12.3% against 13.7%: what a million Ontario hospital stays say about who treats you

A large new study from Canada has a headline that invites a quarrel. Read past the headline and it offers something more useful: a list of habits.

Researchers analysed 958,150 adult patients admitted to hospital in Ontario between 2008 and 2022; their median age was 74². All had one of seven common acute medical conditions: heart attack, heart failure, atrial fibrillation, stroke, pneumonia, COPD or gastrointestinal bleeding¹. The team looked at 15,165 physicians and asked who was mainly responsible for each patient over the whole stay, not just at admission. In about 27% of cases that was a woman, in about 73% a man¹.

The adjusted 30-day death rate was 12.3% for patients mainly treated by women physicians and 13.7% for those treated by men, a gap of 1.4 percentage points¹. Readmissions within 30 days differed far less: 18.6% against 18.9%¹. Death rates were also lower at 90 days and one year, and a higher share of days under a woman’s care went with better results¹. Atrial fibrillation was the exception, with no clear link¹.

The study shows an association, not a cause¹. The authors point to explanations from earlier research: more patient-centred communication and more time for conversation, more consistent use of appropriate tests and guideline-based treatment, more caution with some treatments and more frequent consultation with colleagues¹. Each of these is teachable, auditable and dull, which is exactly why it matters.

One of the authors, Angela Jerath, put the point plainly: the aim is not to favour one group of doctors, but “to identify practices and behaviours” that can improve care across the whole system¹. For you as a patient or relative, the practical lesson is not to request a doctor by sex. It is to ask the questions that good practice answers anyway: what is the plan, which guideline does it follow, and who else has looked at it.