Women More Likely to Survive Heart Attacks When Treated by Female Physicians

A recent review of nearly 582,000 heart attack cases over the span of 19 years found that female patients had a significantly higher survival rate when treated by a female physician in the emergency department (ED).

“We find that gender concordance increases a patient’s probability of surviving a [heart attack] and that the effect is driven by increased mortality when male physicians treat female patients,” said Brad Greenwood, MD, associate professor at the University of Minnesota and lead investigator on the study, in a statement.

Researchers reviewed records from Florida ED admissions for heart attacks between 1991 and 2010. The study authors considered many factors, including a patients’ age, gender, whether they had prior heart problems, whether the patient died during their stay at the hospital, and if the ED doctor primarily in charge of their care was a man or a woman.

Of the 580,000 patient records studied, 11.9% of heart attack patients died while in the hospital. However, when patients shared the same gender as their doctor, the probability of death fell 0.6% once all factors were considered.

For patients treated by female physicians, the gender disparity in survival rates was about 0.2%; specifically, 11.8% of male patients died, versus about 12% of women. However, for patients treated by male physicians, the gender disparity in survival rates increased to 0.7%, where 12.6% of men died compared with 13.3% of women. In addition, the researchers author noted that female survival rates also rose as the percentage of female doctors in the ED rose, particularly if the treating physician was male.

“These results suggest a reason why gender inequality in heart attack mortality persists: most physicians are male, and male physicians appear to have trouble treating female patients,” noted the study authors.

There could be a few reasons for this trend, Greenwood noted, such as female patients feeling more comfortable advocating for themselves when treated by a member of the same sex, as well as the fact that women tend to present heart attack symptoms atypically and female physicians may be better at picking up on those cues.

The results of the study have led authors to suggest that training programs should become more gender neutral and provide increased emphasis on how men and women might present symptoms differently.

Reference

Greenwood B, Carnahan S, Huang L. Patient­—physician gender concordance and increased mortality among female heart attack patients. PNAS. 2018;115(34):8569-8574. doi: 10.1073/pnas.1800097115.