If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.
The world of medicine has historically been dominated by men. But an August 2018 study published in the Proceedings of the National Academy of Sciences suggests that women who have heart attacks might have better outcomes when they are treated by female doctors. Researchers examined data on patients who were admitted to Florida hospitals with heart attacks between 1991 and 2010. They found a lower mortality rate among female patients who were admitted by female emergency department (ED) doctors as compared to male doctors.
Just for women: Learn your personal risk for heart disease.
Studies like these often raise questions in the minds of readers and prospective patients:
- Are female doctors more in tune with how heart disease can affect women?
- Are male doctors not aware of female patients’ needs?
- Should women request female doctors?
While valid concerns, these findings don’t address the major factors involved with women’s emergency heart care outcomes from female or male doctors. It’s not a battle of the sexes. The outcomes for women who have heart attacks depend on a number of factors, including an understanding of women’s heart attack symptoms, the team of providers involved, the trust women have in their doctors, and the culture of knowledge-sharing among doctors.
A Modern Understanding of Heart Attack Symptoms in Women
One big problem I have with this study is that doctors today have a better understanding of women’s heart attack symptoms than we did in the 1990s. We have all seen men in movies or TV shows who clutch their chest and fall to the ground with a heart attack, but women might have more subtle symptoms, such as:
- Back, chest, or abdominal pain or pressure
- Dizziness, lightheadedness, or fainting
- Shortness of breath
I suspect that if the same study were repeated with doctors today, researchers would get much different results. More doctors nowadays are trained in women’s heart attack symptoms, as well as what a patient’s symptoms might point to if they aren’t having a heart attack.
A limitation of this study is that they only studied ED doctors. Without a doubt, ED doctors are crucial in emergency cases such as heart attacks. Their experience is key in deciding if a patient is rushed into emergency surgery, admitted to the hospital for observation, or sent home with orders to follow up with their regular doctor.
But the ED doctor is only one person involved in a patient’s care. If the patient is admitted, they might see a number of medical professionals, including:
- A cardiologist
- A surgeon if we think the patient needs cardiac surgery
- A catheterization lab expert if we need to perform emergency cardiac catheterization
For example, a patient in her 40s came into the ED who was obese and had Type 1 diabetes. She complained of pain she described as indigestion—a symptom that could indicate a heart attack. Her test results were not very unusual, so the male ED doctor called me to come take a look. The patient’s body language when she experienced chest and stomach pain right in front of me absolutely resembled a heart attack. I called the interventional cardiologist on duty, a male, and suggested additional testing so we could know for sure. It turned out the patient had a 90 percent blockage in one of her arteries, reducing blood flow to the heart, which could have been life-threatening. But thanks to our teamwork, the patient recovered the next day with no damage to her heart.
And women also are more aware of the symptoms of a heart attack and their own risk factors. That’s due at least in part to awareness campaigns started within the last two decades. In fact, in February 1997, MedStar Washington Hospital Center launched one of the nation’s earliest campaigns to educate women – and their doctors – about the fact that heart disease affects both men and women. The hospital’s initiative gained national attention by shining a light on a widespread lack of understanding of heart disease in women, particularly among primary care physicians, and by raising awareness of women’s often subtle heart disease symptoms.
Then, in the early 2000s, the American College of Cardiology began to spread awareness of the fact that heart disease, including heart attack, are the No. 1 killer of both men and women in the U.S. And in 2004, the American Heart Association created its Go Red for Women campaign to raise awareness of women’s risks for heart disease and strokes. MedStar Cardiology Associates doctors are actively involved with the Go Red for Women campaign.
It’s vital for doctors to know the science behind treating a woman who’s having a heart attack. But equally important is the relationship doctors and patients have with one another.
The Importance of the Doctor-Patient Relationship
Just like any personal or professional relationship, a good doctor-patient relationship depends on key factors:
- Mutual respect
- Open communication
- Similar goals
The medical profession used to be very patriarchal. The doctor gave a diagnosis and treatment plan, and the patient complied. Now, the relationship ideally is more about shared decision-making. We have a conversation about your concerns and symptoms, test to confirm or eliminate theories, and decide together the best course of action. Providers who haven’t updated how they relate to patients can be very off-putting to anyone—not just women.
In the outpatient setting, patients can select a doctor based on the traits that matter to them. You can search for a particular cardiologist at MedStar Heart & Vascular Institute based on a number of factors, including:
- Language(s) spoken
I have patients who prefer to see a female doctor. There are patients who prefer to see a male doctor, and I don’t take that personally. The important thing is that you see a doctor to whom you can relate. If you don’t, you may be less likely to be honest about your symptoms or listen to their recommendations.
The Heart of the Matter: Share What Works
My great worry about studies like the one of the Florida ED doctors is that women will say, “I only want a female doctor to see me,” when they are really saying they want a doctor who will listen to them, communicate, and practice evidence-based medicine.
At MedStar Cardiology Associates, we identify the qualities that could lead female doctors to better outcomes with female patients and employ doctors who naturally exhibit those qualities and teach them to those who don’t. Because of this approach, we have doctors of many genders, ages, and ethnicities who work together in patient care. This diversity helps us share knowledge and learn from one another, which ultimately benefits our patients.
In fact, the idea of continual learning and sharing knowledge was measured in the study of the Florida ED doctors. The researchers noted that female patients had better outcomes when treated by male doctors if those doctors either treated more female patients or worked with more female doctors. Experience levels, rather than gender differences, are key in female patients’ outcomes after a heart attack.
Women, Take Care of Yourselves
As a mother of five children, I understand that women often take on the role of the family caregiver. We get caught up in caring for our families, providing for a sick or elderly friend, or any of a thousand things we have to balance every day. When something’s wrong with ourselves, we might say, “I don’t have time for that now. If it still hurts tomorrow, I will go get checked out.”
But heart attack symptoms can’t wait until tomorrow. And when seconds count, follow your instincts and get help right away. Your doctor, male or female, will provide the emergency care you need.