Women Die More From Heart Attacks Than Men -- Unless the ER Doc Is Female (scientificamerican.com)

Women who suffer from heart attacks may be at a higher risk of death in the emergency room if they see a male physician rather than a female one, a new study suggests. The study doesn't jump to conclusions, but doctors and cardiologists have a few theories. There could be a systematic bias where male physicians are not listening to female patients' complaints as readily as [those of] a man, or there could be a bias that favors men in the medical literature, leading to misdiagnoses in women. It may also be that female doctors do a better job than their male counterparts. "In the new study everyone was more likely to survive if they saw a female physician, and a study published last year [...] indicated all patients of female physicians had lower mortality and hospital readmission rates," reports Scientific American. From the report: Heart disease is the number-one killer of both men and women, but the latter are significantly less likely to survive heart attacks. According to 2016 American Heart Association statement, 26 percent of women will die within a year of a heart attack compared with just 19 percent of men. The gap widens with time: By five years after a heart attack almost half of women die, compared with 36 percent of men. The reason has eluded researchers for years, but the authors of the new study point to the disparity in male and female representation in emergency doctors as a potential source of answers. The researchers analyzed a Florida Agency for Health Care Administration database containing every heart attack case from every ER in the state (excluding Veterans Affairs hospitals) between 1991 and 2010.

The researchers divided 500,000-plus cases into four categories: male doctors treating men; male doctors treating women; female doctors treating men; and female doctors treating women. "All of those are statistically indistinguishable except for male doctor -- female patient," says Brad Greenwood, an author on the study and a data scientist at the University of Minnesota. If a heart attack patient is a woman and her emergency physician is a man, he says, her risk of death suddenly rises by about 12 percent. Put another way, a heart attack patient dies in the ER about 11.9 percent of the time overall -- but the research team found women with heart attacks will die about 12.4 percent of the time if their cases are handled by male doctors. This means approximately one out of every 66 women with heart attacks dies in the emergency room if she sees a male doctor rather than a female one.

Comments

Coud be that women lie more to male doctors

[Anonymous Coward]

Same way men will lie about their problems so as not to appear lesser. Nothing says women don't have pride.

Re:Coud be that women lie more to male doctors

[arth1]

I'm not sure that's the cause. The study also shows that male doctors with more experience with female patients have a better outcome than male doctors with less experience with female patients.
There are things women and men might lie about or unconsciously "adjust" in different ways. If you had a non-obese patient, the male might claim he weighs a little more than he does, and a woman might claim she weighs a little less than she does. But in a hospital setting, I'm sure they do actual measurements instead of relying on the patient.

But you may have touched upon a potential factor here: communication. It may be, for example, that female patients are less good at volunteering the important information, and that female doctors and male doctors with experience treating females have less problems communicating in a way where the female patient tells important things. Which may include things that a female patient may be uncomfortable disclosing to a young male, like also having an UTI, yeast infection, irregular periods or copper implant. And a younger male doctor may be more uncomfortable with and less good at getting this information, perhaps expecting "any other problems?" to cover that. A doctor that's experienced with either being a women or treating female patients may just be better at asking direct questions.

Re:Coud be that women lie more to male doctors

[cayenne8]

Actually, as I understand it.....womens' heart attack symptoms are often VERY different than mens' heart attack symptoms.

Often with women, the symptoms are very subtle, not the overt chest pressure and discomfort that men readily feel and will know is a problem.

I'm guessing that female doctors are likely more in tune with women and can sense what's going on a bit better than men can.....

That might be part of it.....

Easily fixed

[Anonymous Coward]

Have all doctors identify as women and all patients identify as men.

Females are different to males

[Anonymous Coward]

From the abstract: "We further find that male physicians with more exposure to female patients and female physicians have more success treating female patients."
http://www.pnas.org/content/early/2018/07/31/1800097115

Just seems like people with more experience in treating females are better at treating females.

So which is it?

[SlaveToTheGrind]

First proposition:

In the new study everyone was more likely to survive if they saw a female physician

Second proposition:

The researchers divided 500,000-plus cases into four categories: male doctors treating men; male doctors treating women; female doctors treating men; and female doctors treating women. " All of those are statistically indistinguishable except for male doctor -- female patient ," says Brad Greenwood, an author on the study

Since the second is apparently from an author, I'd tend to guess the first is "journalistic flair" (ahem) from someone carrying around a gender hammer. Unfortunately can't look at the study itself to confirm -- the link in TFS is actually to the AHA 2016 statement and the actual study is paywalled.

Re:So which is it?

[guruevi]

I can get to it since I have subscriptions to these journals:

If you want better P-values, the significance halves. The reporting was done on the raw data which shows a slight variation within the error bars. Even if the study is correct, it comes down that statistically speaking, 2 out of the 500,000 cases may have survived longer if they had a female doctor.

Re: Could it possibly be age?

[phantomfive]

It seems like if it were due to age, then the effect wouldn't disappear when female doctors were treating them.

Re:outrageous!

[asylumx]

It's odd that you don't see that it would still be the same study. Men survive more than women if the doctor is male, and women survive more than men if the doctor is female. There's plenty for both party's fanatics to be butt-hurt about, I guess you just decided to pick one.

Re:Maybe doctors don't want to go to jail

[Antique Geekmeister]

CPR is not used for mycoardial infarction. The heart stopping, such as from atrial tachycardia, is treatable with CPU. CPR is quite dangerous, it tends to break ribs and is not that efficient. The mortality rate for CPR is also quite high: if you ever perform CPR in the field, it's important not to blame yourself personally if it fails, even if you made small mistakes. Only roughly 1/3 of CPR patients survive.

Myocardial Infarctions are tissue death in the heart, caused by a blockage. They're typically painful because muscle tissue in the heart is _dying_. Many people have survived numerous small infarctions. ECG's, however, electro cardiograms, where electrodes are placed on the chest and a few elsewhere on the body to monitor heart activity, does involve at least opening up the shirt and exposing the chest.

Also, many patients are quite frightened in the emergency room. I can easily picture a frightened, older female patient, who grew up more than 50 years ago, being less frightened and less reluctant to share their full medical information with a male physician, and their family or caregivers less able to communicate with a male physician.

But gender is just a social construct!

[blindseer]

Just remove this meaningless social construct that is gender from the study and the problem goes away.

I've known this for some time

[rickb928]

A partner of mine suffered from agoraphobia terribly, sometimes suffering anxiety and tachycardia with HR over 220 for extended periods. Counseling, medication, nothing seemed to be effective, and she was a highly-skilled RN, just adding to her frustration. It ruined our relationship long before it became so debilitating she was considering changing her career.

One attack landed her in the ER and in front of the new-in-town cardiologist fresh from residency in a well-known hospital. According to the ER nurse he took a two minute look at the EKG, ordered tests stat, another two minute read, and was on the phone back to his residency hospital, booking air evac, and sending her to his mentor.

She had a conduction defect. Not merely undetected for her entire life, but actually ruled out by more than one cardiologist previously, certain she was just having panic attacks. Yes, this caused a few uncomfortable discussions, and this fresh new cardiologist left the area and joined a big-city practice, for he had stumbled into a nice, quiet city that loved its doctors, and did not appreciate having them called out as having missed one diagnosis.

Why? Well, first, women were once considered 'hysterical' beings, prone to problems that were psychological and not physical. This is hard to overcome, even generations later. And much heart disease is, even today, considered a male problem, as if women all eat well, suffer less stress, and are not physically active.

How many have died needlessly?