors , when controlling for other variables such as training, level of surgical expertise, etc.
I was unable to read the Harvard study in depth without paying for the article. I am wonder which kind of doctors were included.
2
@DJS
I have access to the Harvard study from my university library.
From the paper:
"Design, Setting, and Participants We analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years or older hospitalized with a medical condition and treated by general internists from January 1, 2011, to December 31, 2014. We examined the association between physician sex and 30-day mortality and readmission rates, adjusted for patient and physician characteristics and hospital fixed effects (effectively comparing female and male physicians within the same hospital)."
The doctors included are general internists.
4
@DJS
A reason why all government-funded studies should be available free on the internet. If the journal refuses, the paper should be submitted elsewhere (and non-compliant authors should be denied future government funding). But such a journal would soon find itself without any papers to publish.
3
As a physician myself, I have two comments:
1. It's wrong to generalize. I've know female physicians who were every bit as abrupt and unwilling to listen very much as were male ones.
2. With regard to listening. When we start paying physicians for their time spent listening to patients, they might start to do more of it. Right now we pay them based on how many patients they see and how many tests and procedures they do. If anyone wonders why we spend so much money but still don't get very good results as to the overall population of our country, here's the prime answer.
72
@Steve
I think you hit on another potential reason for why female and male doctors spend different amount of times listening - money. Females have always been paid less for the same work so maybe the disincentive in taking the time to listen just isn't there for females.
The issue of money sounds like a catch-22. If more time was spent listening to the patient perhaps fewer tests and procedures would be expected then payment structures could be renegotiated. However, I'm going to stick to the shallow end of that conversation because I'm not part of the medical industry. But as an outsider these generalizations are all I have to go on to help me get the best care when the conversation turns from the best care to money.
6
If a study shows that white doctors provide better care than black doctors, would the NYT publish an article asking “Should you pick a white doctor?”?
12
@anappleaday
Would the journal publish it?
4
@anappleaday Pure speculation on my part, but I would put money on my guess that Black doctors provide better care to Black patients than white doctors do. Women and/or Black doctors know what it's like to be ignored and are probably less likely, on average, to do that to patients. But if there's research to support your hypothetical, that would be an interesting article to read.
3
@anappleaday Interestingly, I remembered reading in the UK, they did such a survey asking about both sex and ethnicity (probably not something we would do here in the US!) and the upshot were minority, female doctors were deemed to provide the best care.
There are studies suggesting care outcomes and satisfaction is better in when the ethnicity of the patient and doctor are same/ similar. This is biased to some degree of course by patients self-selecting who they want to care for them. But it might also be that doctors of a specific ethnicity understand or try to understand the culture or language of that ethnicity or others more.
Personally, as someone who used to translate for my parents, I am probably more patient than the average MD with non-English proficient patients. I was complimented by the interpreters at one place I worked at. At another workplace, I remembered taking care of a group of Black patients who all went to the same church. One person told me they just felt more comfortable around me.
I am a male and prefer a male Doctor but the staff in most medical offices are female and if I request a male Doctor...I get the "Look" which is followed by much grief about female Drs be just as good as males. If I were a woman and told the staff that I was more comfortable with a female Dr....My decision would not be challenged...they would be empathetic. I have had female Doctors and it was not the good experience that you read about in the newspapers. I understand that the Doctor is busy....probably sees 20 patients a day. I u derstand that I will get 15 minutes of his time...so there will not be a lot of Chit chat. That's okay. I prefer the business-like ...just the facts sir ...manner of male Doctors. I don't want somebody to hold my hand or be my cycling buddy.
6
I find this article to be painted with a broad brush and sexist.
I am a sixty three year old, heterosexuale male. A few years back I was diagnosed with Peyronie's disease. (penile bending.)
At the time my Dr. was a female. She seemed to think that there was not much to do, and sent me to see three urologists. One was a female. She did not have much information and was unconcerned. She said "keep an eye on it and if it gets worse, let me know. I felt like I was getting short shrift. I saw two other urologists, each male. They were far more interested, informed and concerned about my sexual health. It's been a long process but I feel much more cared for by my male urologists, doctors.
I currently see a male GP I think he's gay. He listens, communicates well, and is genuinely concerned about my overall health. His office is efficient. Follow up is great.
Holding hands and talking to patients is fine. Healing them should be the goal.
Maybe other studies should consider more than just male and female? Maybe a larger question is the time doctors can spend?
Another might be, can they sympathise?
11
I don't care about the gender! Just give me a Doctor who knows what they are doing! And, from experience, that translates to a Doctor who is getting on in years, and has been there and done that, numerous times! That's right, someone who has been in the field many years, and most likely is between sixty and eighty!!!
5
This is interesting but not useful. We not going to take it the next step by evaluating age, race, location, income, debt load, citizenship status and more. There is a real desire to use big data metrics to find best practices for the medical profession. At this point, we have learned that the more measurements we record about health care givers, the less happy they are in their jobs.
2
@G Sometimes a research variable is a proxy variable - one used when you can't or it is too costly to directly measure what you want. This study seems to suggest that for whatever reason - culture? - women doctors appear to take more time listening and empathizing. So maybe the next study can tackle the more difficult thing to measure: how much time a doctor listens or how much a doctor empathizes.
Really, did you think it was gender per se this was studying?
We can all learn from each other's culture. Black Americans and immigrants have been told to assimilate, be more White. No doubt we could all benefit by also being more Black as there are aspects of Black cultures we can learn from. So yeah, why not study the impact of Black doctors vs. White? We already know that despite insurance and income Black Americans have different responses from doctors.
1
@s parson
If you go to the website of The National Medical Association, you can find black doctors, black being the key adjective as this is an association of black doctors, by zip code. Stereotype and discriminate much?
Hopefully your continuity of care does not suffer - recent studies indicate that female Dr's work 25% less than their male counterparts and a full 35% work part-time - and that stat is growing over time.
2
I dunno...I’ve had both...I think it’s an individual thing...but I have an appointment in a week with a new female doctor because my present female doctor had a baby a couple of years ago and ever since she is mostly unavailable when I call for an appointment...I settled for her physicians assistant who is excellent but now she is leaving and I feel I don’t have anyone interested in my well being so I asked the physician assistant for a referral and was referred to her doctor who isn’t the one she works for.
2
My experience is that it has a lot more to do with their character structure than their binary sex.
Some women who are doctors are equally as imperious and abrupt as some men.
Now that I am older I have a
cardiologist , male
dermatologist ( I've had skin cancer ) female
dermatological surgeon, male
orthopedic surgeon , male
primary care internist, woman
gynecologist, woman
gynecologist P.A., woman
They all have different styles but all are very competent, are concerned about my actual welfare and how my conditions might interact, they listen . And they have faces that appear to reflect being people who like their work and manage to do it without having to run over their staff or their patients. I can trust each of them.
Then I've had several that I have had to dismiss;
dermatologist, woman
orthopedist, woman,
cardiologist P.A., woman
primary care, internist, man
They were rude, too hurried, seemed to do a very superficial exam, seemed not to be real concerned with coordinating my medical conditions, wrote down the wrong drug in my record but said " the computer won't give me a way to change this ". They nonetheless wanted a big fee. Being dependent upon their care for my welfare felt risky.
I'm told that I next require an endocrinologist. In my area they are mostly women. But I have several choices and can decide who seems both capable and pleasant.
All women are not saints. All men are not indifferent.
5
After having male physicians most of my life, I switched to female just because that made me feel more comfortable. For a couple of their preschool years, I chose a female physician for my twin sons. This decision had nothing to do with male vs female listening skills; it was just one among many efforts to make sure they would grow up knowing that women can be in any field men can be in. I myself am in a male-dominated field: that of Christian clergy. When my sons were still preschool age, I was ridiculously proud when they looked at an artists' rendering of Jesus and the disciples, and asked, "But Mom, where are the girls?" And at age 19, when it was time to leave their pediatrician and enter the adult world, I was pleased when they chose to see the same female physician whom I see....even when someone in the practice called and said, "Are your sons SURE they want to see a woman doctor?"
My experience is that female doctors spend more time, are better listeners, and are far less condescending and dismissive. And I've never had one chuckle and say, "women have no idea what's going on with their bodies," the way a male doctor once did.
4
I have had more dismissive, incompetent male doctors than female doctors in my lifetime now as a senior because I have had more male doctors.
If female doctors ever equal or exceed the number of male doctors they will catch up being dismissive, incompetent and money hungry.
Like anything in life doctors fall in the 3 part scenario (one can argue the exact percents), 1/3 are good and can help you and even save your life, 1/3 can't help you or tell you what you already know and 1/3 can harm you, rip you off or even kill you.
6
@Paul- To add to my post, same thing goes with bosses in general. When I was younger I only had male bosses and some were good and some bad.
Later on I had as many female as male bosses if not more and they proved themselves just to be like men, some good and some bad.
While I don’t dispute the argument that women might be better doctors, the argument’s credibility is undermined by the answer to one question:
Would the Times run an article arguing that men are better at, I don’t know.... umm, anything?
The answer, I think, is a pretty obvious “no.”
Which makes me think that the Times’ evaluation of the relative abilities of each gender are a bit skewed by ideology.
Personally, I’ll make decisions on individual merit, myself.
9
Once and only once. I chose a female doctor for a surgery; she listened less, much less than the male surgeons and communicated very poorly. They might be awesome but for me definetely and without a shred of a doubt, no more female doctors, surgeons or dentists. Thank you.
2
I wonder if the NYTimes would ever run an article titled “Should You Choose a Male Doctor” (or any other professional) if a study showed men of some profession or other scoring better at some or other metric. I can’t even imagine the resulting ensuing craziness and public protest if that sort of headline appeared.
6
The summary of the new study cited in the article is misleading and irresponsible. I have read the original research paper in full, and I highly recommend all readers to do the same.
The author failed to mention:
First, the r-squared value of the regression with the physician gender as the independent variable is 0.001. This means that among all factors that can impact mortality, physician gender accounts for 1/1000th of the total difference.
Second, acute myocardial infarctions (AMI), the disease studied, are inherently harder to diagnose in women. So women have less likelihood of survival compared to men regardless of physician gender.
Third, it is very doubtful whether treatment of AMI can be generalized to other aspects of healthcare.
Finally, and this cannot be repeated enough, CORRELATION IS NOT CAUSATION! In attempting to attribute the mortality differences to women doctors supposedly being better listeners, the author assumes a causal relationship unsupported by the research.
The gross misrepresentation of scientific research in service of political/ideological ends("another research shows women are better than men!") is not unique to this article. The NYTimes should hire someone with the statistical knowledge and journalistic integrity to cover scientific studies fairly and accurately.
15
@Jason But the question is why it is has a higher mortality for women, and largely that is because it has been diagnosed and displayed as a male disease with male symptoms predominating so that women do not present early enough to live through it.
This bias in medicine is in many, many places and it is not unreasonable to think the gender of the dr. at least for female patients might mitigate the situation.
5
@NSH
No, it is intrinsically more common in men, and intrinsically more difficult to diagnose in women. That's reality, not bias.
Breast cancer has a higher mortality rate in men (who can get it), for roughly the same reason. Not every difference is someone's "fault".
@Jonathan Katz
It is always more difficult to diagnose what you don't look for or study. There is plenty of evidence that the different symptoms women more commonly present with are ignored in both men and women. They are not all Hollywood heart attacks in either group.
The last time I had a male doctor, it was not by choice. My insurance company at the time had only one oncologist in our area, and it was an older white man. Not only did he make inappropriate sex jokes in front of me and my boyfriend, making us both squirm with discomfort, but after surgery, he left me with a major infection and then refused to believe that there was anything wrong with me.
It was my female PCP who ordered the MRI that discovered a large pocket of infected material in the surgical area. She was shocked that a supposedly reputable oncologist would be so careless and unresponsive. But it didn't surprise me at all. I had him pegged after a few minutes' observation: a man who expected deference from everyone around him, who was followed by an entourage of intimidated interns, and who interrupted everyone, especially his female students and patients. I don't think he let me ever finish a sentence. It's no wonder he was a lousy surgeon, too.
9
@Allison Funny -- I just fired my male orthopedic surgeon, who displays similar characteristics, today. He was a complete narcissist who discounted every data point about my condition that did not support his very extreme view of the treatment that I supposedly need for my broken foot. He was pushing a very nasty surgery with a two month recovery time, which would be difficult for me with two small kids. He ignored my observations that my foot was healing, which would indicate less need for surgery, even refusing to believe me when I said that the healing bone was no longer painful. He actually said, "No! You are in pain! You need the surgery because you are in pain!" Uh no, actually, I haven't been in pain for weeks, and have been walking around easily. I don't want to go back to two months on crutches. But he ignored my statements about how I felt because they did not fit the conclusion he had come to once he saw my scan (although it is well known that there is a time lag before healing appears on the scans). He barely even looked at my actual foot. When I tried to ask him questions, he got angry, cut me off, and told me to do what he said or not come back! His website says the same thing. What an arrogant bully.
Frustrated, I saw a younger female orthopedic surgeon this week. She performed a much more thorough exam, and immediately said there was no need for surgery at this time.
We need more female surgeons! (That said, I do love my male GP.)
1
This article is ludicrous. Men and women come in all shapes, sizes and personalities. Just because I am a woman doesn't mean that I connect well all other women. Some are perceived as warm and others as cold.Same goes for men. Frankly, if I am going under the knife, it is a skillful surgeon that matters most. It is the outpatient setting where the relationship matters to me more but my experience has been both good and bad with both genders. (Actually, my worst experience was with a female doctor who was inept, inappropriate and downright unprofessional).
4
I have a young beautiful primary care physician whom it is such a joy to be in the same room with. Yeah it takes a while for my BP to settle, but I wouldn't trade her for the world. Thank you Kaiser Permanete.
2
Fascinating. Thank you, Ms. Parker-Pope.
Research in business shows that women tend to make better decisions than men. See Harvard Business Review, https://hbr.org/2016/07/slow-deciders-make-better-strategists.
It seems the reason why women outperformed men in that study is that women took more time to make decisions than the men, and they were less confident in their decisions. The inference: the women thought more deeply.
After controlling for time and confidence, men and women made decisions of similar quality.
Anecdotally, I have been wonderfully attended to by female internists for years. My interactions with them mirror those highly positive experiences discussed in this piece. My clear choice would be to recommend a female physician “in a heartbeat “.
I don't doubt the study results but haven't had good luck with female doctors. I particularly disliked the primary care doctor at a "holistic" practice who tried to push fertility drugs on me within the first 5 minutes of our first, and last, appointment. The practice I go to now caters to the LGBTQ community and is just wonderful. There's not much choice in doctor for me as I normally I just see whichever resident is available, but all the residents have been attentive, respectful, and less prone to making assumptions.
1
The results of the study can also be interpreted differently. Maybe women who choose to be seen by a woman doctor are more health conscious and therefore have better outcomes. The problem with a convenience sample, such as all Medicare data, is that the groups are not stratified by confounding variables.
4
And if the result had been that the out comes were better with a male doctor, this entire article would be about why the study was flawed. What does it take for people to see the increadable hypocrosy here? A one half percent difference, and the author feels free to write a piece about how women are better than men.
2
31 years ago, post craniotomy, my top [male] surgeon got me the top [male] rehab doc at the rehab. not only did i not care for the rehab guy personally, but over a couple of weeks i didn't think he was being agressive enough in promoting/expanding my care. when he was absent for a day and another rehab doctor [female] got stuck with me, the difference in care/proposed advanced physical work and so forth was astonishing. i 'fired' him, 'hired' her and improved.
which does NOT mean that women are 'better' in every instance. i was just lucky she was on staff, and that i could make a rational judgement and make myself heard.
6
In my experience, gender is largely irrelevant when it comes to physicians' listening skills - unless the M.D. was previously trained as a nurse. If you want to be listened to by a primary care provider or specialist, find a nurse-practitioner.
4
I work with a lot of nurses at all levels, including NPs and ones with doctorates so I know how good they can be. One of my worst care experiences was with an ICU nurse who told my relative to "stop complaining about his pain." This was after cardiac surgery and in front of me. She did not know I am a doctor. I immediately asked that she be taken off my relative's care and filed a formal complaint. I cannot imagine how she would have treated someone older, with less English skills, who might be too sick to advocate for themselves.
I agree that listening is essential. I'm a retired family physician. I can't tell you how many times I heard from my patients "You're the first doctor who has ever listened to me." Its really very sad that such behavior should be notable.
My male partners were constantly upset with me for not being more productive--eg seeing more patients faster. But I was seeing their sisters and wives and other family members who wanted to feel heard and respected. It matters!
36
Then be clear: women see fewer patients and are very late to see the ones they have time for. If you don't have a sense of resposablity to see people at the scheduled time or to help your partners pay for the practice, then you're free to spend more time with each patient and increase those patients chances by one half of a percentage point. Of course some patients end up not getting any care at all, but they don't count in your statistics.
4
I have a teenage son who is a pretty serious runner and thus gets some sports injuries requiring medical attention. The first sports medicine Dr we saw was a man who barely let him get a word in before insisting that he knew exactly what was wrong (in between talking about how great he was and how well known in the area). Fast forward a couple of years and he gets an appointment with a female sports medicine Dr (who also was a college runner a fact she did not mention until I asked her) who started off the exchange by asking him what he thought was going on and listened to him for at least 5-10 minutes. It was headspinning in its confirmation of these study findings which I had discussed with my son when they came out. As we left the appointment he said that those experiences while not proof certainly supported the hypothesis that women are better Drs and he ended up choosing that woman as his adult primary care physician despite their being of different genders because she was clearly a great Dr. (and she gave him good advice that led to recovery from the injury).
11
It's not just about the number of minutes that a doctor spends listening to a patient--it's about HOW they listen. The best doctors I've had listened while making eye contact, asked appropriate follow-up questions, even leaned forward a little to hear better. The bad ones stared at computer screens without glancing up, failed to notice their own body language (or mine), and naturally did not answer my questions well, since they weren't actually listening in any active sense. One doctor (female) had such a dismissive manner that I left the appointment feeling worse rather than better, even though she had just told me that I didn't have cancer.
I don't want to take up additional time that doctors need to spend elsewhere, but I do expect to be really heard during the short amount of time they are already in the room.
6
As a physician I would say that, as a stereotype, women are probably better "listeners" than men -who tend to more directive and, as in Freberg's "Dragnet" parody, "Just the facts ma'am" type people. There is however a big difference between bringing a conversation back on track and not hearing what is being said.
A second point is that until recently most surgeons have been men and surgeons are often not verbal people. They tend to live in a concrete world of "doing" and are often impatient with wasting time on "talking". The same can be true for some internal medicine sub-specialties such as cardiology and gastroenterology. That variance may be a personality characteristic of those who choose those areas of medicine- regardless of gender.
A third point is that each gender will usually be more comfortable with the style of the gender they understand best. A woman will tend to be more at ease talking to a person she feels understands the nuance of her tone and voice cadence. My wife, a physician, frequently accuses me of being "monosyllabic" and when I hear my recorded voice I am stunned by how little inflection there is compared with the complex voice inflections most women employ. There are differences between the sexes in communication styles, even using the same words, and that can be important in how the physician is perceived by the patient even when both are actually hearing the patient.
6
The two best doctors I've ever had were both women. Not only do they listen better than male doctors, they are not as self important as male doctors tend to be. The only "downside" is that neither of my women doctors would let me get away with rationalizations of why I wasn't taking good care of myself. I do have one very good male doctor who listens, but it took a threat to find another doctor and a serious talk with him to get him to pay attention to me.
1
Two major scientific, data-based studies conclude that the death rate is lower for patients being treated by women physicians. This is not an opinion and the studies do not hypothesize the reasons behind this finding, but it is a fact.
There are good and bad men and women physicians, obviously. However, the bottom line is that patients have better outcomes with women physicians for whatever reason.
Knowing this fact, make care choices that are best for you.
9
Male college professors score higher in teaching evaluations than do female professors. This not an opinion, it is a fact. Knowing this fact, make choices about which classes you chose.
2
If students have higher standardised test scores after classes with male professors, then it would make sense to choose male professors. Student satisfaction is, on the other hand, subjective and not a good measure. Mortality rates are objective and are a good standard.
6
I'm not sure I subscribe to the author's thesis but the article does reinforce a few important concepts. In my experience, the best doctors are good listeners. To suggest that women are better listeners may reflect a cultural template rather than an inherently gender-based difference. Add to the equation the reality that the age, race, gender, and class of the patient may affect the doctor's ability to establish a connection with the patient sufficient to encourage a candid disclosure of symptoms, lifestyle, etc. This, in my view, in what distinguishes healers from clinicians. A doctor's ability to leave the patient feeling better psychologically is an important part of the healing and recovery process.
I am concerned that women doctors are given a fair chance to succeed in a profession which is still, but less so, dominated by men. I was operated on by a male surgeon at a top NY hospital who is the Obi Wan Kenobi of head and neck surgeons (Dr. G, you rock!). I believe part of his success is attributable to asking good questions and listening for information that the patient may not realize is relevant but he does. I was pleasantly surprised to see the residents on his service who looked after me post-recovery were all women. I think it is crucial that all doctors try to pass on the lessons of years of practice, successes, and failures, to their proteges, male and female.
4
My cardiologist, neurologist and GP are women. I've always preferred women for the reasons listed in the article. And they had to work harder because they were not part of the "boys club." For the same reasons I prefer a female airline captain.
6
A boy's club? Look at the statistics of who is attending medical school.
2
In individual cases it can be kind of a crap shoot. In my case, in the most important medical crisis of my life, I went to a male doctor (neurologist) who didn't listen well, pretty much dismissed and minimized my reported symptoms - but ordered the right test, which ultimately saved my life. It was back in the 80s when MRIs were very new and seldom ordered. I had pain and growing numbness in various odd places which others had not been able to explain. He seemed to think the numbness in my hands was because I was a jogger, at least that's what he said.
But, he ordered an MRI, which showed a large spinal cord tumor. It definitely shocked even him. But he found it, and it was removed in time before I became a quadriplegic.
So anyway it worked out. Having a good listener and diagnostician would have been better, for sure, but I think what you need is a combination of listening skills (especially for something like neurology), knowledge, and some luck.
10
I am a male specialist physician. This post is for the non-physicians.
Physicians aren't therapists; they are not your best friend; their job is to provide an accurate diagnosis and provide a treatment. A good doctor is an individual that does this reasonably well and is reasonably efficient so they can see multiple patients in a day. Depending on the specialty, listening skills aren't necessarily a requirement. For example, for other doctors, a good surgeon is a physician that completes the operation efficiently and with minimal complications. While it would be nice if the surgeon had good listening skills, it's less important. Listening skills for a diagnostic specialty like primary care, internal medicine, are useful in obtaining a detailed history, but only if they get the information they need, which is one reason why doctors interrupt patients - the information they're getting may not be relevant to the primary issue, despite what a patient thinks.
The take home point is the patients definition of a "good" doctor is different from a health care professional's definition of a "good" doctor. In Canada, doctor's are a limited resource - so the doctor that listens to every complaint and spends a lot of time with one patient isn't seeing other patients. Think about that the next time you're annoyed that the doctor feels like they're rushing you - they're trying to stay on schedule and keep the other patients in the waiting room from waiting too long.
30
@curious
This. I am a female physician, and I agree.
2
@curious, from your comments, you appear to have missed the point of the article, which is that listening appears to uncover symptoms that help lead doctors to better diagnoses -- which result in better outcomes and fewer fatalities, supported by research studies. Your comments also support the conclusion that male physicians do not really listen to their patients, with the attendant adverse effects, and further support the decision of my husband and I to seek out female physicians.
36
@curious From this patient's point of view, the role of a doctor is to help the patient heal and be restored to health as much as possible. Diagnosis and treatment are mere technical requirements for healing. If a doctor doesn't help me regain my health, why should I bother seeing him or her?
2
My GP, dermatologist, gynecologist, oncologist, and dentist are all women. When I visited my GP a few weeks ago, I was delighted to see she was being shadowed by a female medical student.
2
As a gay man, I find it much easier to go to a gay male doctor than either a woman or a straight male doctor. A gay man usually understands my medical need better and it is much easier to have an open conversation on a wide variety of social, sexual, and medical matters. In addition, I found that when my gay physician brought along his female assistant the conversation completely changed and became less beneficial to both him and I. So I understand that gender can make a difference, and in my case, sexual orientation does as well.
12
I graduated rom medical school in 1964 and the three women in my class were missionary nuns.
A few years later while on the faculty of a medical school I interviewed potential medical students and was happy to see bright qualified women applying..
And later was a director of a residency program and women were among my best residents.
Finally I became a retired physician and a patient having both male a female physicians to care for me. I see no real difference in their ability to listen and talk to me or there competence.
Over the years I came to the conclusions that having women make up a high percentage of medical students was a very good thing.
It doubled the pool of qualified applicants and more importantly civilized a bit the male physicians for women are nicer.
1
I am a male physician, mostly retired. I was OK at listening, likely not great, but I was good at caring. I admitted when I did not know what was going on and sought help.
As a health-care consumer (healthy with PCP visits) I have had male and female doctors, and my two favorites were male, but that is because they knew what they were doing, and seemed to include me in decision making (Maybe in part because I was a physician.)
My wife and daughter are Nurse Practitioners, and I am sure better at listening then I am, and many would feel more comfortable with them.
If you are uncomfortable with any provider find one you are comfortable with.
6
I'm surprised there's no mention of the catch-all diagnosis male doctors give to female patients: Depression/anxiety. Here's your prescription for prozac.
I went to a male doc with a list of symptoms. Before I was even through, he stopped me and said I need an anti-depressant. I went to another doctor (female, by chance), and it turns out had a rather severe but correctible medical issue. Male doctors regularly dismiss descriptions of pain from women patients. Other studies have shown it's not that they interrupt; they simply disregard our narrative.
98
Jsb. I would not take any anti depressants or anti anxiety meds from a gp. Their practices are not set up to do the appropriate monitoring. Unless they can regularly provide you with 30 minute appts, my suggestion would be find a good psychiatrist
I had the same issue with a male physician I no longer go. When he said “Lisa you must be depressed. You keep getting Strep throat”. I left, made an appointment with an ENT physician , and within a few weeks, had a tonsillectomy. No more Strep throat. That “depressed” comment would never have been made to a man.
1
My ob/gyn was non-English speaking and I was barely proficient in his native tongue. My situation required sophisticated expertise. He was male. I was fortunate. Most people with my condition lose the child.
As far as I'm concerned, go for the doctor who knows the most.
5
I’ve chosen female doctors for more than 30 years whenever possible. They’re simply more caring, softer touch, and have smaller hands than most male doctors. Being a man, this makes the interactions and the checkups much more comfortable and productive.
4
There is more to it than gender. The training, school and cultural upbringing of the physician may make a difference. Also, the practice and the “many insurance companies regulations.” Like others, I have found that going to a physician that has left the “system” provides me with better care. Now I am a participant in my care and “wellness” is the focus. The added advantage is one has medical care when needed, not when you can be squeezed in. While there is a cost, it is less than my contribution to medicare yearly and my health is better. It is a fallacy that insurance gives us a choice, those companies control our health. Many of us know someone who has perish because the insurance company denied proper diagnosis and healthcare.
7
I learned a long time ago that gender does NOT matter when it comes to choosing a physician. As a woman I have had both good and bad doctors from both genders. When as a young woman, I chose a reputable woman to be my OB/GYN but it was her male partner who approached my pregnancy/childbirth as a miracle. My female internist through the years was an excellent diagnostician but when she retired, her counterpart proved to be lacking in taking history, hysterical and inappropriate. The one thing that has bothered me about female doctors is their limited or lack of availability. I have had too many who moved to part-time due to their family responsibilities or retired mid-career to lessen their load. Men stick with it and often practice way into their senior years bringing tremendous experience.
29
so it's not them, it's society. the men in their lives aren't stepping up. so they have to put their careers on hold.
1
Amy Bales, a cardiologist in Northwest Indiana and previously at the University of Chicago, is the absolute best physician I have ever had the pleasure of managing my care. As a very senior male I am rather open minded on the gender subject. She is so intelligent that she blows away the competition. Even her peers are in awe of her knowledge and ability. She can say a lot in a few words, and they are defintely worth listening to. The downside is that I moved out of state and have little chance of again meeting the "perfect doctor". Previously I visited a Dr. Cantorna in the same area and he was hopelessly inept. Gender does not matter.
2
Except ... sometimes a woman doctor is terrible. I've been to two who extraordinarily neglectful woman doctors. Give me a good doctor of any gender and I'm happy.
22
I think it's appalling that the Times ran this 'battle of sexes' article. If these "studies" had shown that male doctors were preferred by men and women alike, this article would never have seen the light of day. Will the Times next start comparing doctors based on their ethnicity?
15
@Menckenistic: The NYT didn't make this up. It is a summary of a peer-reviewed, statistically valid study. Using my own experience, I would give credence to the difference in listening as a major factor. I can't count the times I've heard something as a last, throwaway comment from a patient that makes me think OMG! and leads to a diagnosis.
3
@mignon
The article was Parker- Pope’s INTERPRETATION of the study.
A). The story is in the New York Times
B). To my knowledge, no story comparing women with men on any parameters using any survey techniques, has ever appeared which resulted in any conclusion other than women being adjudged superior.
C). Any issue, study or editorial stating that women WEREN’T superior in some measure of any random issue, study or opinion would be immediately discredited—that is, if it ever saw the light of day to begin with!
18
@robin Step back a moment from the all too common view that the "left wing media" has a bias toward women or, for that matter, non-whites or immigrants. This is a Health column which is simply reporting the finding of 2 major studies on this issue. Lots of commenters are reporting their own experiences which is interesting but not all that helpful or informative since, as we say in medicine, it is anecdotal and not generalizable. The studies cited here involved hundreds of thousands of cases and also included links to the studies themselves, which all are welcome to peruse, not to mention that all are welcome to Google the subject or go to PubMed (the taxpayer funded National Library of Medicine with excellent search tools). One might also consult the Cochrane database which does meta-analyses on all sorts of medical topics. Your comment would hold more water if you can return to the comments section and cite one or more well designed, comparably large studies that have different findings. As Senator Moynihan once said: "You are entitled to your own opinions; you are not entitled to your own facts."
37
@robin
Perhaps you attend to the contention that I made, though you are thorough in the extreme on research sources!
In fact, there were two comments questioning sampling and covariables before my contention was written.
Tara Parker-Pope no doubt had a point to make by using the studies as proofs; I treat women and men in equal numbers and their reports on gender differences do not at all confirm the studies’ contentions.
Speaking of nurse practitioners, I wish I had tracked all of the Friday afternoon calls from mammographers’ offices (according to the women I treat) who received the fatalistic “We tried to reach you but couldn’t today. Please call Dr. Jones as soon as possible Monday morning” missives,
1
Thats not the point. Im looking for an article stating that men are better in something than women. But cant find it.
Where is the symmetry of number of articles stating that males are better than females and vice versa? Yes, there is a natural asymmetry; males are not equal to females. As a consequence, males must have advantages over females and vice versa. But all I can see is either "females are better" or "females are worse in math because they are better in reading". Do you see whats gone awry here?
So many educated people but almost no critical thinkers here, just a bunch of people so focused on using correct grammar that they are blindly swimming with the crowd.
1
Pl get perspective (from a surgeon).
It is NOT the time a doctor takes with you that is important.
It is whether he/she gets to the right diagnosis and starts the best treatment.
Pl patients stop wallowing in the expectation that every doctor should listen to all you have to say( most of which is probably irrelevant).
Lady doctors make better surgeons, better fine hand skills, and have more brains BUT all this expecation that they LISTEN forever burns them out.
6
@Bob Yes, I have a friend who is a prison doctor, and because there is a psychiatric staff, she is really happy there because she doesn't have to listen to the prisoners, like the old white people she treated in private practice, who always wanted to chat, have someone hold their hand, and maybe were just lonely and wanted company..
"Lady doctor?" Really? You are implicating yourself, here.
3
This opinion piece makes too many generalizations. You can't paint every doctor with the same brush. Some male doctors are good, some bad, some female doctors are terrible, some excellent.
This sounds somewhat sexist to me. Would you say every black, white, Asian, Native American is (fill in the blank)? Of course not. You'd rightly stay clear of such prejudice. Why, then, would you pit male doctors vs female and say the latter is always superior("you should choose female doctors over males)? It's nonsense. Any person with extensive experience as a patient would tell you so.
18
I've been a committed feminist all my life. My best friend in high school and a female relative struggled with sexism when they attended medical school in the 1970s.
As far as the gender of my doctor, I've come to the conclusion it doesn't matter. When I was struggling with endometriosis, a much lauded female ob-gyn in Washington D.C. was just as clueless as the male doctors who didn't diagnosis me.
I've had both male and female doctors and the 2 best were a man and a woman. Both were brilliant and possessed tremendous empathy. My current doctor, a man, less so. He's gruff and difficult. But he's a terrific diagnostician and after my previous life experience, that one thing matters more to me than lots of other issues. Most of all, I want a doctor who knows what they're doing.
The biggest most insensitive jerk doctor I've ever met, by far, was a surgeon who a week after my surgery chewed me out about something totally irrelevant that most doctors would have realized was a stupid obsession on his part. That guy saved my life during an emergency that almost killed me. What I needed was a doctor who could diagnosis me quickly and operate quickly to prevent my death. Which I got. Who cares what he thought about women's issues?
7
@fast/furious
bravo
Why would only women get the short shrift? Wouldn't it be anyone man or women who is seeing a male doctor that won't listen?
4
first reaction: it still sounds odd to say "male doctor," doesn't it? and, yes, men need to change... our world is a messed up place, because of men. i will always have a "female" doctor. you can't trust a man. they lie, and can become quite hysterical and irrational when questioned... not someone you want to take care of you.
17
I wonder is this comment would have been let through if it had said these exact same things about women.
2
@cait farrell I know you are engaging in a bit of hyperbole here to make a point, but the funny thing is that my former male orthopedic surgeon (whom I fired this morning, just before seeing this article, funnily enough) was pushing a very nasty operation that went against the treatment guidelines of not only the American Academy of Orthopedic Surgeons for my condition but contradicted the slew of medical journal articles that I had printed out. I had been suspicious when he had first start pushing the surgery so had decided to research treatment outcomes for myself. He really did become hysterical and irrational when I tried to question him about why I should be getting this surgery before it was clear that my fracture would not heal with more conservative management (evidence shows that fractures like mine almost always heal without surgery). Then he lied and started saying I had a different kind of fracture, which almost always requires surgery, when it is 100% clear from multiple CT scans and x-rays that that is not what I have. He actually lied to my face to try to convince me to have the surgery he was so desperate to inflict on me.
Now, a month on from that conversation, I am finally out of my moon boot and back to exercising. If I had listened to him, I would still be in a wheelchair right now and non-weightbearing for another month. Thank God I switched to my new, female ortho who was willing to listen and pay attention to the evidence.
My mother suffered from a magnesium deficiency for months without diagnosis. In fact, I diagnosed it, and sent her back to the doctor for confirmation. What did a stay at home mom have that the doctor didn't? Time, and a real knowledge of the patient.
I found the answer because I knew that the doctor was not focusing on my mother's actual symptoms, but the ones he believed he heard. But I know my mom well, and know that she has a glorious vocabulary and a real understanding of words. She said what she meant.
And the key was in her words. She didn't have nausea, as he kept assuming, she had a loss of appetite. Four hours on the NIH site, and I had the answer.
When she did her follow-up, he asked how she was feeling, asked about her energy, her memory. She admitted the memory suffered: she could no longer answer **every** question on Jeopardy. And with that she let the doctor know he wasn't dealing with his idea of a fluffy grandmother, but with a real, complicated person.
Here's the thing - he's a good and caring doctor. But he let his assumptions rule - he needed to move on. If he had either the time, or the artificial intelligence tools to reduce the search for an answer to just a few seconds, my Mom would not have suffered months of illness.
13
@Cathy With all due respect, Cathy, loss of appetite has a differential diagnosis (list of possible causes) that includes dozens of conditions with low magnesium pretty close to if not at the bottom. There are very few medical conditions where a single symptom points to the diagnosis. Almost always it is a cluster of symptoms that point in the right direction. Indeed, that is exactly how artificial interlligence medical diagnostic programs work. Moreover, the causes of magnesium deficiency include diet, alcohol abuse, chronic stress, poorly controlled diabetes, excessive or chronic vomiting and/or diarrhea. Also, certain drugs can deplete magnesium levels such as osmotic diuretics (such as IV mannitol), cisplatin (cancer drug), ciclosporin (immune suppressant for preventing transplanted organ rejection), amphetamines, and possibly proton pump inhibitors (Prilosec, Nexium etc). In the age of the internet everybody searches their (or their family's) symptoms and all too many demand various tests to confirm their self diagnoses. Once in a great while they are right but most of the time the (unnecessary) tests prove them wrong, are false positives, lab errors and/or red herrings. Unfortunately we time starved doctors usually just order the (unnecessary) tests rather than patiently explain why they are not indicated, which not only risks losing the patient to a more persuadable clinician but raises the costs of medical care for all of us.
3
Here's an even better question: should you see an Advanced Practice Nurse? For most of the usual ailments, nurse practitioners scored just as well as their MD counterparts and even better in one aspect: knowing when to refer to a specialist.
Recently saw a dermatologist - a woman. She asked about how we are doing and I told her about my husband's Afib and anticoagulants. She says "it's good he's got a nurse to look out for him."
Me: "Actually, he's a doctor."
She: "Oh, I'd rather have a nurse looking out for me than a doctor!"
Me: "Please speak into my recorder here."
She: "Yeah, a doctor says, 'nothing's wrong' but a nurse checks it out."
I love my dermatologist. More women in medicine is a loss for nursing but a huge win for medicine.
12
@Leslie Durr
Actually these studies are funded by the midlevel groups and are not validated at all. They are patently false, used as propaganda to advance their careers while putting patient's lives at risk. I would get another dermatologist. Who know's she may be replaced by a midlevel dermatologist soon anyway.
I have had some fantastic male doctors who all had one thing in common. They approached care as scientists with curiosity and an investigative stance that included evaluating a list of possibilities laid out to me verbally as they ticked them off. This included me in the process as a colleague in my treatment where I was asked to confirm if the list item fit or not. What else did they have in common? They had all started out in a field of biology not just pre med. One had done field biology work and another molecular. But other male doctors have had the female "in your head" response (it wasn't in the end every time) so I revert to women whenever possible.
6
@poslug Uh, "just premed" as well as the first 2 years of med school include a great deal of biology and it's constituent organic chemistry, molecular biology, genetics, microbiology, system and molecular physiology and anatomy. What they typically don't include are psychology, sociology and medical ethics which are regarded as "soft sciences" and have trouble getting into the crowded and territorial curriculum.
1
The best provider I had was a female nurse practitioner. She took the time to listen and provide solutions to some quality of life issues that I was having after a heart attack. Time was never an issue with her. I felt more comfortable with her than any primary care provider I had earlier, be they male or female. When I received word that she was recalled to active duty with the Air Force I was not a happy camper. But on the other hand, there are military folks at Wilford Hall Medical Center getting some of the best care out there now.
7
You know the medical saying, when you hear hooves assume a horse, not a zebra? In my youth, I suffered from steadily increasing chronic pain from a zebra (a rare glandular disorder). My female doctor patiently ruled various common physical causes of pain out, identified my zebra, and treated it with successful outpatient surgery that completely eliminated the pain. Every other person I have met with this particular disorder was first told by a male doctor that it was basically in their heads, and encouraged to take anti-depressants or see a psychiatrist instead of getting the simple surgical correction.
46
My experiences with female doctors has been mixed. It is a result of my own socialization, I suppose, to find it easier to chat with a female doctor, presuming our shared experience as women. However, when faced with decisions about diagnoses and courses of treatment, I've not found my female doctors to be "better."
IMHO, it's not the sex of the Dr. or even whether she listens; what matters is whether his questioning provokes the patient to disclose sufficient info to allow for an informed diagnosis and, more significantly, patient buy-in re plan of treatment or lifestyle changes to reduce risk factors.
I serve as a Standardized Patient for Motivational Interviewing at a local med school. Fortunately, the new iteration of doctors is/will be nothing like what I experienced in my youth or pre-senior adulthood. Also fortunately, the Drs. and PA's in my PCP and the specialists with whom I consult are proponents of MI.
4
At a certain point in my life, say around 45, I decided my medical care providers were going to be women. Primary care, eye doctor, OB/GYN and eventually my dentist. My cardiologist is male but it was my primary care doctor that detected the issue and ordered the tests that confirmed my heart problem. Now almost 25 five years later, I feel very fortunate to have had such good care and remember with great satisfaction the relationships I've had with my doctors. I felt they knew me as a person. Never could say that about the male doctors I saw during the first half of my life.
24
In 2015, I was having episodes of intense chest pain. I went to a male cardiologist who worked in the same group practice as my PCP. After spending five minutes with me, he told my it was anxiety. I do have a history of depression and anorexia (both of which were in full remission at this time). I've had anxiety attacks and I knew this was not an anxiety attack. I sought out Dr. Goldberg at the Joan H. Tisch Center for Women in NYC and she asked the appropriate questions regarding my history such as the including of Raynaud's and migraines. Dr. Goldberg diagnosed me with coronary artery spasms, prescribed me the appropriate medication and the spasms have been under control since.
68
@Andrea--I've had male doctors misinterpret my postural orthostatic tachycardia as anxiety. However, a male specialist correctly diagnosed my genetic condition.
On the other hand, I had a miserable experience with a female specialist who decided she knew better than that highly experienced male specialist and challenged my diagnosis. She had me move my arm in a specific way, despite my protests. I subluxated my shoulder joint in the process--ironically, that's a hallmark of my genetic condition. I should have filed a complaint against her. I am still angry.
8
I had a stitch left from a surgical wound that hurt so much I couldn’t tell if my injury was better I spoke to the doctor for less than a minute and the doctor broke in and went to work. Then the doctor dictated into a recorder, recording what had happened. Everything said showed that the doctor understood, took appropriate action and schduied a follow-up appolintment at what seemed like the ideal interval. I don’t go to doctors for therapy. If they get it all in half a minute, they’re doing right by me. Male or female I don’t care. Anyone who can cut to the chase and do what needs to be done is top notch by me.
8
@michjas
Patients. Should be aware that doctors cannot spend all their time listening to an endless monologue. It would hep the doctor in figuring out what the problem is if patients would write down their problems in concise languae just as they should bring a complete list of medications they are taking and even those of the near past. Then give the physician an opportunity to digest this information before they offer new or renewable prescriptions.
3
@MK--I have brought in a concise list of symptoms to doctor appointments (along with current Rx/OTC list). Guess what--the doctors pooh-poohed my list. In fact, they were angry I had brought in a list in the first place. They then proceeded with THEIR endless monologue.
It would help if doctors actually listened to patients instead of automatically tuning out patients who are trying to get their needs met by explaining their problems.
2
@MK Many times I have concisely written a short paragraph of my issue and the doctor has refused to read it; he was more comfortable following his established Q&A technique. I've quit writing it out for the doctor, but I still write it out for my own clarity.
I don't question the results of this study, but my personal experience has been very different. The doctors who have taken the most time to talk to me and who have been the most caring and compassionate have all been men. This doesn't mean I seek out male doctors, but it does mean that I don't assume that, because a doctor happens to be a man, he is going to be less sensitive to my needs. I know that this is not a popular view among many women, especially those, like I, who consider themselves feminists.
16
Where did they go to med school? Residency? Fellowship? Publications? (which means they keep up on research and new methods). Recommendations?
That is usually enough for me. I have had both male and female GPs and specialists. Skill is more of an issue than personality or gender.
I do admit though that I will go the extra mile for a male urologist, rather than female. Chalk it up to being old fashioned.
8
I don't buy any of this, but if you're inclined to make groundless comparisons, I'd suggest you study doctors vs. physicians' assistants. I find that PA's are the real listeners, they don't make me feel rushed, and their technique in office procedures is far superior. When they give shots, probe your body, or relocate dislocated appendages, they prepare you better and hurt you less. I had a doctor give me a steroid shot. He turned me black and blue and the shot did not help. Two months later a PA did the same thing and I was all better in a couple of days.
6
@michjas--PA's were never able to diagnose complicated cases like mine. They may be good for some simple procedures, but I would never in a million years trust any of them to relocate a dislocated appendage for one thing.
5
I have chosen female doctors for years. My feeling has always been that they listen better - they're more *present* - than male doctors. I guess that jives with the studies. I think that listening leads to a more thorough and nuanced understanding of issues. Female doctors have tended to look deeper into problems, consider longer term treatments rather than quick fixes, and follow up more assiduously. If that means I have to wait an extra two minutes for my appointment - or 15 or 30 - because she's providing the same standard of care to another patient, that's fine. Anyway, that's a failing of the health care system, not the doctor.
I'm not saying there is anything "wrong" with male doctors; I don't know if I've had a *bad* doctor of any type. It's just that this is a quality I look for in a doctor. Not everyone wants the same thing. I want a good listener and my experience tells me to ask for a female doctor when choosing a GP. Maybe they're better at putting the "care" in healthcare. Regardless, if there is in fact a difference, I hope more women go into the profession, and men get with the program.
13
Don't really know the point of this. As an MD who has worked with many doctors there are plenty from bother genders who listen and plenty who could learn to listen better. This is just another in a string of articles about how doctors could be better instead of recognizing that we are humans too. Behind every doctor who spends extra time with their patients is a wife or husband, son or daughter who wishes they would be around more often to pay attention to them.
12
Insured by Medicare and in that odd category we state as "elderly , I am glad when any Physician male or female spends more then 5 minutes of time listening and talking with me.
46
I am a female surgeon in a male-dominated field (8% of practicing urologists are female). I find these stats in the article to be interesting and I believe that female physicians internally hold themselves to a higher standard. Personally, I feel that I have to prove my competence daily. Routinely after counseling a patient on surgical options, I am almost 100% of the time asked “so who will perform the surgery?”
125
@Emilia Hoping you don't infer that your pts are unaware of your ability to operate because of your gender. I ask this question of our doctors because I want to know if residents will be doing it under supervision, or potentially others from the group being on surgical call that week. From a long career, I have noted low medical literacy frequently in patients, and they may not even understand that ANY urologist performs surgery--they may think a general surgeon does this. So lucky to have female uro's like you and for the record, the men in our family see a female uro.
8
@Emilia: I sympathize with your suspicions of sexist bias, no matter how minor. Our single-payer government here audits a certain proportion of visits by sending letters to patients asking if they saw a Dr. So-and-So on the specified date. One patient whom I had seen in the EKG Lab in consult for chest pain, and for whom I did a stress test, said he hadn't seen me. On further questioning, he did say he had seen "a bunch of girls".
4
@Emilia
What you've written may be the key, Emilia.
Given that our physicians are still trained in a rather sexist milieu, it's been my observation that the female doctors who come out of it are often more competent, less hidebound, and more willing to think outside the box.
And yes, it's been my experience that they do listen better, and they have less ego invested in being the god-like expert all the time. The latter is especially important when dealing with a patient like myself who has unusual conditions and so has been forced to become quite an expert on them--female doctors do not tend to take the "I'm the expert, no matter what you may have researched" attitude.
7
Always best to try to find the best doctor, no matter the gender.
My vascular surgeon (male) is brilliant, kind, and patient. My rheumatologist (male), now retired, always spent as much time as I needed -- usually very little since, truthfully, the sight of him always made me feel better, and I never could remember whether I had any aches or pains.
Friends of mine have had the same experience with other (male) specialists.
And I've had a couple of excellent (female) doctors.
It really doesn't do to rely on some battle-of-the-sexes study when choosing a physician.
17
The amount of sexual abuse at the hands of male doctors is enough to make it reasonable for every woman to avoid them.
17
@Cecelia
The slightest rationale for that statement please..
6
When you end up in the emergency room, you get whoever is on duty. Best is to get one, regardless of gender, who speaks understandable English.
38
Instead of sending everyone to female doctors, perhaps we should be training all doctors to listen better--or really all people.
200
@Kelly
IMHO .. my young female Ivy Med-level M.D. listen enough to be sufficient, and not a second more. I chose her, because she had the highest GPA. She's the most accurate, IMHO. She asks very good questions.
Not just amount of time -- smarts and perception also required.
3
clinic visits are in 20 minute slots. it has nothing to do with training and everything to do with billing. primary care visits actually are a net negative. my clinic loses half a mil every year
1
I prefer female doctors. Most of the males have been arrogant and a few have actually exhibited the predatory behavior that brought about the metoo movement. It's not fair to characterize all male doctors this way, but if I had a daughter, I wouldn't take her to a male doctor.
25
@Karen "Me, too".
2
perhaps this needs to be done with obstetrics where all the patients are female and most do not feel listened to.
16
I like doctors who are not only good listeners but also good questioners. Doctors who are kind but aren't easily mislead by patient self-diagnosis. Doctors who aren't overly swayed by their own hunches and who constantly keep their potential for bias in check. Who are observant and possess a sharp analytical mind. As a result, the doctors I favor my not have a winning personality, but put me at ease because of their knowledge, skills and abilities.
45
Gender isn’t the issue at the moment. Reducing screen time and increasing patient interaction has to happen....
25
I chose a female pediatrician for my two daughters and have never looked back. When my daughter recently "aged out" of seeing her pediatrician I sought out a female internal medicine physician. There are just some issues that a male physician would never understand from a psychological perspective versus a female one. While I would not discount using a male physician for other areas I would never consider one for my, or my daughters, primary care.
41
There are questions about about both the 2018 and 2016 studies being cited.
There is, for now, a general consensus that women physicians communicate better than men. I would guess this would hold for any number of professions--not just medicine.
The 2018 study of the half million heart patients said that those male physicians who worked more frequently with female physicians, or treated more female patients, did a better job.
The earlier study has been subject to a number of questions: https://www.health.harvard.edu/blog/does-your-doctors-gender-matter-2017... . Considerations included:
"Would the results be the same if other areas of medicine were similarly studied? This study excluded patients cared for by other types of doctors such as surgeons, obstetricians, and psychiatrists.
Would physician gender matter if the patients were younger? The average age of patients in this Medicare-covered study population was nearly 81.
How would the results be affected if outpatients were included?"
I suspect that, ultimately, we will find that the genders can learn from one another. This should not be difficult given that roughly half of entering medical students are now female.
[Disclaimer: I am a retired male physician from a time when female physicians were not so common.]
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@JSK, broadening the external validity-- whether other fields of medicine/age groups are affected by the same phenomena-- was not implied within this article. The journalist was responsible and very clear about this study being about heart patients. Also, patients on Medicare. Anyone extrapolating to OB with 25 year olds is misusing the empirical research.
Considering the outcome was mortality, outpatient visits may have lacked sufficient power to be useful. These are great questions... for future projects. Critiquing this project for having an appropriating focused research question is perhaps not helpful. As an aging population, knowing how to serve ourselves well would be wise.
I also hope the medicine continues the trend to broaden its training to be more inclusive of social science concepts and applied skills. As I use more health care, I appreciate those who can/will respond to me as a human being as well as a series of data points.
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@Stephanie
Thanks for the comments. Another suggested factor contributing to the observations is that the women physicians were more likely to follow available clinical guidelines than their male counterparts.
Given the male skew of physicians over the years in these studies, one wonders whether physician age was also a factor (i.e. older physicians were more likely to be male). Gender identification of physicians was done by name alone, at least from what I can see.
These studies also support another major point: there is relatively little justification for paying male physicians more than their female counterparts.
@Stephanie
One other point, related to your remarks about external validity. The title of this essay does not confine itself to heart patients. In addition, the second study linked relates to patients treated by internists, and was not confined to heart patients.
As you can see from comments on these boards, quite a few people are already generalizing beyond the confines of what was being discussed. That is not a surprise.
Listening to the patient is really important, because they are in their body all the time, whereas the doctor only sees them for limited amounts of time. Dismissing what a patient has to say is basically throwing away the majority of the information you need to make a diagnosis, as well as hurting the patient.
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There are many other variables that affect my level of comfort and confidence in my contacts with physicians: Age, years of experience, personality, location of medical education, time of day of contact and day of the week, and familiarity in terms of past contacts. Broader research that goes beyond gender and listening skills could be useful.
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Im 73 years old, and very healthy. Despite being married to an academic physician for 45 years, I have always received all of my primary care from nurse practitioners. They listen, they question, they're interested. And they don't pay more attention to their computer screen than they do to me.
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@Susan--I've had the exact opposite experience with nurse practitioners. Most have been absolute nightmares to deal with, not to mention ineffective.
It's a whole other ballgame, trust me, when you have chronic health problems. If you're "very healthy" you wouldn't understand what it's like trying to explain your medical needs to someone who thinks they're more important than a physician.
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@Susan
My male M.D. uses a "medical scribe," who does the PPACA-mandated computer work. Scribes are usually pre-meds who make $9.50/hour, to pick up job exposure.
He's a pretty good M.D., accurate and perceptive. Yeah, more time would be nice, but he's pretty busy.
@Norton ~ I agree with you. The worst medical professional I've ever experienced was a female nurse practitioner. She was a terrible listener and seemed to have a chip on her shoulder. One nasty comment she made still irks years later. I had commented how I had liked so many Harvard trained doctors while living in Boston. Her snide reply, "Harvard doctors are a dime a dozen in Boston."
As a physician, I can't say that any traits specific to the practice of medicine have to do with the sex of the physician. I am a surgeon, who happens to be female. My surgical skills are the result of my excellent training; my personality traits come from my personal experiences over the years of my life. If one chooses a physician largely based on sex rather than based on clinical knowledge, clinical skills and rapport (quite important to build a good therapeutic relationship), than one will be quite disappointed. If your therapeutic relationship is not working, then choose another physician if you can. Physicians are as individual as the patients they treat and one size does not fit all. Does gender matter? Only if the gender of the patient (or physician) runs counter to a good therapeutic relationship.
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We live in an age of boilerplate medicine where most physicians male and female attempt to encapsulate a diagnosis to get you out of the treatment room and get the next patient in. According to the CDC, 91% of Americans age 65 and over are on a prescription drug. 69% for ages 45 to 64. That is indicative of an ignorant profession that disregards lifestyle advice and preventative measures.
Be they Men or Women, the majority of doctors should not be trusted.
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@Dan M
"Be they Men or Women, the majority of doctors should not be trusted."
While some doctors are overly eager to prescribe medication, I'd say that some patients are also overly eager to receive medication; some even get suckered in by those ubiquitous television commercials ("Tell your doctor . . .").
At the same time, I know at least a couple of people who owed 10-15 very good years, after diagnoses of Stage IV cancer, to their caring, expert oncologists.
Selling an entire profession short isn't helpful.
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@Dan M. That's a bit harsh.
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Ego seems to be a big issue preventing good doctors from being great ones.
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Wouldn't that be counter-intuitive, though?
Two of the worst doctors I ever had were women. Neither could be bothered to listen to me and one was just downright nasty. I've got a good Primary Care Doctor that is a woman. However, I've had many male doctors that are great, along with some that are not. This is just another was to lock women into the 'nurturing' personality stereotype. Not all women (or men) are good listeners, or caring, etc. I'm not particularly nurturing, not very maternal either, or my daughter. That doesn't mean we are missing something as women.
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This is not at all surprising, and yet my friends who are female doctors have all horrific stories of abuse from male colleagues. Perhaps this is why so many men in medicine are so afraid of them. Puts the Japanese discrimination against admitting them into perspective, too.
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Very strange, I've had nothing but bad experiences with women doctors and avoid them where possible. They don't treat mental illness very well and they also do not care much about quality of life. It's quantity all the way. So you present with a migraine, they start with a brain tumor and work backwards - not good if you have an anxiety disorder. I had one that couldn't diagnose an inguinal hernia and kept telling me it was a UTI that needed more and more powerful antibiotics even though all tests were negative. I now stick to Jewish and Middle Eastern men as they aren't as dictatorial to me and are strangely better with my anxiety than women are.
My husband has a female doctor and she basically aged him a decade in the first year from her tests for everything under the sun and a pile of drugs "just in case" with many side effects. She has him on a cocktail of old men drugs now and he now acts 75 not 65. He injured his knee, it swelled up like a baseball. This is Canada where it was an 8 month wait time for a specialist consult. He then injured his shoulder trying to manipulate himself around with the pain. Then he developed rheumatoid arthritis which was completely dormant until the pain took over. She was too terrified to prescribe him even 1 painkiller a day so he could sleep. Net consequence, he's chronically ill for life but that just gives her more business tending to him.
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Doctor-patient relationships are very important to achieving a correct diagnosis and in making patients feel less anxiety throughout the medical interactive process. What I am unclear about is how well the diagnostician skills of the doctors, male and female, were assessed.
The argument can be made that part of what makes diagnosticians good is superior communication skills which, among other things, get the patient to better articulate his/her symptoms and how it is affecting their quality of life. I think this aspect of patient outcomes needs more granular investigation.
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Meh. Went out of my way to get a female doctor with my most recent city move, she was the only one on the list, and this lady might as well have been a missionary in 19th cent. Africa, for the way she worked. Good with bandages and tummy aches, but beyond that, nothing, no imagination, no interest in delving into problems, no nothing. She definitely enjoyed the lower level type of doctoring, but her simple abilities were a far cry from meeting my needs. I think all doctors are taught to be egotists and can't take criticism after Med school - I have had several male doctors yell at me, one actually yelling "This is taking too much time!." He was a neurosurgeon.
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@Grace Thorsen Hmmm...maybe you should take "too much time" to pay that arrogant individual's bill!
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@Grace Thorsen
"Good with bandages and tummy aches, but beyond that, nothing, no imagination, no interest in delving into problems, no nothing. She definitely enjoyed the lower level type of doctoring, but her simple abilities were a far cry from meeting my needs."
Good heavens, she sounds like the veterinarian I'll never take a pet to again. Kind of lazy to characterize my big galoot as a fussy eater. The poor old fellow had cancer, diagnosed by a different vet. The result, needing to euthanize him after medication failed, could not have been avoided, but it's nice to know what's ailing the beast.
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My current internist is a woman, and she listens. To be fair to men, some do listen. Maybe 30 years ago I had a male internist, pretty young guy but very old fashioned. Office on Park Avenue. First time I went to see him, he didn't start examining me until he had talked to me about myself for more than half an hour. The appointment lasted more than an hour. Don't get that nowadays.
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@Jeff M I am a woman and believe the findings of this study but I also think time and reimbursement is a huge factor. In the early 1990s, one of my mentors was close to retirement and if I were to use quick phrase to describe him, it would be "old school." He used to have 2 rooms, one for talking to the patient and one for examining them. He did not believe it right to only talk to people who were naked or in dressing gowns since that might make them feel uncomfortable or embarrassed. He would take a history with them in their regular clothes, then have them change and examine them, then have them return to his other room, fully dressed, to talk about the next steps. He would also dictate his notes right in front of them so they could hear what he thought, save himself time, and correct any errors. I didn't realize how unique his ways were until many years later. He took his time and treated people with respect. Not sure how financially possible it would be now though. He was old school but in the best way.
I wonder if higher levels of female anxiety/lower levels of confidence play a role, rather than just communications styles. I was given a year of complex treatment for cancer in Germany, which meant being bounced around the hospital to different departments and many different doctors.
Some of the senior women doctors had a horrible communication style, being very curt and dismissive. But all of them had a tendency to check and re-check. The younger female doctors told me that they sometimes had trouble sleeping because they ruminated over whether they had done the right thing that day.
The men were confident, cheerful - and careless. They strode into an isolation room without wearing a gown. They ordered treatments that didn't fit the disease. Every mistake I endured was from a man who didn't read the bloody notes.
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@Fenella Of course, they were German, not American. Vastly different culture relating to power.
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As a female physician, I find your interpretation of the act of caring as a manifestation of anxiety both hilarious and sad.
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@MIndful I'm only offering anecdotes. But the doctors I spoke to (at length) all told me they checked and re-checked and thought about their patients out of hours. If you don't like the word 'anxious' maybe the word 'conscientious' would be better. 'Caring' is not the right word, though, because the male doctors definitely cared a great deal as well.
I'm a 75 year old guy. I've always had male doctors (and I had no serious complaints about them) but for the last few years my primary care physician has been a woman.
The differences -- particularly in talking and listening -- aren't huge, but they are definitely there. And I appreciate that.
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I have purposefully sought out female physicians because they tend to listen more than their male counterparts and don't have the same issues with ego. I love my current endocrinologist. In preparation for a consultation, she indicated that she had researched my symptoms and we discussed the results of her research. I can't think of a similar situation where a male doctor would "confess" the need to research anything. I briefly treated with a male specialist who purposefully raised his chair so that he loomed over the desk and towered over the patient. Those two encounters basically sum up the difference between male and female doctors for me.
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@AS--I've had horrible results with female endocrinologists. You would think they would be more attuned to the needs of women since more women than men present with thyroid problems, but that is hardly the case. I'm currently seeing a male endocrinologist who I believe is on my side and interested in ordering the tests I need, and getting to the bottom of my concerns, as opposed to the females who brushed me off and wouldn't investigate my case further, despite my condition getting much worse under their care.
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@AS
Any M.D. should be "on her/his game." If s/he is lacking -- get another M.D. .. STAT.
@AS Interesting. Maybe to survive as a species, male and female had to evolve differently.
Not that I haven't had a number of male doctors who were excellent listeners - for instance, my primary care physician, who is a male, does a fantastic job with this - but overall my experience matches the patterns described in this article. Generally speaking my female doctors have simply seemed more concerned about what I was telling them than were my male doctors (again, speaking in generalities here and certainly not suggesting that some of my male doctors haven't also displayed genuine concern) and this seemed to motivate them to listen longer and more closely to what I was telling them.
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If mortality rates in an ER for both men and women were better when the treating physician was female, that means more than just female patients are more comfortable talking to a woman doctor. The patient in an ER is treated by a team, not just a single physician. If female physicians produce measurably better outcomes, we should be looking not just at their communications with the patient, but with their communication with other healthcare staff.
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@Catherine This old retired RN has almost never worked with a female doctor who wasn't collaborative and team-minded. Can't say the same for many male MDs or more recently Physician Assistants (deliver me from them).
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@Leslie Durr I'm sure you will agree with another old retired RN--if you want to know who is a good listener and has good outcomes and low complications, and who collaborates within a multidisciplinary team, ASK A NURSE!
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This research is basically revealing something all women already know. I have dismissive doctors of both genders, but the dismissive ones are more often male. It takes compassion to make a smart doctor a good doctor, and that's something both male and female doctors need to keep in mind.
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