Hospitalized medical patients treated by female physicians experience lower 30-day mortality rates and similar readmission outcomes compared to those cared for by male physicians, according to a large-scale observational study published on October 30 in JAMA Network Open.
The study analyzed 958,150 patients in Ontario admitted with common medical diagnoses between 2008 and 2022. Researchers examined outcomes across 259,759 patients treated by female physicians and 698,391 treated by male physicians, revealing a 30-day mortality rate of 12.3% for female physicians versus 13.7% for male physicians. Hospital readmission rates remained comparable at 18.6% and 18.9% respectively.
Unlike surgical evaluations where elective scheduling introduces selection bias, internal medicine admissions offer quasirandomization. Patients present directly to emergency rooms and face rotating assignments.
“An important strength of this study is that, unlike surgical care, patients admitted to hospital for medical conditions are generally assigned physicians based on rotating schedules rather than patient or referring physician preferences, helping to minimize referral bias,” said Angela Jerath, MD, who works as an adjunct scientist at the Institute for Clinical Evaluative Sciences and serves as an associate professor of anesthesiology and pain medicine at the University of Toronto, during an interview with Medscape News Canada.
Female Physician Care Correlates with Lower Mortality Risk
- Mortality Difference: Adjusted statistical models showed patients under female physician care faced a slightly lower relative risk of 30-day mortality.
- Quasirandomized Assignment: Because hospital medicine relies on rotating attending schedules rather than patient choice, the data successfully avoids the self-selection biases seen in elective surgeries.
- Behavioral Dynamics: Researchers point toward qualitative variations in communication styles, listening habits, and best-practice adherence rather than biological sex as the underlying mechanism.
Greater Exposure to Female Physician Care Improves Outcomes
Investigators expanded their operational model by measuring the proportion of in-hospital days managed by a female physician. “The findings demonstrate that the greater proportion of time a patient was cared for by a female physician, the better the outcome,” noted lead author Angela Jerath, MD—an adjunct scientist at the Institute for Clinical Evaluative Sciences and associate professor of anesthesiology and pain medicine at the University of Toronto, in a statement to Medscape News Canada—explaining that increased exposure to female physician care was linked to decreased mortality at 30 and 90 days, along with reduced 1-year readmission rates.
Jerath said that the results point to underlying behavioral differences. “The underlying cause for this isn’t gender,” Jerath told Medscape News Canada. “It’s most likely differences in behavior and practice that are probably engendered in some women. Women spend more time with their patients for the same surgery, but this is just one way of quantifying the qualitative difference in physician-patient interactions.”
Study (N=958K; 2008-2022) finds hospital patients treated by female physicians less likely to die or be readmitted vs those treated by male physicians. 30-day mortality: 13.7% for male physicians; 12.3% female. Readmit rate: 18.9% male; 18.6% female.https://t.co/AWCrOpLtg1
While both male and female patients demonstrated better clinical trajectories under female physicians, the magnitude of the effect increased for female patients. Jerath attributed this to a sense of shared identity or an understanding of lived experience.
Speaking with Medscape News Canada, study co-author Christopher Wallis, MD, PhD—who serves as an assistant professor of urology at the University of Toronto and a urologic oncologist at Mount Sinai Hospital in Toronto—explained that internal medicine settings enable researchers to assess physician teams and follow longitudinal care ratios.
| Physician Cohort | Patient Population (N) | 30-Day Mortality (%) | Hospital Readmission (%) |
|---|---|---|---|
| Female Physicians | 259,759 | 12.3% | 18.6% |
| Male Physicians | 698,391 | 13.7% | 18.9% |
Associations Do Not Establish Direct Causality
Because the study design relies on associations, it cannot establish direct causality between physician sex and survival rates. Christine Soong, MD, professor of medicine at the University of Toronto, told Medscape News Canada that multiple external variables influence inpatient metrics. “The temptation is to say that female physicians provide better care and reduce patient mortality, but that’s not supported by the data,” Soong told Medscape News Canada.
Soong emphasized that systemic elements, such as hospital procedural volume and specialized institutional experience, heavily affect patient prognosis. The underlying research received funding from the Institute for Clinical Evaluative Sciences, supported by the Ontario Ministry of Health and the Ontario Ministry of Long-Term Care, with additional backing from the Canada Research Chairs Program and the University of Toronto.
References
- Jerath, A., et al. (2026). Association of Physician Sex With Patient Outcomes During Hospitalization. JAMA Network Open.
Disclaimer: Statistical data in medical articles provide general population trends and do not dictate individual prognoses. Always seek personalized medical advice for healthcare decisions.
Does Physician sex impact on clinical outcomes in close to 1 million patients with an acute medical hospitalisation? Our @JAMANetworkOpen publication led by @propelresearch @JonZipursky @WallisCJD and colleagues suggests that pts cared for by female physicians experienced lower… pic.twitter.com/NXvyvsIp1y
