From "Should You Choose a Female Doctor?/Studies show that female doctors tend to listen more, and their patients — both male and female — tend to fare better" (NYT). So should you pick the female over the male? "The difference in mortality was slight — about half a percentage point — but when applied to the entire Medicare population, it translates to 32,000 fewer deaths." I guess that means 32,000 fewer deaths per year. Can that be right? I think fewer than 2 million Americans over 65 die each year, and .5% of 2 million is 10,000, so I find the number hard to understand.
Anyway, the article goes on to guess that the difference is that women are better listeners.
From the comments over there:
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?”The theory there is that the female doctors are discriminated against and therefore try harder to demonstrate their worth.
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64 comments:
I wonder if a half a percentage point can be considered statistically significant in this analysis? It seems to me that heart issues are readily diagnosed by lab work and other analyses. Does electrocardiography work better with a sympathetic listener? I doubt it. Are the patients expert at self-diagnosis that only females have the patience to hear out? I look forward to hearing from Michael K and the other resident docs on here.
male doctors handle harder cases
"I wonder if a half a percentage point can be considered statistically significant in this analysis? "
Excellent point.
If the sample size is relatively small and there is lots of within groups variance, then that difference is likely not statistically significant. That analysis is transparent in scientific journals, but not often in articles written by journalists. Statistics is hard for them.
When my gall bladder doctor told me I needed it removed, I asked him who would be doing the surgery. I didn't ask because he was a girl, I asked because I wanted to know.
Ps, it was going to be another doctor
The NYT story proves our gracious blog sponsor's maxim: Stories pointing out any gender differences are unacceptable unless it argues that women are better.
This one is a major stretch. An insignificant statistical difference with no context provided arguing YOU WILL DIE if treated by a man, but YOU WILL LIVE if treated by a woman. THe predictable and tedious quote from a female doctor arguing she has to work harder to prove her self, implying that she is superior ad male doctors are lazy slobs who coast and don't care because privilege.
Sarah Jeong will fit in like a glove in that joint.
I wonder if Sarah Jeong edited this article and wrote the headline.
Of course, it could also be a matter of selection by both doctors and patients, where patients with more severe illnesses seek out male doctors, and/or female doctors pawning off more seriously ill patients on male colleagues. Beware the hidden covariates.
Ineresting stuff. Penn Gillette suggests in an interview that women magicians are better able to fool Penn and Teller than males. http://www.vulture.com/2018/08/penn-jillette-in-conversation.html
"This year on Fool Us we had six women magicians working solo. And out of those six, five fooled us. Now the average rate we have for being fooled is 12 percent. But solo women fool us almost 100 percent of the time. The reason for the difference is that there is a way of thinking about magic that doesn’t have anything to do with the boys’ club. And as much as I’ve railed against that boys’ club, I’m 63 years old and every book I’ve read, every magician I’ve seen, is based on the boys’-club way of thinking about magic. Women who were excluded from that club have rhythms and styles and nuance to the way they do magic that I don’t understand. And that’s great! I’ve been wanting to see that for 50 years."
A small sample size but: women may be more innovative, thinking of new and better ways of doing things? And/or they make patients more confident, and the mental state of the patient contributes to recovery?
How can anyone possibly think the NYT has an anti-male bias? It's not like they are hiring gender haters there.
We can be confident that if the results were reversed, the difference would be treated as trivial and simultaneously explained away as a consequence of sexism.
I wonder if Sarah Jeong edited this article and wrote the headline.
The journalistic equivalent of 'who will be doing the surgery'.
Sarah J is truly making the NYT seem like Yellow Journalism.
Medicine is feminizing. 60% of medical students are female.
In a med mal case about 20 years ago, I was asked to testify for the defense because their expert was female and the lawyer thought a female urologist would be less likely to impress the jury as knowledgeable. She was an assistant professor at UCI.
Maybe it's different now. I work with male and female doctors now, not surgeons anymore. I don't see a difference.
When I was still in practice, I did see a few female surgeons and I thought they were not as gentle with tissue, the opposite of what I would have expected. Maybe they were early adopters and felt they needed to be macho.
These studies will probably all be biased toward female doctors. Just a guess.
It seems to me the only ones not getting special treatment becoming doctors are white men.
Seems like you would need to have a series of cases where one randomly selected male and one randomly selected female doctor (of the appropriate specialty) independently examine the patient, make their diagnosis, and then see which one proves to be correct. Of course, that will never happen.
But gender doesn't matter anymore anyway, right? So what's the point of the article?
Did they control for age of the doctor? Since there were fewer female doctors in the past, and more now, the average age of female doctors would be lower. Maybe older doctors tend to lose their touch, or not be up on the latest and greatest protocols.
And, of course, you need to control for the age of the patients. It might be that older patients tend to prefer male doctors. Or even just that older patients tend to have older doctors for their general practitioners, who tend to refer them to cardiologist they know, who are the older, male cardiologists.
"The difference in mortality was slight — about half a percentage point" That's called a negative result. There was no significant difference in mortality. Unless the sample was really huge.
I didn't go to the article, but this says ER doctors, whom one doesn't get to choose. Communication isn't always possible and is necessarily short with heart attacks. It could be the males fear heart problems more and over-treat, or over do CPR.
I assumed the mortality rate difference was for heart-related ER visits.
How many women want to deal with strange boners?
How are you supposed to pick your doctor in the emergency room?
i?Michael K said...
Medicine is feminizing. 60% of medical students are female.
90% of the nurses?
70% of the small animal vets?
Where is the government campaign to get more men into the Biological careers?
-------------
Seriously though, I remember studies that looked at productive career hours for male and female docs. IIRC the male docs ended up with twice the hours. This was when most docs were in private medical groups not hourly hospital staff, but the differences were:
- marriage drop-outs
- 40 hour weeks
- earlier retirements
IOW, the quality of life decisions
Horseshit, at least from my perspective. The female physicians I have had were downright rude, interupped me constantly, and projected their own experiences onto mine. The last was so bad, finishing my sentences with wrong assumptions, I nearly called the licensing board or whatever one does when a physician acts horribly. Finding a primary care doctor has been terribly frustrating.
Is also could be that male doctors listen every bit as well as female doctors, but that patients provide more information to female doctors?
If I'm not mistaken, women are increasingly filling up med schools. There will be more female doctors than male doctors in this country within a decade. For a number of reasons, not the least of which is that more women are graduating high school and going to college than men these days. (because of a number of factors including discrimination against boys/men and entire generations of boys being drugged with Ritalin). More women going to college and more women being strongly pushed into STEM curricula, more women excelling in college and more choosing to go to med school.
Now this is where it gets tricky. If our entire society is geared toward moving women forward and placing shackles on the ankles of men, don't you think this would apply- eventually- in med schools as well? I suspect it will, if it hasn't already begun. I don't know if women being singled out in med school will continue- especially when there are incentives to increase the # of female graduates of med schools.
The great equalizer should be that med school is tough for everybody. The women that feel like they're being singled out are too full of themselves. EVERYBODY in med school is being singled out. It's a great filtering process. We're not talking about an editorial position with the New York Times here. We're talking about peoples lives.
Still- more women in med school means eventually more female doctors. And I'm fine with that. I just want someone competent. I happen to prefer female doctors, so maybe I do have some sort of bias toward a female doctor's competence. Just as I have a bias toward preferring a man to fly the plane, even though I'm seeing more and more female pilots. Why would I care if it's a woman as long as she's competent? I also prefer male soldiers, police, mechanics, and...surgeons. Don't know why- but I can probably list it if I spent another minute.
As for female surgeons- it takes quite a bit more intense schooling to become a surgeon (i.e. more life sacrifice). It also takes a different sort of personality and skill set that is not present in every med student or doctor and may be a trait found more in males. Time will tell. Surgeons are just a different breed, and as such, they get paid more for their work. In time there may or may not be more female surgeons.
Russia has a tradition of women doctors, and it's a low status job.
Pre-med is where women STEM students go, after chemistry. It's more like cooking.
A sympathetic female can give more comfort than an equally sympathetic male. That's why I'm in favor of motherhood, especially for the vulnerable population of newborns, being restricted to women.
Imagine if someone did a study that concluded that men were (by a tiny percentage) genetically predisposed to higher success in fields like engineering, and law enforcement...
My dad and I both have female primary doctors. I hope it will improve our mortality rate.
First thought on seeing this was - Who paid for this study and do they have an agenda? I am too lazy to look it up. I really do not care either.
Picking the right gender for your engineering project of a pedestrian bridge may be a matter of life and death!
Re Dr. K at 6:39:
Long ago, before today's feminista were even born, someone observed that when necessary to jimmy open a desk drawer, a man will apply just enough force to break the lock, while a woman is likely to give it all she has got, splinter the drawer and ruin the desk.
Back in my twenties I picked a doctor simply because she was the only female choice. She was my doctor for twenty-eight years. Throughout her moves between practices and mine through different jobs I managed to keep her. My husband started seeing her when we were first married and she signed my son out of the hospital when she was born. She has been through every major life event with me.
Side note - she was happy to open her office to see my husband on a Saturday before he flew to Europe. He ended up canceling, went on the trip, and came home with pneumonia. Neither she nor I were willing to let him forget that. :)
I love her and I pray for her.
"I am almost 100% of the time asked “so who will perform the surgery?""
That isn't that strange. I've asked a male doctor that. The patient doesn't know how many layers of people he's dealing with.
My female doctor is great. My male doctor has decided that anti-Trump chatter is his way of showing good bedside manner.
I don't have the nerve to tell him,,....
Is also could be that male doctors listen every bit as well as female doctors, but that patients provide more information to female doctors?
This. I once had a patient in the hospital who had a stroke. All the consultants (male) thought he was because he wouldn’t open his eyes and talk to them when they came into the room. I asked him why the hell he was doing that, and he said, “Because, they’re assholes!”
The ladies at JHU sewed my brain back together after a DAVF Cognard type 2 blew out my right parietal lobe, Working Under X-Ray hoods they did a synchronized Ballet,for eight hours of dual controls microsurgery. Closing the bleeders. None better. Was on my feet in two days. Reminds me that Seymour Cray found that only women could do the micro wiring required in my time working with him. Males failed. Small hands,great control and unassisted eyesight and endurance.
I don't have the nerve to tell him,,....
You need a variant of the old "How dare you assume I'm heterosexual" Tee shirt...And enough imprudence to wear it.
"The theory there is that the female doctors are discriminated against and therefore try harder to demonstrate their worth."
Hmmm... Give her another shot of that "discrimination", it seems to be working.
Everyone could use a Lady Doctor.
I got a lady doctor
She cures the pain for free
I got a lady doctor
And there ain't nothing wrong with me
I went in with a heart burn
Into the surgery
To my surprise, two pretty eyes
Was running up and down me
Said now be a patient patient
Stretch right out on that couch
Help yourself to the pills, cure your ills
I'm never gonna square it on out
I got a lady doctor
She cures the pain for free
I got a lady doctor
And there ain't nothing wrong with me
All the cats said go see her
It's only just down the road
You go in with pneumonia
Come out with just a heavy cold
She won't give you no jargon
No medical "how do you do?"
Just get right down on that stethoscope
Baby, let that lady mess on with you
I got a lady doctor
She cures the pain for free
I got a lady doctor
And there ain't nothing wrong with me
"Routinely after counseling a patient on surgical options, I am almost 100% of the time asked “so who will perform the surgery?”"
-- Isn't that a normal question?
Reporters never understand statistics. Thus news reports about them are never reliable. Even most researchers are bad with stats.
Thinking about it...I saw a new doctor for the first time in January. I chose another female. She was very nice and we chatted away. But I had a purpose in my chatting. I could conceivably start another fifteen to twenty year relationship. I wanted to get a feel for whether she planned so stay in San Diego.
I asked her a lot of questions an employer shouldn't. How long has she been in town? Is she married? Does she have children? Was she planning for more?...
I could have asked her directly if she thought she was going to stay here, but people lie. My husband has now gone to see her.
My male doctor has decided that anti-Trump chatter is his way of showing good bedside manner
He must feel a need to school you.
Bless his heart.
I met a Doctor from Mongolia who visited our church.
I asked about medicine in Mongolia. She related that Mongolia had a shortage of doctors for a time. So the Russians, or the sock puppets of the Russians, gathered a large cohort of women and shoved them into medical school to be doctors.
This story has all sorts of layers, depending on how one looks at life. My primary take away is that I won't see a doctor in Mongolia. Not for sexist reasons. Just because I feel a Socialist thumb on their quality control scale.
30% of NHS doctors in Britain are foreign born. They've been encouraging that for 50 years. Looks like the former colonies have more need of them.
30% of NHS doctors in Britain are foreign born.
It is going that way here too.
Likewise engineers with advanced degrees.
And from the Middle East or SE Asia.
MikeR said...
"The difference in mortality was slight — about half a percentage point" That's called a negative result. There was no significant difference in mortality. Unless the sample was really huge.
Yes.
You would think journalists could get at least this sort of statistics right, since it's the kind they do constantly for one year out of every four.
"The poll shows the purple candidate for President in a statistical dead heat with the green candidate, leading by only 1 percentage point, well within the 4.2% margin of error..."
But, as always, identity politics wins, no matter the margin of error.
So making female heart surgeons feel undervalued results in better health outcomes for their patients?
That's an interesting path to walk down.
Lol, if the study showed that male doctors outperformed, would the NYT ever report it?
I prefer a female doctor just because when it comes down to examining those parts I'd rather have a chick doing it.
You know, smaller fingers and stuff.
Mainly I just go to them to get drugs anyhow, so whatever.
If you're not proving yourself daily, then you don't have a very challenging job. What a boring life that would be.
It's not just women who face this of course.
"I am almost 100% of the time asked “so who will perform the surgery?""
That isn't that strange. I've asked a male doctor that. The patient doesn't know how many layers of people he's dealing with.
Yeah, but it happened to her, a women doctor. So therefore it happens disproportionately to all female doctors.
Or something. Do they teach logic in Med School?
Utter pc bullshit as usual from current day NYT.
Not unlike what they headlined a few years ago, I paraphrase, “ companies run by female CEOs outperform those led by male CEOs”. They cited numbers from some feminist group as their basis. As a very, very senior headhunter I can tell you that my 25 year experience across virtually all industries, and globally, this is pure propaganda. Great leadership is not a gender driven characteristic.
Similarly, the canard that women earn less than men is also bs. Fact is that men IN AGGREGATE earn more in total as a group than all women as a group. Men tend to have more of the dangerous, risk based paying jobs, do not take maternity leave, have disproportionate representation in higher skill higher paid jobs in medical, teaching, white collar etc roles. Think brain surgeon vs dermatologist, elementary ed vs college prof, engineer vs secretary as examples. As for women in the same job as men, all corporations have compensation ranges for each job position, so male and female employees are paid relatively the exact same. Based on my experience, one could argue that qualified women ( and minorities) often are paid at the top of the scale as they are more in demand and in shorter supply for achieving diversity targets than are white males.
when it comes down to examining those parts I'd rather have a chick doing it
Check her fingernails first.
I was skewered for a bladder exam 2 years ago. Just as glad it was a male, though they put two personnel in the room for intimate procedures. You get a roomful for colonoscopies.
I would bet that people with more serious conditions choose a male surgeon...which means higher risk of death.
I went to go see an orthopedic doctor about my knee. I did not know that he was an orthopedic surgeon. When it came time to schedule the cortizone shot, I asked him who would be performing the surgery. Did I damage his agency as a person or was I just unclear about what type of doctor he is?
"Small hands,great control and unassisted eyesight and endurance."
That is why I assumed that women surgeons would be more gentle and have small motor skills.
I didn't see it but there may be more skillful women surgeons now. One of my best medical students, a girl from China that I have mentioned before, is now a breast surgeon. I think a lot of women in surgery go into that field, which is low risk and limited hours.
Women surgeons have pretty much taken over breast centers, just as male OB residents can't find a job.
As for primary care, my wife who is a nurse practitioner, was the family doc for my daughter-in-law's family for years.
We were divorced at the time, but she would call me for advice about cases that puzzled her. She was working foe a GP who was supposed to supervise her work but he was very busy and did not have time.
They did not realize we had been married.
We have since remarried.
To those arguing that half a percentage point is insignificant:
If your index finger weren't plumb tuckered out from typing comments all day, you could click through to the the NYT article and from there to the published study. It turns out that it used a whopping sample size of over 1.5 million. So, as the study itself concludes, yes, half a percentage point is statistically significant. P < .001 and a margin of error was provided.
It's not only journalists for whom statistics are hard.
No avoiding the Althouse Rule here.
Openidname said...
To those arguing that half a percentage point is insignificant...It turns out that it used a whopping sample size of over 1.5 million. So, as the study itself concludes, yes, half a percentage point is statistically significant. P < .001 and a margin of error was provided...It's not only journalists for whom statistics are hard.
I'm sympathetic to your comment, and I have no trouble believing that there is a repeatable, measurable (albeit small) difference in outcome that seems attributable to gender, but it's worth pointing out that P values, even very strong ones, are not necessarily appropriate tools for every study and can be misinterpreted very easily. Not only journalists, but published biomedical researchers find statistics "hard."
This has led to a (dare I say significant?) movement aimed at challenging their overuse in the literature. Based on my firsthand experience in the field, I'd gladly take a wager that most biomedical researchers (including peer reviewers of the literature) would be utterly incapable of explaining the appropriateness of using a P value to characterize their own studies (versus other statistical tools) that goes much beyond, "Everyone else uses them, so I guess I should, too."
For those interested in understanding the issues a little more, Derek Lowe had a good blog post on the subject not too long ago at Science.
The main point I wanted to comment on was the remark by the female surgeon about getting asked about who will perform a particular surgical procedure. I don't doubt that she may get asked the question somewhat more frequently than male counterparts, but, FWIW, it's a question that I ask 100% of the time any loved one is getting surgery, regardless of the gender of the surgeon, and I suspect that's true for most medically-savvy patients and family members. I absolutely believe and sympathize with her remarks about the real world issues of being a female surgeon in such a male-dominated field, but I am surprised that's the example she used, when I'm sure that there are much more egregious examples of outright sexism she is likely to have experienced in and around the operating theatre.
@ OpenIDname - I NEVER click to the NYT. If YOU read carefully, you would see that I asked the question, I did not answer it. While you are analyzing the NYT article for us, did the study control for any other factors, or just M, F and mortality?
An interesting article on the NHS doctors.
Patients’ groups said the rise of the part-time GP was “terrifying” given the national shortage of family doctors - fuelling ever longer waits for an appointment. But GPs said the job has become so intense that full-time working was increasingly “untenable”.
The survey of more than 2,000 family doctors shows that on average, they are now carrying out 6.7 half-day sessions a week - the lowest figure on record.
Patients’ groups said family doctors were lucky to be able to opt for part-time hours, with average earnings of more than £100,000 for a GP partner.
For the last five years, female GPs have outnumbered male family doctors, adding to demand for family-friendly working.
Separate polling of more than 700 trainee GPs reveals the vast majority have no intention of ever working full-time as a family doctor. Just 22 per cent plan to be working full time as a GP within one year of finishing their training, the research by the King’s Fund found.
When I was applying to medical school, admissions committees discriminated against female applicants, assuming they would only work part time.
Guess what ?
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