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Are women really better doctors? A PhD in stats refutes viral story

(AP Photo)

(AP Photo)

Last week, the results of a new study claiming that women are superior doctors to men was featured in dozens of media-outlets, including the Washington Post, The Atlantic, Cosmopolitan, and NPR. The study, published in the JAMA Internal Medicine, concluded that “patients who receive care from female general internists have lower 30-day mortality and readmission rates than do patients cared for by male internists.”

Yet, a closer investigation reveals a number of problems with how the results of the study is being presented in the media.

William M Briggs, an academic with a PhD in Statistics from Cornell University, sounded off about the problems of the study in an essay he wrote for the website STREAM, which dedicates itself to “challenging the worst in the mainstream media.”

The new study which suggests patients treated by women do better isn’t convincing” he says.  

Not only is the difference between male and female doctor’s 30-day mortality rate very small (11.07% versus 11.49%), but there are numerous statistical issues with how these numbers were derived, says Briggs.

For example, these numbers are not real results. Rather, they have been “adjusted” based on over 1,000 different confounding factors (or “covariates,” in statistical terms.) Briggs gives the full statistical breakdown here.

“Are there other possible explanations to account for the small differences noted by the models? Yes. Female docs were about 5 years younger on average, and female docs also treated many fewer patients on average than men. This implies women docs had more time per patient,” he wrote.

“Even more intriguing, we also know “female physicians treated slightly higher proportions of female patients than male physicians did.” And since women live longer than men, particularly at those advanced ages, maybe — just maybe! — any slight change in mortality or readmission rates between male and female docs could be explained by women doctors treating more longer-lived patients.”

Other doctors have expressed concern with the results of the study. “I don’t really see where being a man or a woman affects you know how they’re being a doctor,” said Florida doctor Rashel Barnes.

Dr. Leah Lynch of Lee County, Florida said “It’s one study and we never make big decisions on one study.”  

Indeed, this is the first study to find such a result.

In an interview with Red Alert Politics, Yusuke Tsugawa, MD, PhD, a research associate at the Harvard School of Public Health, acknowledged that his study is the very first study to find such a result. “This is the first study that showed that female doctors have lower patient mortality and readmission rates compared with male doctors,” he said.

He also stood by the claims that media outlets have made, most of which regurgitate his study conclusion as true.

“The differences in patient mortality and readmission rates between male vs female doctors were statistically significant. We also argue that it was clinically significant” he said.

He also rebutted the idea that there could be other reasons for the small difference in mortality outcomes, such as the average age of female doctors or the possibility that female doctors may be assigned to more women (who live longer).

Tsugawa told Red Alert that there are no other reasons for the gender difference “other than the ones we explained in our paper, i.e., differences in adherence to clinical guidelines, evidence-based practices, patient-centered communications, and risk-taking behaviors between male vs female doctors.”

Tsugawa did not respond to a request for comment on Briggs critique as of press time.

UPDATE

Briggs provided the following statement to Red Alert responding to Tsugawa’s defense of the study:

“That women doctors treated more women patients, who live longer on average, especially in elderly populations, is more than enough to account for any observed differences in survival rate of patients. Besides, the study never (and this is key) presented the actual data. They only showed the results from overly complicated statistical models. And these can be used to say anything.”


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