Dr. Shikha Jain wants women to thrive in the medical field.
Jain is the founder of Women in Medicine, a Chicago-based nonprofit helping women advance to leadership positions as medical professionals while empowering men to help reduce and eliminate the gender gap in the field.
So she wasn’t surprised by the results of recent studies showing how good female doctors are at their jobs.
“Women are exceptional physicians, exceptional health care workers,” Jain said. “And despite that, they are not being appreciated for that and they’re being chased out of medicine.”
Two recent national studies found that patients are more likely to receive lifesaving care from women than from their male counterparts. But women in medicine often don’t have the same opportunities to advance in their careers, are overlooked for promotions and mentoring and are paid far less than men in the profession, several female doctors in Chicago told the Sun-Times.
“All of these things are driven by implicit and explicit bias,” said Jain, also a medical oncologist at UI Health. “So the challenge becomes how do we navigate a system that is set up with barriers for women to advance?”
One of the studies, published in the Annals of Internal Medicine in April, examined the hospital outcomes of nearly 800,000 patients ages 65 and older between 2016 and 2019. Patients who saw a female doctor were less likely to die and less likely to be readmitted to the hospital compared with those who saw a male doctor, researchers found. And female patients had even better outcomes when treated by women.
“There is evidence in the primary care setting suggesting that, compared with male physicians, female physicians are more likely to practice evidence-based medicine, perform as well or better on standardized examinations, and provide more patient-centered care,” the study reads.
Researchers suggest several factors are driving these differences. Male doctors may underestimate the severity of a female patient’s illness and female doctors are more likely to be deliberate in treating complicated problems. The study concludes that if male doctors could achieve the same outcomes as female doctors, an estimated 32,000 fewer patients would die each year.
Patients operated on by women also had fewer complications after surgery, according to another study published last August in the Journal of the American Medical Association looking at surgical outcomes for over 1 million patients.
Patients treated by men were 25% more likely to experience an adverse outcome one year after surgery compared with the patients treated by female surgeons, the study found. Adverse outcomes include death, readmission to the hospital and complications from the procedure.
Overlooked and underpaid
These findings come as more women than ever are practicing medicine in the U.S. By 2021, more than 37% of doctors were women, up from about 28% in 2007, according to the most recent data from the American Medical Association.
Still, women continue to get the short end of the stick.
Almost 40% of women physicians go part-time or leave medicine altogether within six years of completing their residencies, according to a 2019 University of Michigan study. Women working in medicine deal with more burnout than men, according to an analysis published in February by George Washington University School of Medicine and Health Sciences. They’re also paid significantly less. Over the course of a 40-year career, female doctors were paid $2 million less than their male counterparts, according to a study published in the medical journal Health Affairs in December 2021.
Women also often don’t receive feedback and mentoring that would help them be considered for promotions, said Dr. Vineet Arora, an academic hospitalist and the dean for medical education for the Pritzker School of Medicine at the University of Chicago.
And in environments where doctors need to take charge, like in operating rooms, women often pay a “likability penalty,” Arora said.
“They’re told to be more of a leader and to be more assertive, but when they actually do, they pay a penalty for acting against the gender norm,” said Arora, who also does gender equity research in medical education.
Princess Currence, chief officer of diversity, equity and inclusion at Rush University and a doctor of social work, wasn’t surprised by the studies’ findings either.
“Those people are not magic. The reason that happens is that the clinician has an experience and knowledge base that lends to better questioning,” Currence said. “When physicians have the same identity as their patient, they’re more likely to ask for more consults, do more referrals and request more tests. They will also ask nonmedical questions about their life.”
A doctor’s biases about gender, race, ethnicity or class, whether they’re aware of them or not, can lead to poor health outcomes for their patients.
“The clinical environment is a pressure cooker for bias,” she said. “When doctors are dealing with the stress of the illness or having little time to make decisions, they fall back on what they know because it’s quick.”
But when the doctor shares something in common with a patient — like a female doctor treating a woman — they’re more likely to ask questions that will lead them to a fuller picture of what could be wrong with the patient.
However, anyone can correct a bias they have, said Currence. Medical students at Rush are taught how to ask better questions, maintain their curiosity and learn about the context of their patients, such as the social, political or economic barriers they’re facing.
“Bias awareness is not about being nice,” she said. “It’s about being effective, having the best care, and looking at that patient in front of you and giving them full dignity and respect.”
Jain said these findings are not pitting men against women, or saying that men make for bad physicians. Rather, there seem to be certain strengths that women have, such as building relationships with their patients, that likely help them determine a diagnosis and effective treatments.
Despite the barriers, Jain is hopeful organizations like hers will not only lead to more women in leadership but also healthier patients.
“When the leadership is representative of the patient population being served, the outcomes are better,” Jain said. “So not only is it the right thing to do to keep women in leadership and to elevate them into leadership, it also is what’s best for the health of our communities.”
