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If your doctor recommends surgery, there are a lot of questions you need to think about and answer.Do I really need this surgery?Should I get a second opinion?Will my insurance cover my surgery?How long will my recovery take?
But here’s something you probably haven’t considered: Does the gender of your surgeon affect your chances of a smooth surgery?According to a study by JAMA Surgery, it may.
The study looked at information from 1.3 million adults and nearly 3,000 surgeons who performed one of 21 common elective or emergency procedures in Canada between 2007 and 2019.The range of surgeries includes appendectomy, knee and hip replacement, aortic aneurysm repair and spine surgery.
The researchers compared the frequency of adverse outcomes (surgical complications, readmissions, or death) within 30 days of surgery in four groups of patients:
The study was not designed to determine why these results were observed.However, its authors suggest that future research should compare specific differences in care, doctor-patient relationship, trust measures, and communication styles between the four patient groups.Female surgeons may also follow standard guidelines more strictly than male surgeons.Physicians vary widely in how well they adhere to the guidelines, but it is unclear whether this varies by physician gender.
This is not the first study to show that physician gender matters for quality of care.Other examples include previous studies of common surgeries, studies of hospitalized elderly patients, and heart disease patients.Each study found that women physicians tended to have better patients than male physicians.A review of studies in patients with cardiovascular disease reported similar results.
In this latest study, there was an additional twist: Much of the difference in outcomes occurred among female patients cared for by male physicians.So it makes sense to take a closer look at why this is the case.What are the differences between female surgeons, especially for female patients, that lead to better outcomes compared to male surgeons?
Let’s face it: Even raising the odds of a surgeon’s gender issues can make some physicians defensive, especially those whose patients have worse outcomes.Most physicians probably believe that they provide high-quality care to all patients, regardless of their gender.Predictably, making other recommendations will incur more research scrutiny and criticism than usual.
Of course, it’s fair to ask questions and be skeptical of a study.For example, is it possible for male surgeons to take over or assign more complex cases?Or, perhaps non-surgeon members of the surgical team, such as nurses, interns, and physician assistants who provide care before, during, and after surgery, are relevant to the outcome.While this study attempts to account for these and other factors, it is an observational study and it is often not possible to fully control for confounders.
If your surgery is an emergency, there is little chance of doing much planning.Even if your surgery is elective, in many countries—including Canada, where the study was conducted—the majority of surgeons are men.This is true even where medical schools have similar numbers of male and female students.If there is little access to female surgeon care, any potential advantage may disappear.
The surgeon’s expertise and experience in a particular procedure is most important.Even according to this latest study, selecting surgeons based on gender alone is impractical.
However, if patients with female surgeons do have better outcomes than patients with male surgeons, then one must understand why.Identifying where female surgeons are doing well (or where male surgeons are not doing well) is a worthy goal that could improve outcomes for all patients, regardless of their gender and the gender of the physician.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content.Please note the last review or update date for all articles.Nothing on this website, regardless of date, should be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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