If your doctor recommends surgery, there’s a lot to think about and many questions to answer. Do I really need this operation? Should I get a second opinion? Will my insurance cover my operation? How long will my recovery take?
But here’s something you might not have thought of: does the gender of your surgeon affect the chances of your operation going well? According to a study in JAMA surgeryit’s possible.
How a Surgeon’s Gender Can Affect Surgical Outcomes
The study looked at information from more than 1.3 million adults and nearly 3,000 surgeons who performed one of 21 common elective or emergency surgeries in Canada between 2007 and 2019. surgeries included appendectomies, knee and hip replacements, aneurysm repairs and spine surgeries.
The researchers compared the frequency with which adverse outcomes (surgical complications, hospital readmissions or death) occurred within 30 days of surgery among four groups of patients:
- male patients operated by a male surgeon (39% of operations)
- patients with a male surgeon (50% of operations)
- patients with a female surgeon (7% of operations)
- male patients with a female surgeon (4% of operations).
Here is what they found:
- About 15% of all patients experienced adverse outcomes.
- There was a 9% higher risk of complications, such as major bleeding, heart attack, or kidney failure, and a 7% higher risk of death, when the sex of the surgeon and the patient was different (compared to to patients whose gender was the same as their surgeon).
- Most of the increased risk of having a different-sex surgeon was felt by the female patients. Compared to women who had a female surgeon, women who had a male surgeon had an 11% higher hospital readmission rate, a 16% higher complication rate, and a 32% higher risk of death.
- Smaller differences were seen for male patients, but their results still favored female surgeons. Male patients had a 13% lower mortality rate and a 6% lower readmission rate if their surgeon was female rather than male.
The study was not designed to determine Why these results have been observed. However, its authors suggested that future research should compare specific differences in care, patient-surgeon relationships, measures of trust and communication styles between the four patient groups. It’s also possible that female surgeons follow standard guidelines more closely than their male counterparts. Physicians differ widely in the extent to which they adhere to guidelines, although it is unclear whether this may vary by physician gender.
Does other research suggest that the sex of a doctor and a patient matters?
This isn’t the first study to suggest that doctors’ gender matters when it comes to the quality of medical care. Other examples include an earlier study of common surgeries, research on elderly patients admitted to hospital, and patients with heart attacks. Each study found that patients of female physicians tended to fare better than those of male physicians. Similar results were reported for a review of research on patients with cardiovascular disease.
In this latest research, there is an additional twist: Most of the differences in results were for female patients seen by male doctors. Therefore, it is worth considering carefully why this may be the case. What do female surgeons do differently – especially with their female patients – that leads to better results compared to male surgeons?
It’s a sensitive subject
Let’s face it: even by increasing the possibility that a surgeon’s sexual issues might make some physicians defensive, especially those whose patients had poorer outcomes. Most doctors probably believe that they provide high quality care to all of their patients, regardless of gender. To suggest otherwise will, predictably, invite more than the usual amount of research scrutiny and criticism.
Of course, it’s fair to raise questions and be skeptical of a single study. For example, is it possible for male surgeons to take on or be assigned more complex cases? Or maybe the nonsurgical members of surgical teams, such as nurses, interns, and physician assistants who provide care before, during, and after surgery, had something to do with the results. Although this study attempted to control for these and other factors, it was an observational study, for which it is often impossible to completely control for confounding factors.
The bottom line
You’re unlikely to do much planning if your surgery is an emergency. Even if your surgery is elective, in many countries, including Canada, where this study took place, most surgeons are men. This is true even in places where medical schools have similar numbers of male and female students. Any potential benefit may vanish if there is little chance of receiving care from a female surgeon.
A surgeon’s expertise and experience with specific procedures is most important. It’s not practical to choose your surgeon based solely on gender, even in light of this latest research.
But if patients of female surgeons really have better results than patients operated on by male surgeons, it is imperative to understand why. Sorting out what female surgeons do well (or what male surgeons don’t do as well) is a laudable goal that could improve outcomes for all patients, regardless of their gender and that of their doctors.
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