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Female Doc Male Patient
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I'm a year-old guy and I just found out my new family doctor is female. I'm really nervous about this because she might need to see or touch me down there. I've had a history of painful infections when I urinate — and I have some questions about sex.

Name: Moreen

Age: 31
What is my ethnicity: Slovak
Tint of my iris: I’ve got misty hazel green eyes but I use colored contact lenses
Color of my hair: Gray hair
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Covariates held at sample means. Compared with the base mortality rate of were similar if we relied on the raw of female colleagues, as opposed to the percentage of female colleagues. In addition, when patients visit the emergency room ERthey have little agency over their choice of attending physician, allowing for a quasirandom asment of physician and patient We first examined mortality differences in outcomes when there was gender concordance between the attending physician and the patient i.

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are in Table Female doc male patient. In most models, the estimator was a linear probability model LPM. While nonlinear models, such as a logit, are sometimes used to model dichotomous outcomes, the LPM is easier to interpret, particularly for interaction terms 20and has been extensively relied upon by researchers using administrative data to examine patient mortality Nonetheless, we also reported from a conditional logit model.

suggest that medical providers may need to for the possible challenges physicians particularly male physicians face when treating AMI patients of the opposite gender. We saw P values of 0. We compared differences in the effect of Female Patient across male and female physicians using the Z-score approach noted in Clogg et al. Our decision to focus on ED admittances was deliberate, because it creates a discrete interaction between a patient and the attending physician, allowing for a clear and immediate measure of success i.

M is a vector of patient controls, including dummies for patient age yearlyseven dummies capturing patient race, and dummies capturing the 43 most common comorbidities listed in SI Appendix. We used the presence of female physicians treating AMI patients at the same hospital as the focal physician because female colleagues may offer opportunities for male physicians to benefit from intraorganizational knowledge spillovers as they may be more equipped to properly diagnose and treat female patients suffering from AMIs.

Finally, to further for physician heterogeneity, we created a matched sample that paired without replacement each female patient to a male patient who was treated by the same doctor in the same hospital in the same year. Finally, we examined contextual factors that may exacerbate or attenuate the effects to better understand the relationship between gender concordance and survival. K is a vector of fixed effects, either for hospital-quarter the most granular unit of time in the data or the physician, depending on the model being estimated.

Columns 7 and 8 replace the interaction term with a vector of patient—physician gender concordance dummies. were consistent using alternate measures of performance quality i. To empirically capture the effect of female colleagues, we interacted the percent of female physicians in the ED with the gender of the patient. Furthermore, and corroborating recent research, we saw that patients treated by female physicians were, in the unmatched sample, more likely to survive, regardless of patient gender Columns 1 and 2 display of the base interaction model without control variables or fixed effects.

Such analyses may help explain the stark relationship between gender concordance and survival and provide direction to policymakers Female doc male patient to resolve such issues. LPM and conditional logit estimates of relationship between gender concordance on patient survival with sample split by physician gender. in columns 1 and 2 indicate that survival rates were two to three times higher for female patients treated by female physicians compared with female patients treated by male physicians.

We split the sample by physician gender, which allowed us to see how these interactions vary across male and female physicians.

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This experience offers the physician an increased opportunity to experience any difference in symptom presentation that might occur between female and male patients. These persisted in the presence of a physician fixed effect columns 3 and 4but the moderating effect of female colleagues on female physicians dissipated in the matched sample columns 5 and 6. Columns 3 and 4 add control variables and hospital-quarter fixed effects. In addition to bed-level information about the patient e. However, distressingly, in the absence of gender concordance between advocates and those they advocate for—particularly in instances where men are advocating for women—women have been found to fare worse than their male counterparts, facing disadvantages in terms of pay equality 1ascension to leadership positions 2educational outcomes 3Female doc male patient dispute resolution 4and even medical treatment 5.

The baseline mortality rate is The estimated coefficient of gender concordance implied that gender concordance reduced the probability of death by 5. Furthermore, the likelihood of survival for female patients treated by male physicians remained lower when physician fixed effects were included columns 3 and 4in the matched sample columns 5 and 6and if the estimate was made by using a conditional logit columns 7 and 8. in Table 3 test the interaction effects by splitting the sample based on physician gender. in Table 2 indicate that female patients treated by male physicians were the least likely to survive an episode of care.

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To examine the effect of patient history, we interacted the of female AMI patients the physician treated in the last quarter the most granular measurement of time in our data with the gender indicator of the patient. Female colleagues might also influence ER protocols in a way which helps the diagnosis and treatment of female patients.

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This was done in two ways. Columns 5 and 6 includes control variables and physician fixed effects. LPM estimates of relationship between gender concordance on patient survival. In this work, we posit that gender discordance between physician and patient helps to explain why female patients are less likely to survive AMIs. We find empirical support for these ideas, documenting that gender concordance between the patient and physician influences measurable, substantive outcomes like patient survival and length of stay during an AMI.

Furthermore, this relationship is much stronger for female patients. Empirical extensions indicate that mortality rates decrease when male physicians practice with more female colleagues or have treated more female patients in the past. Finally, we examined conditions under which female patients were more likely to survive being treated by a male physician.

This approach allows patient characteristics to vary flexibly across male and female physicians.

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In this work, we posit that these difficulties may be partially explained, or exacerbated, by the gender match between the patient and the physician. We further argue that the benefits of gender concordance will be strongest for female patients due to the difficulty of diagnosing and treating AMIs in female patients.

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Furthermore, people do not always have their choice of advocate, and advocates may differ from those they advocate for in terms of values, beliefs, background, race, and even gender. Compared with the baseline mortality rate of This relationship was particularly true for patients treated by male physicians column 1although female patients also experienced better outcomes from female physicians in EDs that have a higher density of female physicians column 2.

We next broke concordance into its component pieces. LPM estimates of the relationship between gender concordance and patient survival as moderated by of female colleagues and of female patients seen by the physician. All other indicators were consistent with Eq. are in Tables 2 and 3 and displayed graphically in Figs. SEs are clustered at the hospital-quarter level. A full discussion of these data, including descriptive statistics broken down by physician—patient concordance and descriptions of the empirical estimations, are available in the SI Appendix.

We used physician name to infer gender and excluded from the sample those physicians with gender-ambiguous names.

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If more than one candidate match was available, one was selected at random. In terms of effect size, we see in column 8 that female patients treated by male physicians were 1. Using a census of heart attack patients admitted to Florida hospitals between andwe find higher mortality among female patients who are treated by male physicians.

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To examine the impact of gender match between patient and physician during an AMI, we used emergency department ED admittances of patients to Florida Female doc male patient between and Patients were identified by using International Classification of Diseases 9 diagnosis codes associated with their stay at the hospital i. Estimates include controls and hospital quarter fixed effects. In columns 1 and 2 of Table 4we see that female patients experienced better outcomes in EDs that have a higher percentage of female physicians. Waters July 3, received for review January 3, A large body of medical research suggests that women are less likely than men to survive traumatic health episodes like acute myocardial infarctions.

In the medical setting, research suggests that gender discordance may yield lower rapport and patient satisfaction 6reduced adherence to preventative care protocols 7and weaker patient—physician communication 8. With regard to patient history, columns 1 and 2 of Table 4 suggest that female patients treated by male physicians experience a 0. We further find that male physicians with more exposure to female patients and female physicians have more success treating female patients. In column 1 of Table 1we estimate Eq.

This result is robust to the use of the matched sample column 2the inclusion of controls and hospital-quarter fixed effects columns 3 and 4and controls with physician fixed effects columns 5 and 6. LPM estimates of relationship between gender concordance and patient survival. These concerns regarding the deleterious effects of gender discordance are becoming increasingly salient in the presence of two emerging literatures: a growing body of medical research suggesting that women are less likely to survive traumatic health episodes like acute myocardial infarctions AMIs and research examining performance heterogeneity across male and female physicians.

We examine patient gender disparities in survival rates following acute myocardial infarctions i. This type of experience might be particularly valuable for male physicians. Comparison group is male doctor, male patient.

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First, we used a simple interaction between patient female and physician male. We then examined each specific concordance configuration—men treating women, men treating men, women treating men, and women treating women.

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W is a linear measure of physician tenure, calculated as the of years the physician has been d to practice in Florida. To date, researchers have offered a of explanations for the gender disparity in AMI survival: Female patients may have Female doc male patient increased propensity to delay seeking treatment 9may present symptoms that differ from men 51011and may be more challenging to diagnose and treat At the same time, researchers have observed that female physicians outperform their male counterparts across a variety of conditions in terms of mortality and readmission once potential confounds e.

We posit that these challenges exacerbate the difficulty of diagnosing and treating AMIs, such that physician—patient gender concordance contributes to better patient outcomes. A deep body of social science research explains why individuals often possess in-group biases 14 and have difficulty communicating effectively with members of social groups who possess different ascriptive characteristics than their own Furthermore, extant work in physician—patient communication 816 and patient satisfaction 6 shows that these issues are salient in the medical setting.

Male patients and female patients experience similar outcomes when treated by female physicians, suggesting that unique challenges arise when male physicians treat female patients.

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