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Winter 2017


clinical medicine

The first card of the Rorschach test, developed in the 1920s by Hermann Rorschach. The test is one of several projective tests, which, broadly speaking, are designed to tap the unconscious attitudes or motivations of the person taking the test.

You may live longer if your doctor is a woman, according to research published late last year by Ashish Jha ’96 and a team of collaborators. And while you’re digesting that, think about this: Recent research has shown that significant salary inequities persist between female and male physicians, a discrepancy that previously has been attributed to women’s career patterns, with women on the short end of the earnings stick.

Reflecting on the findings, Jha, an HMS professor of medicine at Brigham and Women’s Hospital, said in an interview that the salary gap “is particularly unconscionable given the performance of women in terms of providing high-quality care.”

Research from as far back as the mid 1990s has reported that women physicians provide higher-quality care and that practice patterns between male and female physicians differ, with women tending to hew to guidelines more strictly, to recommend preventive care more often, and to use patient-centered communication more than their male counterparts.

The recent study by Jha and his team from HMS and Harvard T.H. Chan School of Public Health is one of the first to look into whether these differences had an effect on patient outcomes. The research also examined whether the influence of physician sex on outcomes differs across disease states and severity of illness. Overall, it provides empirical evidence that patients of women physicians have better outcomes than those treated by men.

The study, published online on December 19, 2016, in JAMA Internal Medicine, worked with a sample of Medicare beneficiaries 65 and older who were admitted to acute care hospitals over a three-year period from 2011 through 2014. Outcomes were measured based on mortality and readmission rates within 30 days after discharge.

In a final sample of 1.5 million hospitalizations treated by nearly 58,000 physicians, patients cared for by female physicians had a lower 30-day mortality rate and significantly lower readmission rates after correcting for patient characteristics, including age, sex, race, and primary diagnosis. The authors estimate that 32,000 lives could be saved “if male physicians could achieve the same outcomes as female physicians every year.”

Other authors included Daniel Blumenthal ’11 and Anupam Jena, of HMS and Massachusetts General Hospital, and Jose F. Figueroa ’11, John Orav, and Yusuke Tsugawa, of the Harvard Chan School and Brigham and Women’s Hospital.  

Image: Hermann Rorschach, Psychodiagnostics Plates, Hans Huber Medical Publisher, Bern (CH), 1927 

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