In the current year alone, I have learned of three doctors, two whom I personally know and one who was a year senior to me in medical school, being disciplined by the Medical Board of California. They are all men!

I thought nothing of this until I perused this study http://www.biomedcentral.com/1741-7015/13/172 from the United Kingdom, detailing pervasive gender differences in rates of doctor misbehavior.  The researchers collected many different past studies looking at different aspects of misbehavior or disciplinary action. Overall, male doctors were more likely to be disciplined by regulatory bodies; more likely to have “malpractice experience” (presumably, an accusation of malpractice, whether he turned out to be liable or not), more likely to be accused of a crime; more likely to have their cases or complaints escalated to a regulatory body. Overall, they were 2.5 times more likely to get in trouble, and this hasn’t gotten any better even as women have become a larger and larger presence in medicine. It seems the boys truly just demonstrate or are perceived to demonstrate more bad behavior than the girls.

The study authors point to women doctors generally working fewer total hours over a year than their male counterparts. This is rooted in reasons from child rearing to specialty choice. Of course, the more time you spend in the office, the more chances you have to anger or dissatisfy a patient. Stress from these increased work hours (or more dire job responsibilities in male over-represented fields like cardiothoracic surgery) could be factors in doctor misbehavior. Psychologists often comment on the link between testosterone and aggression in males, and this may be related to this phenomenon as well.

Disciplinary problems can result in increased costs for hospitals, from filling vacated jobs during suspensions to fighting expensive lawsuits. But, even if a hospital hired all women, it would be no guarantee of a trouble-free environment. The current trend toward empathy and patient satisfaction, and training efforts is an important step towards preventing unhealthy dynamics in physician-patient or doctor-hospital relationships. To some degree, women are socialized to be agreeable and empathic, which makes it less likely that they will be sued or complained about. Men, on the other hand, are socialized to be aggressive risk-takers. As a result, male doctors should be offered patient interaction and staff interaction training to reduce their medico-legal risks.  Recruitment efforts should focus on candidates who have demonstrated their ability to be successful in stressful situations, and who do not have criminal records that raise concern for future misbehavior that could endanger the hospital. Ultimately, a hospital stands to gain much from a talented pool of doctors—male and female—that also stay out of trouble.

Dr. Monya De, MD, MPH is a specialist in internal medicine and previously was a medical reporter for ABC News. She graduated with her MPH degree from the University of California, Berkeley School of Public Health and her MD degree from the University of California, Irvine; she received her undergraduate degree with honors in human biology from Stanford University. Dr. De is also a member of the Proactive Health Labs Medical Advisory Board (www.phlabs.org), which monitors all programs, products and services offered by this nonprofit health and wellness organization.  .