In Women's Heart Attacks, a Doctor's Gender Matters

Male doctors are believed to misdiagnose heart problems for women or underestimate their risks

Male doctors are believed to misdiagnose heart problems for women or underestimate their risksPeopleimages Getty

The US study looked at 580,000 emergency room admissions over 19 years to see how the gender of the doctor affected the outcome.

Heart disease is the number-one killer of both men and women, but the latter are significantly less likely to survive heart attacks.

Although women patients matched with women physicians have been studied before, this study is the first time heart attack outcomes were assessed for gender concordance.

Whereas much more work is needed to understand the gender gap in heart attack survival, the new findings do imply having more female representation in hospitals may save lives, says Michelle Lall, an emergency physician at Emory University School of Medicine and president of the Academy for Women in Academic Emergency Medicine, who did not work on the study.

The team also found women were more likely to survive if the emergency department had a higher proportion of female doctors who had treated heart attacks - a trend particularly strong if the woman was being treated by a male doctor.

Lead scientist Dr Seth Carnahan, from Washington University, in St Louis, said: "Our work corroborates prior research showing that female doctors tend to produce better patient outcomes than male doctors".

Medical practitioners should be aware of the possible challenges male providers face when treating female AMI patients-for example, a propensity among women to delay seeking treatment and the presentation of symptoms that differ from those of men.

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The baseline rate of someone dying from their heart attack while in the hospital was 11.9 per cent. On average, men experience a heart attack at age 65 and women 72. That, said Greenwood, could be because female doctors might share their experience in tackling heart attacks in women. Furthermore, heart attacks can often present differently in men and woman.

The study did find two factors that seemed to "protect" patients from a poorer prognosis when treated by a male doctor.

Rather than rely on women to act as test dummies for inexperienced doctors, though, it'd better to just stock our emergency rooms and health care centres with more women doctors. For one thing, doctors may not be spending the time to realize that men and women may have different symptoms, and women may have more subtle symptoms, she said. "A male physician sees a female physician treat a female patient successfully, and sees potential cues. Male physicians may be less "deliberate" in addressing complicated patients' problems (as suggested by past research)". The records not only detailed the patients' ultimate fates, but also provided the names of their attending doctors, which the researchers used to figure out their gender.

And because heart attacks come about suddenly, patients are rarely able to choose their doctor - or his or her gender - when entering an emergency department. "Getting to an ER in a timely fashion is likely to matter more than the gender of one's physician".

Women suffering from a heart attack are more likely to wait before seeking medical treatment and are less likely to be taken to a properly-equipped hospital, making them almost twice as likely (12 percent) to die in the hospital than men.

Aditi Vyas, M.D. specializes in radiology and occupational and environmental medicine and is a resident in the ABC Medical Unit.

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