You are less likely to die if your doctor is female

Xavier Prida dr.xavier.prida at GMAIL.COM
Wed Dec 21 19:08:55 UTC 2016


Furthermore, why lower mortality with diagnosis of sepsis, pneumonia, acute
renal failure, arrythmia for female physicians, but equipoise with heart
failure , UTI, and GI bleeding for female vs male physicians. Are the
posited qualities that are thought to mediate the advantage such as
adherence to guidelines and evidence base or communication skills diagnosis
dependent?

On Wed, Dec 21, 2016 at 11:49 AM, Hess, Dr. Donald <
dhess at susquehannahealth.org> wrote:

> I have a question for anyone who actually read the article: How did the
> authors determine that a given patient was specifically treated by a female
> vs. male hospitalist? Because of rotating shifts and schedules, the
> majority of patients are treated by both male and female hospitalists.
>
>
>
> Regards, Don
>
>
>
> Dr. Donald Hess
>
>
>
> *From:* Peggy Zuckerman [mailto:peggyzuckerman at GMAIL.COM]
> *Sent:* Wednesday, December 21, 2016 1:31 AM
> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> *Subject:* Re: [IMPROVEDX] You are less likely to die if your doctor is
> female
>
>
>
> My example will be inadequate to explain some of the differences that may
> exist between the listening and social skills of men and women, but I must
> note that there are very successful salesmen.  Their listening skills and
> ability to draw out the needs of their customers and to respond to those
> needs makes them successful.  Those same skills are not typical of many
> men, but can be taught to them.   Wondering if there is not a lesson to be
> learned from this field.
>
>
>
> Naturally, I have to take note that the female is often thought to have
> these necessary social (and dare I say, nurturing skills) more frequently.
> However, there are vast differences in the female population as to that.
> The less-nurturing female may seem somehow odd, cold, etc, while the
> more-nurturing male is thought to be odd, but in a more positive manner.
>
>
>
> Assuming I have gotten myself in trouble with both the males and the
> females of the species...
>
>
>
> Peggy
>
>
>
>
>
>
> Peggy Zuckerman
> www.peggyRCC.com
>
>
>
> On Tue, Dec 20, 2016 at 3:52 PM, HM Epstein <hmepstein at gmail.com> wrote:
>
> So, Dr. Jena, where do you think gender plays a role in diagnostic
> accuracy? Patience in listening to patients?  I don't want to display
> gender bias but there are many studies that demonstrate that while our
> brains are very similar, stereotypical female brains process data
> differently than stereotypical male brains do. [See cartoon below ;-) ]
>
>
>
> [image: Inline image 1]
>
>
>
> Or perhaps we can identify it within Buster Benson's Cognitive Bias Cheat
> Sheet
> <https://betterhumans.coach.me/cognitive-bias-cheat-sheet-55a472476b18#.lmlyvgxp3>under
> Problem #3: Need to Act Fast such as "Illusory Superiority" or "Egocentric
> Bias"?
>
>
>
>  "In order to act, we need to be confident in our ability to make an
> impact and to feel like what we do is important. In reality, most of this
> confidence can be classified as overconfidence, but without it we might not
> act at all."
>
> See:* Overconfidence effect, Egocentric bias, Optimism bias, Social
> desirability bias, Third-person effect, Forer effect, Barnum effect,
> Illusion of control, False consensus effect, Dunning-Kruger effect,
> Hard-easy effect, Illusory superiority, Lake Wobegone effect, Self-serving
> bias, Actor-observer bias, Fundamental attribution error, Defensive
> attribution hypothesis, Trait ascription bias, Effort justification, Risk
> compensation, Peltzman effect*
>
>
>
> ​Regards,
>
> Helene*​*
>
>
>
>
> hmepstein.com
>
> @hmepstein <https://twitter.com/hmepstein>
>
> @DxErrors <https://twitter.com/DxErrors>
>
> Diagnostic Errors on Facebook <https://www.facebook.com/DiagnosticErrors/>
>
>
>
> On Tue, Dec 20, 2016 at 9:39 AM, Jena, Anupam Bapu <
> Jena at hcp.med.harvard.edu> wrote:
>
> Hi Mark, wonderful to hear from you! I’ll share my thoughts and Ashish
> should chime in.
>
>
>
> First off, terrific question, but hard to say.  The first issue we
> have/had to address is whether our findings are driven by something
> unmeasured about the patients male and female docs see. We don’t think
> that’s likely b/c we focus on hospitalist physicians who within the same
> hospital are plausibly ‘quasi-randomized’ to patients, i.e., patients don’t
> choose M vs F docs in that setting. We also observe that the
> characteristics of patients are similar, which is consistent with the
> randomization hope.
>
>
>
> That begs the question, why? It’s not about spending intensity, LOS, or
> where patients are discharged. We look at those. So, we are left w/ two
> things, are there slightly more misdiagnosis, incorrect treatments, or a
> hybrid problem of prognosis (i.e., may not matching the best treatment to a
> given patient).  If I had to guess, misdiagnosis would have to be an
> element b/c we are looking at mortality here. I think it’s more likely that
> a misdiagnosis may be made than the correct diagnosis made but the
> incorrect treatment offered. I say that b/c I think (w/o data) that doctors
> would be better at identifying the correct trx if they have the right
> diagnosis, but the right diagnosis may be elusive.
>
>
>
> There are reasons to think that misdiagnosis may play a role. There may be
> differences in the ability to ‘extract’ important information, due to time
> spent, patient comfort w/ the doctor, etc. All this is plausible but hard
> to know if it could actually improve mortality. I would lay my money on
> differences in clinical decisionmaking, e.g., anchoring, premature closure
> of diagnosis; these are features of decisionmaking that are different on
> average between M and F in other settings (e.g., finance is where this has
> been shown I believe).
>
>
>
> Those are my 2 cents!
>
>
>
> Hope all is well, Bapu
>
>
>
>
>
>
>
> Anupam B. Jena, MD, PhD
>
> Ruth L. Newhouse Associate Professor
>
> Harvard Medical School
>
>
>
> *From:* Mark Graber [mailto:graber.mark at gmail.com]
> *Sent:* Monday, December 19, 2016 12:51 PM
> *To:* Listserv ImproveDx
> *Cc:* Jha, Ashish; Jena, Anupam Bapu
> *Subject:* You are less likely to die if your doctor is female
>
>
>
> Patients of female hospitalists had lower 30 day mortality rates and
> readmissions - see article attached, or here: http://www.msn.com/en-us
> /health/medical/you%e2%80%99re-less-likely-to-die-if-your-
> doctor-is-female-according-to-a-new-study/ar-AAlKb6o?li=BBnb4R7
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.msn.com_en-2Dus_health_medical_you-25E2-2580-2599re-2Dless-2Dlikely-2Dto-2Ddie-2Dif-2Dyour-2Ddoctor-2Dis-2Dfemale-2Daccording-2Dto-2Da-2Dnew-2Dstudy_ar-2DAAlKb6o-3Fli-3DBBnb4R7&d=CwMFaQ&c=WO-RGvefibhHBZq3fL85hQ&r=Xq_etsANojVYFKQHAR8Zagjs9xmtdmxIs8TLN5U_xd4&m=68ElPU8pnAeaPazp_CS1XwQeoWWNNIpaw_i31Ex8pxE&s=SCe-wzgscmnZ7YLiXXpjUJt-xIMF2epKSMCbrRL7sEY&e=>
>
>
>
> Two of the authors were on the IOM panel that drafted “Improving Diagnosis
> in Health Care”, copied on this message.  Congratulations guys, and maybe
> you can help us:  Does this difference relate to doing a better job with
> diagnosis, treatment, or both?
>
>
>
>      Mark
>
>
>
> *Mark L Graber MD FACP*
> Senior Fellow, RTI International
> Professor Emeritus, SUNY Stony Brook
> President Society to Improve Diagnosis in Medicine (SIDM)
>
>
>
>
>
>
>
>
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>
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-- 
Xavier E. Prida MD FACC FSCAI
Assistant Professor of Medicine
Program Director Cardiology Fellowship Training
USF Morsani College of Medicine
Department of Cardiovascular Sciences
2 Tampa General Circle
STC 5 th Floor
Tampa, Fl 33606
813 259 0992 <(813)%20259-0992>(O)






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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