Patients seen by female gastroenterologists for initial consultations were less likely to utilize emergency department, hospital, or primary care services over the following 2 years compared with those seen by male gastroenterologists, according to study results presented at Digestive Disease Week 2024 in Washington, DC.
"If there really is something different about the way female and male gastroenterologists provide care that impacts patient outcomes, it will be important to share these learnings broadly among health care providers to improve the standard of care for all patients," said lead author Laura Targownik, MD, in an interview with this news organization.
The study analyzed data from over 2.7 million gastroenterology consultations between 2002-2020, drawn from the Ontario Health IC/ES population-wide database. Female gastroenterologists conducted 15% of the consultations, and female patients made up 55% of the study population. Overall, female patients had higher rates of emergency department visits (51.5 per 100 patient-years) and primary care visits (619.6 per 100 patient-years) compared to male patients (44.6 and 505.6 per 100 patient-years, respectively).
However, when female gastroenterologists provided the initial consultation, subsequent use of all health care services by all patients, regardless of gender, was lower compared with patients initially seen by male gastroenterologists. The reduction was more pronounced among female patients, with those who saw female providers having 43.4 ED visits, 11.1 inpatient visits, and 656.1 primary care visits per 100 patient-years, compared to 51.5, 14.5, and 619.6 respectively for those who saw male providers. Male patients also saw reductions, although smaller, with 41.5 ED visits, 14.1 inpatient visits, and 470.9 primary care visits per 100 patient-years after seeing female providers, versus 44.6, 15.8, and 505.6 after seeing male providers.
Determining the factors driving these differences is an ongoing process, noted Dr. Targownik, a clinician-investigator at Mount Sinai Hospital in Toronto. "When people see a female doctor, are female doctors doing something that is leading either to a change in a patient's overall health, maybe making them feel better, treating their disease better, or maybe providing another outlet for them to seek care so they don't necessarily need to go back to their primary care doctor?"
Patients are "talking about very sensitive issues with a gastroenterologist, [so] it is possible that this effect is more pronounced in GI compared to other fields," noted Jordana Herblum, a second-year internal medicine resident at the University of Toronto.
Dr. Targownik noted while female and male physicians may practice differently, the traits driving better outcomes are likely transferable. "The way I would take this is ... what do female gastroenterologists do that women find beneficial? And are those the type of things that we can teach" to men.
Grace Wang, a gastroenterology resident at the University of Toronto, highlighted the need for further research. "The next step is to take a closer look at the patient data – including preexisting conditions, the health care utilization patterns prior to an initial GI consultation, and the diagnoses that occur during that consultation – in order to investigate whether there are other factors driving patients' health care-seeking behavior."
All authors declared having no conflicts of interest.