Doctors treat women differently from men when it comes to controlling cardiovascular risk factors, in ways that may be harmful — and it appears that the doctor’s gender makes a difference, according to a new report published in the Journal of the American College of Cardiology.
The report looked at previously published research on the subject, and found that in six out of eight studies, clinical outcomes in women were related to whether their doctor was a man or a woman. Although this evidence was somewhat limited — especially since it’s hard to know all the factors that go into treatment decisions — it does suggest a pattern of women potentially not getting the best possible care, the report suggests.
Impact of doctor’s gender on cardiac outcomes
For example, in one study looking at primary care settings, women with diabetes were much less likely than men to have their treatment for hypertension (high blood pressure) intensified — and this was even more true if their doctor was a man, as noted in an article on the report at MedPage Today. Doctors who were women were also more likely to intensify treatment of abnormal blood lipid (cholesterol and triglyceride) levels, suggesting that women with diabetes may receive better cardiac care from primary doctors who are women.
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But despite the differences seen in cardiovascular treatment decisions and outcomes based on whether a doctor was a man or a woman, most of the studies didn’t find any link between gender concordance (whether the gender of patients and doctors matched) and whether patients liked or trusted their doctor. Only two out of five studies that examined this issue found a link between gender and patient preferences, suggesting that even if women are getting less intensive treatment of cardiovascular risk factors, they may like their doctor and feel like he or she is responsive to their needs.
A variety of possible solutions
There are no easy solutions to the potential undertreatment of women for cardiovascular risk factors, but the report did include some basic recommendations. One is that there should be greater gender diversity in the area of cardiovascular medicine, which may be accomplished by changing policies to address bias in training programs and increasing mentorship opportunities for women. While women make up the majority of medical students in the United States, only 12.6% of cardiologists are women, the report notes.
The report also recommends gender-specific medical education that stresses potential barriers to effective communication, as well as further research on how the genders of patients and doctors affects treatments decisions.
“We need to incorporate comprehensive patient-centered communication and care into medical education,” said study author Malissa J. Wood, MD, co-director of the Corrigan Women’s Heart Health Program at Massachusetts General Hospital, in a press release from the American College of Cardiology. “It is imperative that we ensure that all physicians provide the same level of high-quality care for all patients, regardless of gender.”
But, Wood notes, “More research is needed to understand the physician behaviors associated with improved patient outcomes,” especially as they relate to different outcomes based on the genders of patients and doctors. “A better understanding of the mechanisms driving gender differences in patient outcomes, including whether patient–physician gender concordance truly impacts patient outcomes, can help guide targets for interventions.”
Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Be Heart Smart: Habits That Can Harm Your Heart.”