IMPORTANCEStudies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown. OBJECTIVE To determine whether mortality and readmission rates differ between patients treated by male or female physicians. DESIGN, SETTING, AND PARTICIPANTSWe 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). As a sensitivity analysis, we examined only physicians focusing on hospital care (hospitalists), among whom patients are plausibly quasi-randomized to physicians based on the physician's specific work schedules. We also investigated whether differences in patient outcomes varied by specific condition or by underlying severity of illness. MAIN OUTCOMES AND MEASURES Patients' 30-day mortality and readmission rates.RESULTS A total of 1 583 028 hospitalizations were used for analyses of 30-day mortality (mean [SD] patient age, 80.2 [8.5] years; 621 412 men and 961 616 women) and 1 540 797 were used for analyses of readmission (mean [SD] patient age, 80.1 [8.5] years; 602 115 men and 938 682 women). Patients treated by female physicians had lower 30-day mortality (adjusted mortality, 11.07% vs 11.49%; adjusted risk difference, -0.43%; 95% CI, -0.57% to -0.28%; P < .001; number needed to treat to prevent 1 death, 233) and lower 30-day readmissions (adjusted readmissions, 15.02% vs 15.57%; adjusted risk difference, -0.55%; 95% CI, -0.71% to -0.39%; P < .001; number needed to treat to prevent 1 readmission, 182) than patients cared for by male physicians, after accounting for potential confounders. Our findings were unaffected when restricting analyses to patients treated by hospitalists. Differences persisted across 8 common medical conditions and across patients' severity of illness. CONCLUSIONS AND RELEVANCEElderly hospitalized patients treated by female internists have lower mortality and readmissions compared with those cared for by male internists. These findings suggest that the differences in practice patterns between male and female physicians, as suggested in previous studies, may have important clinical implications for patient outcomes.
IMPORTANCE The proportion of women at the rank of full professor in US medical schools has not increased since 1980 and remains below that of men. Whether differences in age, experience, specialty, and research productivity between sexes explain persistent disparities in faculty rank has not been studied. OBJECTIVE To analyze sex differences in faculty rank among US academic physicians. DESIGN, SETTING, AND PARTICIPANTS We analyzed sex differences in faculty rank using a cross-sectional comprehensive database of US physicians with medical school faculty appointments in 2014 (91 073 physicians; 9.1% of all US physicians), linked to information on physician sex, age, years since residency, specialty, authored publications, National Institutes of Health (NIH) funding, and clinical trial investigation. We estimated sex differences in full professorship, as well as a combined outcome of associate or full professorship, adjusting for these factors in a multilevel (hierarchical) model. We also analyzed how sex differences varied with specialty and whether differences were more prevalent at schools ranked highly in research. EXPOSURES Physician sex. MAIN OUTCOMES AND MEASURES Academic faculty rank. RESULTS In all, there were 30 464 women who were medical faculty vs 60 609 men. Of those, 3623 women (11.9%) vs 17 354 men (28.6%) had full-professor appointments, for an absolute difference of −16.7%(95% CI, −17.3% to −16.2%). Women faculty were younger and disproportionately represented in internal medicine and pediatrics. The mean total number of publications for women was 11.6 vs 24.8 for men, for a difference of −13.2 (95% CI, −13.6 to −12.7); the mean first- or last-author publications for women was 5.9 vs 13.7 for men, for a difference of −7.8 (95% CI, −8.1 to −7.5). Among 9.1% of medical faculty with an NIH grant, 6.8%(2059 of 30 464) were women and 10.3% (6237 of 60 609) were men, for a difference of −3.5%(95% CI, −3.9% to −3.1%). In all, 6.4% of women vs 8.8% of men had a trial registered on ClinicalTrials.gov, for a difference of −2.4%(95% CI, −2.8% to −2.0%). After multivariable adjustment, women were less likely than men to have achieved full-professor status (absolute adjusted difference in proportion, −3.8%; 95% CI, −4.4% to −3.3%). Sex-differences in full professorship were present across all specialties and did not vary according to whether a physician’s medical school was ranked highly in terms of research funding. CONCLUSIONS AND RELEVANCE Among physicians with faculty appointments at US medical schools, there were sex differences in academic faculty rank, with women substantially less likely than men to be full professors, after accounting for age, experience, specialty, and measures of research productivity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.