Heart Attack Prevention Video - Brigham and Women's Hospital
Women Survive Heart Attacks Better When Treated by Female Doctors
A new study shows a gender gap in patient mortality, depending on the sex of the treating physician.
By Stacey Colino
Medically Reviewed by Michael Cutler, DO, PhD
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It’s long been recognized that women have a higher risk of mortality after a heart attack. This has been thought to stem partly from the fact that women tend to delay seeking medical care for heart symptoms more than men do. Now, a new study suggests another possible explanation: If a woman goes to the emergency room (ER) with symptoms of a heart attack, the gender of the doctor who treats her could affect her chances of surviving.
In a review published August 6, 2019, in the journalProceedings of the National Academy of Sciences, researchers examined the medical records of nearly 582,000 patients who were admitted to Florida hospitals with heart attacks over 19 years, and their survival rates based on the gender of the treating physician. The most eye-opening finding: Female patients who were treated by male physicians in the ER had a higher mortality rate than those who were treated by female physicians. Looked at another way: Women were more likely to survive a heart attack (aka an acute myocardial infarction, or AMI) if a female doctor treated them in the ER.
What’s the Connection?
The exact reasons for this outcome aren’t known, but there are several theories. For one thing, “gender concordance often facilitates communication between the patient and the physician — men [doctors] might not be getting the signals they need to diagnose AMI, or might not pick up on the atypical symptoms women more often show,” notes Brad N. Greenwood, PhD, lead author of the study and an associate professor of information and decision sciences at the University of Minnesota Carlson School of Management in Minneapolis. “Alternatively, women may feel more comfortable advocating for themselves with a female physician. Or, female physicians might simply be faster at picking up on cues than their male counterparts.”
The study also revealed some interesting nuances: Women were more likely to survive a heart attack after being treated by a male physician if the ER had a higher percentage of female physicians; also, male physicians who have treated more female patients in the past are more effective at treating women with AMIs. “We need to be careful about why this effect might be appearing,” Dr. Greenwood says. “It could be that female physicians are helping their male counterparts — if they recognize something the male physician does not. Alternatively, it could be something about male physicians observing their female counterparts practicing and a tacit learning that emerges.”
What Patients Can Do
If you arrive at the ER with symptoms of a heart attack, you won’t be in a position to choose who treats you, nor should you choose based on gender.
“Certainly, training matters — we need physicians to understand that women and men are at risk for heart disease and strive for accuracy in diagnosis,” says Martha Gulati, MD, chief of cardiology at the University of Arizona College of Medicine in Phoenix. Doctors “need to be able to identify both women and men having a heart attack and know if there are sex differences” in their symptoms.
In both men and women, the most common heart attack symptom is chest pain or discomfort, but women are more likely than men to have atypical symptoms, such as shortness of breath, nausea or vomiting, light-headedness, or back or jaw pain, according to the American Heart Association.
Even if you’re not sure whether you’re having a heart attack, call 911 immediately if you have any of these symptoms. You’ll get treated faster, which is important because “when it comes to heart attacks, delays in getting care can impact outcomes,” Dr. Gulati says. It’s wise to have a friend or loved one come with you to the hospital to advocate on your behalf in case you can’t communicate optimally.
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