If your doctor advises surgery, there are several factors to consider and numerous questions to address. Is this procedure truly necessary? Is it necessary for me to get a second opinion? Is my insurance going to cover my surgery? How long will it take for me to recover?
However, here's something you may not have considered: can the gender of your surgeon have an effect on the likelihood of a successful operation? According to research published in JAMA Surgery, it very well may.
The effect of a surgeon's gender on surgical outcomes
Between 2007 and 2019, the study analyzed data from more than 1.3 million people and nearly 3,000 surgeons who conducted one of 21 common elective or emergency procedures in Canada. Appendectomies, knee and hip replacements, aortic aneurysm treatment, and spine surgery were some of the things that were done.
After 30 days of surgery, the researchers looked at how often four groups of patients (surgical complications, readmissions to the hospital, or death) had bad things happen to them.
Male patients who have had surgery performed by a male surgeon (39% of operations)
Female patients undergoing surgery with a male surgeon (half of all operations)
Female patients (7 per cent of operations) undergoing surgery with a female surgeon
Male patients (4 per cent of operations) undergoing surgery with a female surgeon
What they discovered was as follows:
Around 15% of the patients had adverse outcomes.
When the surgeon's and patient's sexes differed, there was a 9% increase in the risk of significant bleeding, heart attack, or kidney failure, and a 7% increase in the risk of death (compared to patients whose sex was the same as their surgeon).
Female patients suffered the most from the increased risk associated with having a surgeon of different sex. In comparison to women who had a female surgeon, those who had a male surgeon had an 11% higher likelihood of hospital readmission, a 16% higher rate of complications, and a 32% higher risk of mortality.
Male patients had smaller variations in results, although their outcomes favoured female surgeons. Male patients who had their surgery performed by a female surgeon had a 13% lower death rate and a 6% lower readmission rate.
The study was not meant to ascertain why these findings occurred. The authors emphasized, however, that future studies should compare particular differences in treatment, patient-surgeon interactions, trust metrics, and communication methods amongst the four patient groups. Additionally, it is probable that female surgeons adhere to standard operating procedures more strictly than their male counterparts. Physicians are very different when it comes to following guidelines, but it isn't clear if this changes based on gender.
Do other studies indicate that a doctor's and patient's sex matters?
This is not the first study to demonstrate that physician gender has an effect on the quality of care. Additional examples include a previous study of common procedures, studies on elderly hospitalized patients, and heart attack patients. Each study discovered that female physicians' patients fared better than male physicians' patients. Similar findings were observed in a review of data on cardiovascular disease patients.
There is an additional twist in this current research: the majority of the differences in outcomes occurred among female patients treated by male physicians. Thus, there is a need to investigate why this may be the case. What do female surgeons do differently than male surgeons—particularly with their female patients—that results in superior outcomes?
This is a delicate subject.
Let's face it: merely implying that a surgeon's sexual orientation may be a factor may make some professionals defensive, particularly those whose patients had poor outcomes. The majority of physicians undoubtedly believe they give high-quality care to all of their patients, regardless of their gender. To say otherwise will almost certainly lead to more scrutiny and criticism of the findings.
Naturally, it is reasonable to express concerns and to be wary of a single study. For instance, is it feasible that male surgeons take on more challenging patients or are allocated to them? Alternatively, non-surgeon members of surgical teams, such as nurses, trainees, and physician assistants who provide care prior to, during, and after surgery, could have influenced the outcomes. While this study attempted to account for these and other confounding variables, it was an observational study, which frequently makes comprehensive control of confounding variables difficult.
In summary, if
your surgery is an emergency, there is limited time for planning. Even if your operation is elective, the majority of surgeons in many countries—including Canada, where this survey was conducted—are male. This is true even in areas with about equal numbers of male and female medical students. If the chances of getting care from a female surgeon are very low, any possible advantage may be lost.
What matters most is a surgeon's knowledge and experience with specific treatments. Even with this new research, it is not possible to choose a surgeon based on gender alone.
However, if female surgeons' patients genuinely have better results than male surgeons' patients, it is critical to understand why. Identifying what female surgeons do well (or what male surgeons do poorly) is an admirable goal that could enhance results for all patients, regardless of their sex or that of their doctors.
