Women more likely to die of heart attack if doctor is male

Desiree Burns
August 7, 2018

The results from more than 580,000 patients reveals that overall, 11.9% of heart attack patients died while in hospital. "Such research might include experimental interventions, or tests of more targeted training, to examine how exposing male physicians more thoroughly to the presentation of female patients might impact outcomes", they say.

Female heart attack patients treated by male doctors have a worse chance of survival than those treated by female doctors, a study suggests.

That is according to a review of almost 582,000 heart attack cases over 19 years in Florida, which confirmed a long-held theory that female surgeons provide better returns with female patients.

According to their findings in "Patient-Physician Gender Concordance and Increased Mortality Among Female Heart Attack Patients", of more than 500,000 heart attack patients admitted to hospital emergency departments in Florida between 1991 and 2010, female patients treated by male physicians were less likely to survive than patients of either gender treated by female physicians or male patients treated by male physicians.

This study offers a new explanation for why gender inequality in heart attack mortality persists.

In that case, 12.6 per cent of men died compared to 13.3 per cent of women.

Researchers found that the more women a male doctor treated in his life, the less likely his female patients were to die.

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Emergency doctors and cardiologists, however, are wary of jumping to conclusions just yet.

Previous studies based on data from Australia and Sweden have revealed that men and women experience different care if they have a heart attack, while United Kingdom research has shown women are more likely to be misdiagnosed. "Spurious signals sometimes come up [in research], so this should be replicated", she says.

As well as looking at the patients' age, gender, and whether they had other health problems, the team also looked at whether the patient died during their stay in hospital and whether the emergency room doctor primarily looking after them was a man or a woman. Or there could be a bias that favors men in the medical literature (in which heart attacks are better understood when they happen in men), leading to misdiagnoses in women. "There have definitely been several studies that have shown that women are slower to be diagnosed, and that might be explained by the fact that women are more likely to have "atypical' symptoms", O'Donoghue notes". In the new study everyone was more likely to survive if they saw a female physician, and a study published past year in JAMA Internal Medicine indicated all patients of female physicians had lower mortality and hospital readmission rates.

A variable omitted in the study was the previous finding by other researchers that female doctors tend to perform better than male doctors across a wide variety of ailments. Given the cost of male physicians' learning on the job, it may be more effective to increase the presence of female physicians within the emergency department. This could help them to pick up on heart attacks, even if women have more atypical symptoms.

Their chances were also improved if treated by a male doctor who had a lot of female colleagues in his team. Or you have assistance: "A female colleague cues him into what's going on".

"You have highly trained experts with life or death on the line, and yet the gender match between the physician and the patient seems to matter a great deal", Lead scientist Dr Seth Carnahan, from Washington University in St Louis, said. "I would hope that in reading this leaders in emergency medicine-whether directors or department chairs-would consider that we are an asset beyond being a diverse workforce".

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