Are female doctors better than male doctors? Data from observational studies give clues

What About Hospital Mortality?

A retrospective observational study from the USA, published in 2017, analyzed data from 1.6 million hospitalized internal medicine patients older than 65. It found that mortality and readmission rates were lower among patients treated by female physicians.

The 30-day mortality rate for patients cared for by female doctors was 10.8%, compared to 11.5% for those treated by male physicians. There was also a difference in readmission rates (15.0% vs. 15.6%). The analysis was adjusted for patient characteristics (demographics, comorbidities) and physician characteristics (age, education). Differences persisted across most primary diagnoses, regardless of disease severity.

Differences Persist

The same authors conducted an updated analysis last year aiming to assess how outcomes for hospitalized patients differed by physician and patient gender. Researchers examined a randomly selected sample of 20% of Medicare-insured patients hospitalized between 2016 and 2019. Again, the primary outcomes were 30-day mortality and readmissions. Of the total 458,000 female and 319,000 male patients, approximately 31% of cases were managed by female physicians.

Female patients treated by female doctors had significantly lower mortality (8.15% vs. 8.38%; average marginal effect [AME] −0.24 percentage points [pp]) and lower 30-day readmission rates (AME −0.48 pp) compared to those treated by male physicians. However, among male patients, there was no significant difference observed (mortality 10.15% vs. 10.23%; AME −0.08 pp).

Thus, even though the gender-related differences in patient outcomes have decreased compared to the original study, they remain significant among female patients. However, it remains unclear exactly what causes this gender disparity.

The authors themselves note that while the difference is statistically significant, it is relatively small. The study’s lead author, Associate Professor Atsushi Miyawaki from the University of Tokyo, suggests that female physicians "may help mitigate embarrassment, discomfort, and socio-cultural taboos during examinations and confidential discussions with female patients."

Systematic Review

This was further confirmed by a systematic review and meta-analysis published in January 2025 in the journal BMC Health Services Research. The random-effects meta-analysis included all observational studies of adult patients evaluating outcomes based on the treating physician or surgeon’s gender.

The primary outcome was overall mortality, with secondary outcomes including complications, readmissions, and length of hospitalization. Thirty-five observational studies with nearly 13.5 million patients were included (9 million surgical patients from 20 studies and the remaining 4.5 million patients from 15 studies on medical/anesthesiological care). Methodological risks of bias were found in 15 studies.

Mortality was significantly lower among patients treated by female doctors (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.93–0.97) for both surgical and non-surgical patients. A significantly lower rate of readmissions was also observed among medical/anesthesiological patients cared for by female doctors (OR 0.97; 95% CI 0.96–0.98).

In the qualitative synthesis of 9 studies involving 7.2 million patients, physician-patient gender concordance was typically associated with improved outcomes, especially for female patients treated by female physicians.

A Global Trend?

Interestingly, significantly lower mortality among patients treated by female doctors was consistently observed across studies conducted in North America, whereas studies from other continents did not demonstrate this effect.

However, it remains unclear whether this inconsistency is due to a lower proportion of female physicians, lack of data, or demographic and cultural differences. Therefore, large prospective studies from different regions are needed to confirm these findings.

Editorial Team, Medscope.pro

Sources:

1. Tsugawa Y., Jena A. B., Figueroa J. F. et al. Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians. JAMA Intern Med 2017; 177 (2): 206–213, doi: 10.1001/jamainternmed.2016.7875.
2. Miyawaki A., Jena A. B., Rotenstein L. S., Tsugawa Y. Comparison of hospital mortality and readmission rates by physician and patient sex. Ann Intern Med 2024 May; 177 (5): 598–608, doi: 10.7326/M23-3163.
3. Dressler D. D. Are hospital mortality and readmission affected by the sex of the physician or patient? NEJM Journal Watch 2024 Apr. 25. Available at: www.jwatch.org/na57405/2024/04/25/are-hospital-mortality-and-readmission-affected-sex
4. Grant K. Are female doctors better? Here’s what to know. WebMD 2024 May 1. Available at: www.webmd.com/women/news/20240501/are-female-doctors-better-heres-what-to-know
5. Heybati K., Chang A., Mohamud H. et al. The association between physician sex and patient outcomes: a systematic review and meta-analysis. BMC Health Serv Res 2025 Jan 17; 25 (1): 93, doi: 10.1186/s12913-025-12247-1.