to a University of Montreal research team, the quality of care provided by
female doctors is higher than that of their male counterparts while the
productivity of males is greater. The research team reached this conclusion by
studying the billing information of over 870 Quebec practitioners (half of whom
were women) relating to their procedures with elderly diabetic patients. "Women
had significantly higher scores in terms of compliance with practice
guidelines. They were more likely than men to prescribe recommended medications
and to plan required examinations," said lead study author Valérie Martel,
who devoted her master's thesis with the Department of Health Administration to
the subject. Roxane Borges Da Silva, Professor at the Faculty of Nursing, and
Régis Blais, Professor at the Department of Health Administration,
co-supervised the study.
quality of care, the researchers relied on the recommendations of the Canadian
Diabetes Association, which provides clear guidelines for clinical treatment of
the disease. All patients aged 65 and over with diabetes must undergo an eye
exam by an ophthalmologist or optometrist every two years. They must also
receive three prescriptions for specific drugs, including statins, and it is
recommended they undergo a complete medical examination annually. Since the
Quebec public health insurance board (Régie de l'assurance maladie du Québec)
medical-administrative data bank includes comprehensive information on every
medical procedure, the researchers were able to measure these variables. In
each case, statistical tests confirm a significant difference between men and
middle-aged doctors, three out of four women, for example, required their
patients to undergo an eye examination vs. 70% of their male counterparts; 71%
prescribed recommended medications compared to 67% of male doctors, and a
similar proportion prescribed statins (68% vs. 64%); 39% of female doctors
specifically asked their patients to undergo a complete examination (vs. 33% of
male doctors). In terms of productivity, there is a reversal. On average, male
doctors reported nearly 1,000 more procedures per year compared to their female
study includes a section on clinicians' age. "My hypothesis was that the
differences between male and female practices have diminished over time. It
seemed to me that more and more men are taking time with their patients at the
expense of productivity, and more and more women tend to increase their number
of procedures. This aspect was shown: the younger the doctors, the less
significant the differences," she said. "People assume that women
doctors spend more time with their patients, but it is difficult to observe in
a scientific study. This study does just that," Blais added.
he cautions against misinterpreting the results. While a more productive doctor
would seem more "profitable" for a hospital, there is more than meets
the eye in the long term. "Doctors who take the time to explain problems
to their patients may avoid these patients returning after a month because they
are worried about a detail. More productive physicians may not be the ones we
think," Blais said.
context of the feminization of the medical profession, the results "should
be of concern of decision-makers in terms of human resource planning in health
and the challenges posed by the increased prevalence of women," the
authors write in their conclusion. "In particular, the cost-benefit ratio
of greater quality combined with lower productivity should be examined."
on the reorganization of the health system is therefore required. "Gender
parity has been recognized for several years among general practitioners. Among
specialists, we're almost there. However, women temporarily leave the network
to start a family. They work fewer hours to spend more time at home when they have
children. Inevitably, this change has an effect on the management of resources.
We need to prepare for these changes," Martel said.
Silva agrees. "Our study lifts a corner of the veil on this issue and has
several limitations. For example, it is not known whether medical prescriptions
and recommendations for examinations are followed. But the differences remain
significant. They tell us about the differences in medical practice that need
to be taken into account."
Silva continues her work in studying other chronic diseases such as
hypertension, asthma, and chronic obstructive pulmonary disease. Recently hired
by the Faculty of Nursing after working for two years at the Department of
Health Administration, she obtained a master's degree in Econometrics from the
Université d'Aix-Marseille and a doctorate in public health before joining the
Université de Montréal faculty.