A large study has found patients experience better outcomes after being operated on by a female surgeon than by a male surgeon.
The team, investigating if there was a link between the sex of the surgeon and outcomes, looked at data from one million patients having surgery in Ontario, Canada, between January 1, 2007, and December 31, 2019. The team followed the patients, who had had one of 25 common elective or emergency surgeries, looking at any "adverse postoperative event, defined as the composite of death, readmission, or complication" that may have happened in 90 days and one year after surgery.
Outcomes between male and female surgeons were then compared. This study, like another published yesterday looking at the outcomes of cholecystectomy patients, found that people treated by male surgeons had worse outcomes.
"After accounting for patient, procedure, surgeon, anesthesiologist, and hospital characteristics, the findings of this cohort study suggest that patients treated by female surgeons have lower rates of adverse postoperative outcomes including death at 90 days and 1 year after surgery compared with those treated by male surgeons," the team wrote in their study. "These findings further support differences in patient outcomes based on physician sex that warrant deeper study regarding underlying causes and potential solutions."
The difference in outcomes became more pronounced a full year after surgery.
“This association is interesting and important,” President of the Royal College of Surgeons of England, Tim Mitchell, told The Guardian “However, association is not causation, and one possible explanation may have to do with case complexity. The authors tried to take the case mix into account by adjusting for confounders, but residual confounding factors cannot be ruled out. I agree that the ideal of the surgeon as the ‘lonesome cowboy’ belongs to an era long gone.”
Despite these differences being found across several studies, and suggestions being made, the cause is still unclear.
“Women and men practice medicine differently, although little research exists on the differences in learning styles, acquisition of skills, or outcomes for female and male surgeons," the authors of a similar study wrote in 2017. “We don’t know the mechanism that underlies better outcomes for patients treated by female surgeons, although it might be related to delivery of care that is more congruent with guidelines, more patient-centered, and involves superior communication.”
The current team notes that other studies have found female patients fare better when treated by a female doctor.
"Despite these data, women continue to be marginalized in the workplace in many ways," they conclude. "To provide the best patient care, organizations should support women physicians and learn how they accomplish these improved outcomes."
The study is published in the journal JAMA Surgery.