Reading Into Things


“I don’t want to see the oncologist you referred me to. I checked the online ratings and he got some pretty bad reviews. Find me someone else,” the phone message read.
The patient had multiple myeloma. The specialist I had picked was the best in the area for this condition. I had no idea what the reviews said. I just knew that this patient wanted to live. 

No amount of discussion would dissuade them. Even when I explained why I had chosen this specialist.

What do you look at when you are trying to pick a physician? What qualities are you looking for in a physician? Skill? Personality? What is the most important to you? How do you as a patient measure what is important? 

An interesting article I read the other day in the Journal of Medical Internet Research looked at cardiovascular surgeons in five states that allow reporting of outcomes data and compared the risk adjusted post-operative mortality rate with that physician’s online reviews from patients. 

Guess what?

There was no correlation. 

Now, here is something else provocative. In USA Today there is an article entitled, Don’t Want to Die Before Your Time? Get a Female Doctor. It is referencing a study published in JAMA today that found patients in the hospital who had female physicians were more likely to survive and less likely to be readmitted within 30 days of discharge.

“The researchers estimated that if male physicians could achieve the same results as their female colleagues, they would save an extra 32,000 lives among Medicare patients alone each year — a feat that would rival wiping out motor vehicle accident deaths nationwide.”

Practice differences between men and women translate into real, measurable differences in outcomes.

So, when we talk about income disparity between male and female physicians, one recent study showed that women are paid on average $20,000 less per year than their male counterparts

What a bargain, huh?

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121 thoughts on “Reading Into Things

  1. The important thing to me would be to have a physician that listened to you.
    I’m wondering if the female physicians do better statistically because they listen better to their patients?
    BTW, my physician is a woman.
    Leslie

    Liked by 2 people

  2. My oncologist has a reputation for not being warm and fuzzy. His on line reviews after reading between the lines confirm this. My surgeon’s nurse also told me this but she said for the situation I was in, if it were her, she’d want him as her oncologist. He is awesome. He was very business like and provided me with more than enough information and confirmed I understood everything. I work in a law office so this was fine by me, I don’t need warm and fuzzy, I need knowledge. However, he and I did connect and he has his warm and fuzzy side too. He told me at our last appointment that he really needed to get back to work as our conversation kept creeping away from my cancer treatment ๐Ÿ™‚ I would trust you to refer me to the right oncologist, you would do your research knowing placing the patient with the right oncologist is key.

    Liked by 3 people

  3. I had a female primary care physician. I did everything she said because I trusted her. She sent me to a cardiologist for a stress test. I had many symptoms of an impending heart attack and she was worried. I took the stress test and the cardiologist said my test was “within fairly normal parameters and I should stop listening to the hysteria from a doctor that was ONLY a primary care” two days later i had a nearly fatal heart attack. I know that the vast majority of docs are caring and empathetic humans that want the very best for their patients. But if these were the only two docs I had ever seen, I think I would be highly biased against male docs. And, the financial disparity sucks.

    Liked by 4 people

  4. Is it possible that woman physicians need to compromise families and a life
    outside of their speciality, if they want pay equality?
    We saw a retired cardiologist friend and his wife last week. In asking how his
    daughter a cardiologist in LA was? His reply was that she works more hours
    than she imagined. I asked why? You need to work that hard to keep up
    with her older partners. And yes, in doing so, her salary was higher.
    At home she has a nanny, 2 yr old twins, and a 3 yr old toddler, and a
    husband who helps when she is called out at night.

    Liked by 1 person

    • The study I quote here on the disparity took a much more objective point of view when looking at the disparity. They corrected for things like lower patient volume and such. That being said, I have chosen to not work as hard or make as much money because it is more important that I spend time with my kids.

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  5. The best doctor I had was a female. I think females tend to give up hope well after make doctors, don’t seem to let their egos keep them from doing the right thing, and actually listen to their patients. But I’m just generalizing, based on my experience, I’m sure.

    Liked by 1 person

  6. My GP is a lady, and smashing (if I can get to see her as I did today). The Consultants, Specialists, Nursing Staff and team of professionals who looked after me recently were mainly female. The oncologist I saw was male and fantastic. Talking with my GP today, she said I could not have been in better hands. It’s wrong that salaries differ so greatly between the sexes, but having confidence in your care and doctors was paramount for me, and I have to confess, I am glad my Consultant Surgeon was female.

    Liked by 1 person

  7. It may be that women read between the lines better than men. Patients leave a lot of things unsaid.
    I would certainly take my physician’s recommendation for a specialist over crowdsourcing, which I don’t trust on any level. (K)

    Liked by 2 people

  8. “What do you look at when you are trying to pick a physician?” Respect rises to the top. I need to be able to respect the physician and I need to be respected. I left a practice that I liked, because the doctor showed no respect for me.

    Example, he would not call my insurance provider to explain why he prescribed a medication that was working for me, but which the insurance provider doesn’t have on their list. I have allergies to the medicine they would recommend. I was told by the insurance company that I had a good reason and that they would probably grant an exception, but that they had to speak to the doctor. He told me that the loss of money to his practice while being on the phone was more significant than any savings I might enjoy. So, I was stuck paying $65 instead of about $7 for a prescription.

    When I asked him if he was planning to support a new insurance group in our area, one that has much better reviews and is growing very fast, he said “no”. He said that I should continue to see him as an “out of network” provider. I told him I could not afford to do that and he basically said I was being stupid for choosing a provider for financial reasons.

    Sorry for the lengthy comment, but I don’t care how medically good a physician or a specialist is, if I feel bad, before, while and after being treated by them. I don’t think that’s good for me. If I had paid attention to the insights in the reviews I found for this physician, I never would have signed up with him. I chose him because he was recommended by another health care provider.

    Liked by 1 person

    • I appreciate lengthy replies! It is hard for physicians to jump on the bandwagon with new payouts without knowing how they are going to hold up their end of the bargain for timely and commiserate remuneration (will I be getting paid for the work I do?) AND work with patients (i.e. How often do I have to call to argue a care plan for a patient?). That being said, I would never tell a patient to pay out of network to see me. That requires a significant amount of ego. And I do not understand why a physician would refuse to step up to get an Rx covered. I am glad you switched.

      Liked by 1 person

      • Thanks. The new provider was going into year three in our state and their network was (and still is) growing. Patients and physicians all give the high marks. I can understand not wanting to get on board, though. One more system to learn, I guess.

        The sad thing is that both providers and insurers like to say “we have your (me/my) interests at heart” but none seem to act like it. I feel like I have to research everything.

        Liked by 1 person

      • I agree that the system is getting to the point where everyone but the insurance companies are getting screwed over but in the end, the one person who really takes the hit, the real victim, is the patient. Sometimes physicians forget that fact.

        Liked by 1 person

  9. I don’t doubt your data about female physicians, but I wasn’t very impressed with my last female physician. Of course, that’s anecdotal, just like the reviews of doctors. It would be nice if we patients could have access to outcome statistics for individual doctors before deciding who we’ll trust with the knife.

    Liked by 1 person

    • The key is risk adjusted data and knowing how to interpret. There are plenty of surgeons now refusing to operate on anyone who is even a tiny bit risky because it will affect their published outcomes data. That is going to have an undesired effect on access to needed care. For primary care, quality is determined by how well our diabetic patients are controlled for instance. So there are patients getting dismissed from practices because their A1C is not pretty enough. How to convey quality of care in a meaningful way is a dicey thing. As far as female physicians are concerned, I would wager that there are as many bad ones as there are bad male docs. But apparently good care from the good female ones is better than good care from good male doctors. ๐Ÿ˜‰

      Liked by 1 person

  10. My radiologist was a pip but he was the most skilled in the area. I talked to my oncology surgeon (who had recommend him) about it and he helped me work through my distrust. I wasn’t looking for a drinking buddy. I was looking for a damn good radiologist and that’s what he was. Fortunately my surgeon was warm and fuzzy and approachable and I saw him a lot more often.

    Liked by 1 person

  11. i almost always look for a female practitioner. i have gotten burned by the female doctor personality of “i have something to prove because i’m not a man” but, in general, i prefer women doctors and they should definitely be paid more because they have to put up with more crap.

    Liked by 1 person

  12. I’ve chosen mostly female doctors when I could because I feel more comfortable taking off my clothes and confiding intimate personal details about my health to another woman. So I’m interested to read these stats! My husband chooses a lot of things based on online reviews, including doctors, so that statistic is interesting too. In his defense, it’s hard to know what are the best indicators to use when picking a doctor, especially for the first time, such as when you move to a new place.

    Liked by 1 person

  13. Problems between the patient and the medical professional could very well be the male to female relationship that caused the patient to reject the doctor you recommended. It could have been a simple misunderstanding from the beginning or even that one of them was reminded of someone they disliked intensely. That happens; it is called prejudice or pre-judging.

    For me finding a doctor blended with intelligence, skill and compassion is key. When a female lacks compassion, there can be nobody meaner. When a male enters medicine just to make money, there is no one less compassionate.

    Liked by 2 people

  14. I was going to send you that link!

    I look at a number of things in choosing a doctor. (1) Where they practice; I’m a complicated patient — I want to be treated by professors who teach their specialty to others; (2) Medical school — although I am less of a snob than I used to be. I do look at where they did their residency because that is an indication about how well they did in med school; (3) If i meet with them and don’t like them but think they’re a good doctor, sometimes I continue seeing them; if they are an asshole and I don’t trust their judgment, I’m outta there.

    I never read reviews. Never ever. Reviews are written by people who don’t like the doctor (or whatever other service). I also don’t care if my doc is male or female (although that salary discrepancy is disgusting).

    Liked by 1 person

    • Thank you for thinking of me when you saw the link! Where they did their residency says something about how well they did in med school but if they picked a hard program it says something about their work ethic, too. ๐Ÿ™‚

      Liked by 1 person

  15. The pay discrepancy is totally unfair and in this day and age…. SAD. I chose a doc by the reputation I hear about through the nurses.Worse doctor ever was a male. He was the head of endocrinology and supposed to be brilliant. I had seen him once and swore I would never return. Come to find out, he has a terrible reputation but because he is department chief, people are supposed to recommend him. I had to work with him again when we put on a wound symposium. What a jack ass.

    Liked by 1 person

  16. Sometimes when I read one of your posts I have the same reaction:
    1) I must be very naive that I’ve never noticed or thought of these issues
    2) I must be very, very lucky that I’ve never experienced or noticed these issues
    3) Maybe Canada and the US are on different planets.

    This has certainly been one of those posts. Yowzer.

    Liked by 1 person

  17. I still find it hard to wrap my head around income inequality. How does it even exist? Well, we know “how” it exists, someone in Business likes the extra money saved, but how did it come about? And why aren’t there more voices raised in protest? In a country that prides itself on its PC-ness when it comes to talking about terrorism, how is this un-PC issue not a banner one for liberals? Ok enough ranting for one morning, I need my meds….

    Liked by 1 person

    • I don’t get it, either. No, I do. Women have been led to believe that this is acceptable, that because they have to take time off to give birth, to take care of their children, to care for ailing parents…. that this is what we deserve. Less pay. It is gratifying, at least in this one study, that all of those things don’t really matter. Maybe it will succeed in encouraging the nurturer in all of us, men and women? Dunno.

      Liked by 1 person

  18. Total bargain. :/
    I have a bizarre prejudice about doctors. I’ve actually never cared about gender, apart from this one small thing, this not-nice preference. I don’t like white male American doctors. I’ve had some, an OB, a general surgeon, a pediatrician, a rheumatologist — just, they’ve all been extremely arrogant and condescending, and not a one of them has had a particularly… esteemed education, but they act like…Have you seen Alec Baldwin in Malice? I realize this sounds bad, but I have this preference nonetheless.
    If I’m fighting for my life, talk to me about stats, but overall, I just want a well-educated doctor who doesn’t act like a jackass. My family doctor apparently spoiled me for most. I still miss him.

    Liked by 1 person

  19. Yes conditioned by Scottish Doctors of the 1960s. But this is a small countryu town and although we do have a specialist here I prefer a visiting specialist from Adelaide or just go to Adelaide. I prefer a specialist from the main City Hospital.

    Liked by 1 person

  20. Ah yes…we’ve come a long way baby..from the continued disparity between male/female incomes (one main reason I’m in a commission based profession)…the fact that we tend to spend the effort to go online and review (anything!) only if our experience has been bad, lending an automatic bias to the negative (please people, realize where most of these are coming from!)…to being penalized for insisting on work/life balance (I’ve always maintained, I don’t need to make a million, I simply want to make a living.)
    I’d had a female PCP (or GP-General Practitioner, as we call them up here in the frozen north) for many years and remember a visit in which I waited for nearly 90 minutes and was still waiting. I informed her receptionist I was leaving as I had appointments waiting for me back at my office. My GP called me later that day and apologized. Very classy. Can’t imagine a male physician doing this. I have a male GP now (for completely different reasons) and I never wait more than a few minutes before seeing him (his commitment to work/life balance I’m sure) but I still don’t feel the same connection as I did with my previous doc.

    Liked by 1 person

    • It was classy that she called you, for sure! My observation would be that male physicians have an easier time than I do keeping patient visits on track as far as time is concerned. There are a myriad of reasons why. Maybe patients are more open with me, hence there is more ground to cover. I get asked TONS of questions about my personal life. Perhaps I am more in tune with the emotions of patients and end up delving into their personal life, depression/anxiety and such, than a male physician might. These are difficult things to study and measure, honestly.

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  21. Who puts that much faith in online reviews!? The interwebs are choked with bitter half-truths. I tell my daughters to take everything they see online with a healthy degree of skepticism.

    We need more women doctors and more women politicians, for that matter. I’ve always thought that but my opinion has been ratcheted up since having two daughters.

    Liked by 1 person

  22. I’m definitely against pay differences for same hours worked etc, but I have to say that my experience with a female doctor was pretty awful. My first gynecologist was a woman who was extremely dismissive of my concerns during a pregnancy and really awful at the delivery. I kept thinking I was imagining her insults and passive aggressive behaviors but my family and friends who sometimes came on visits agreed.

    My next gyn was a group practice of males who were kind, sweet and funny. My pregnancy was a much happier one and when I got a serious blood clot during a third and tragic pregnancy it was a male vascular surgeon who not only kept me alive but sat with me through the night as I almost bled to death after I was advised to terminate my pregnancy.

    I wonder if the studies don’t overstate things a little. Compassion and skill are not all male or female traits.

    I think one bad experience can color things a lot. (of course this doesn’t mean I dislike female doctors–I like you ๐Ÿ™‚

    Liked by 1 person

    • Experiences affect so much of our future perceptions! You are absolutely correct that there are bad female docs just as there are bad male physicians. All these studies can do is generalize based on behaviors. For instance, physicians DO tend to spend more time with their patients and they do tend to follow evidence based guidelines more then men but there are always going to be those outliers. What this study does, in my opinion, is highlight the fact that women have strengths as physicians, that certain behaviors (generally the things that male physicians perceive as weaknesses) DO translate into lives saved. Hopefully what we will see as a result is not that men are beaten down but that women are given their due respect and these positive behaviors, these things that save lives, will become more the norm rather than the exception. ๐Ÿ™‚

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  23. I wonder if the male physicians who have families and choose to spend more time with them suffer the same income loss as female physicians? That women’s skills are undervalued is an old, familiar story. The shocking part is that it is still happening. ๐Ÿ˜

    Liked by 1 person

    • My pay structure is based on how many patients I see, patient satisfaction scores, quality indices, and then all the “other stuff” like logging into websites monthly or attending meetings and such. In that structure, one would have a hard time seeing how it can be biased. I earn what I earn, regardless of my gender. Where it DOES come into play is when I have to be out for pregnancy or maternity leave or for sick kids. Those things are gender biased and I have taken huge hits financially because of them. For instance, I had no maternity leave.

      Liked by 1 person

  24. The important thing to me is a kind Dr. who takes me seriously. I want to feel like my Dr. has got my back.
    I actually put up reviews for Dr.’s I had one Rheumie who was so arrogant, nasty and so rough with me he hurt me and I was crying. He didn’t care. My Hubby was there for that appointment, he didn’t know what to do. Same Dr. misdiagnosed me. I told both my GP and my Internist that if they care about their patients at all to never send any to him. I found out my Internist consults said Dr. for situations like mine. That’s fine but I made it clear I will never go back to see him.
    I do rate MD thing when a Dr. is good and bad. Around here it seems the ratings are fairly accurate in general.

    Liked by 1 person

  25. I personally do not have a preference when choosing a physician. I came across good and bad both gender. I will leave a bad physician immediately in search of a compassionate doctor. There are doctors out there who are great, but lack bedside manner. Don’t need one like that. I will chose one that is caring , I believe that connection will make a difference in your care and recovery.

    Liked by 1 person

    • I agree. While online ratings may not say anything about a physician’s skill, really, it can give a clue as to their personality. Sometimes. It will be fun to drill down, hopefully, to the behaviors exactly that affect patient outcomes more positively. Is it only that female physicians are following evidence based guidelines more often or is it something more in how they generally treat patients. Female voices are picked for GPS programs because people respond to the voice better. Is that it? Hopefully they won’t just stop the research there. It would interesting to see if the positive effect on patient outcomes also extends to the outpatient arena. It is only an effect for the older Medicare patients or is there benefit for younger patients, too?

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  26. So true. My lady GP is wonderful, thoughtful and does not treat me as a ‘mental health’ patient. My wonderful male psychiatrists gets terrible reviews, many from patients who he can’t ‘fix’. It’s a thankless job and I am so grateful for you and all your good colleagues.

    Liked by 1 person

  27. Its so not right the difference in wages for men to women…its actually utterly ridiculous that there is a difference….I worked in dinner houses and the men on the line always got offered higher pay…so I stopped helping them…I could easily run circles around most of them…finally my boss heard one of them whining that I wasn’t helping them, hummmm doing my job on top of half of his too….not fair…he agreed and fired him and gave me a raise….yay….hang in there….I only have woman MD’s….I have had male doctors in the past, but to compare the different sexes, I think woman MD’s are more thorough and follow up is sooo much better…..so thanks for that……glad you back at work….even though you can never replace the time you get with your kids….but I agree on how difficult it can be to be sequestered in the same house 24/7 …LOL Happy New Year….kat

    Liked by 1 person

  28. Not surprised at the results. All of them.
    But then, if we are talking correlations, I would start by taking away one part of the equation:
    I dislike the very idea of on-line reviews. For Physicians. For teachers. (And my wife who’s a teacher and researcher disagrees). I do not believe that such reviews can be objective. The reviewers are not qualified, mostly, and too much emotion can easily sneak in. “He did not save my mother!” (Who was terminally ill).
    So let’s hear it for women. (From a biased sample of one) ๐Ÿ˜‰

    Liked by 1 person

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