vendredi 23 décembre 2016

Female vs Male Physicians: Better Outcomes?


Female vs Male Physicians: Better Outcomes?

An early discovery  as a Medical Student was that Women made excellent physicians, that I wanted to be looked after by one, when the need arose. Male physicians used to say or hint, women cannot manage the rigours of a medical career with family life and that they were not fully interested in their careers. I also realized that in Australia and UK and Israel, there were far more women graduates than in the USA at that time and it took no brain to realize that it has to do with remuneration. 
Based on key findings, women make up a larger percentage of residents in:
  • Family medicine (about 58 percent)
  • Psychiatry (about 57 percent)
  • Pediatrics (about 75 percent)
  • Obstetrics/gynecology (about 85 percent)
The data show male residents prefer to specialize in:

  • Surgery (about 59 percent)
  • Emergency medicine (about 62 percent)
  • Anesthesiology (about 63 percent)
  • Radiology (about 73 percent)
  • Internal medicine (about 54 percent)
  •  women were substantially underrepresented in neurosurgery, orthopedics, urology, general surgery and radiology
You can see the gender specifics and annual income, as one of the incentives for male physicians to enter a speciality.
I did ask a senior female physician this question: why do women choose primary care specialties rather than subspecialties? Her answer was very convincing and to this day I believe it
Women choose primary care specialities, such as Paediatrics she said, I remember her name was Dr Cohen, herself had to forsake the dream of becoming a surgeon, because women care.
I have known a fair number of female physicians, an almost all of them are in primary care specialities or those requiring a much more humane touch (rehabilitative medicine, oncology). 
I usually mention the name of the mexican primary care provider to the Kickapoo Traditional Indians of Texas, Dra Estela Rosales Garza as an example of unselfish commitment for the welfare of her patients.
https://medicoanthropologist.blogspot.fr/2014/08/dra-estela-rosales-garza-incredible.html

so it was good to read this article .
Specifically, statistically significant differences were observed in mortality rates for female physicians' patients being treated for sepsis, pneumonia, acute renal failure, and arrhythmia. The mortality differences by physician sex were not statistically significant for patients with congestive heart failure, urinary tract infection, and gastrointestinal bleeding, the authors report.
"Patients' readmission rates were significantly lower for female physicians than male physicians for most of the conditions," they write.
Uysuke Tsugawa, MD, MPH, from Harvard T. H. Chan School of Public Health, Boston, Massachusetts, and colleagues published their study online December 19 in JAMA Internal Medicine.
I am an Endocrinologist, considered to be an erudite as well as caring specialty and I realize that in the future the majority of practising endocrinologists would be women.
A recent study had this to say:
According to a new analysis, over 70 percent of early-career trainees in endocrinology are women, while the majority (56 percent) of practicing endocrinologists are male. This indicates that female physicians will dominate the endocrinology workforce in decades to come and raises concerns that biases faced by women in medicine will have particular impact on this specialty. Endocrinology is the field of medicine devoted to conditions involving endocrine glands and hormones, including diseases such as diabetes. 
You cannot imagine how happy that makes me! I have noticed that at annual meetings of our professional societies, most of the young doctors attending are women, whether they were born in India or Iran or Malaysia or USA..
I dont have to read an article to acknowledge a fact that I had known all along ever since I entered medical school: women tend to be more caring and better than men in talking about feelings, which comes in very handy in improving the doctor-patient relationships.
Now that the doctors are being paid for better outcomes, this study is very timely as the majority of chronic diseases have better outcomes with female physicians, the long held disparity in income is set to disappear.

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