Patients treated by female surgeons have a small but significant decrease in 30-day mortality and similar surgical complications compared with patients treated by male surgeons, according to data published in the BMJ.
Researchers from the University of Toronto conducted a population-based cohort study of 104,630 patients undergoing a surgical procedure in Ontario, Canada between 2007 and 2015. A total of 3,314 surgeons were included in the study, 774 female and 2,540 male. Participants undergoing a procedure performed by a female surgeon were matched by age, sex, comorbidity, surgeon volume, surgeon age, and hospital to patients undergoing the same operation by a male surgeon.
The results showed that fewer patients treated by female surgeons died, were readmitted to the hospital, or had complications within 30 days compared with those treated by male surgeons (11.1% vs 11.6%; adjusted odds ratio [OR], 0.96).
Patients who were treated by female surgeons had a significantly lower likelihood of death within 30 days compared with patients treated by male surgeons (OR, 0.88), and comparable likelihood of hospital readmission (0.96) or complications (OR, 0.96). The investigators note that patient, physician, and hospital characteristics did not modify the effect of surgeon sex on surgery outcomes. In addition, there were no differences in outcomes by surgeon sex among patients who underwent emergency surgery.
“These results do not support the preferential selection of a surgeon of either sex in clinical practice,” the authors note. “Rather they indicate the need for further study in independent cohorts using different research methods. In addition, they support the examination of surgical outcomes and mechanisms related to physicians and the underlying processes and patterns of care to improve mortality, complications, and readmissions for all patients. Our findings have important implications for supporting sex equality and diversity in a traditionally male dominated profession.”
In an accompanying editorial, Clare Marx, immediate past president of the Royal College of Surgeons of England, and Derek Alderson, current president of the organization, note that surgery is a specialty that continues to struggle with gender bias among patients and healthcare professionals. The current study confirms the safety, skill, and expertise of women surgeons relative to male surgeons.
“With so many critical factors to consider, trying to find out why there is a very small difference in short term clinical outcomes between male and female surgeons is unlikely to prove worthwhile,” they note. “Nor are we convinced that the sex of the surgeon will emerge as an important determinant of a good outcome for patients having surgery.”
- Marx C, Alderson D. Improving patient outcomes after surgery [published online October 10, 2017]. BMJ. doi: 10.1136/bmj.j4580
- Wallis CJD, Ravi B, Coburn N, Nam RK, Detsky AS, Satkunasivam R. Comparison of postoperative outcomes among patients treated by male and female surgeons: a population-based matched cohort study [published online October 10, 2017]. BMJ. doi:10.1136/bmj.j4366