The field of surgery has long been dominated by men, and still is today.
But two new studies show that if patients want safe, effective long-term results, picking a female surgeon might be key.
In one study involving more than 1 million Canadian surgical patients whose outcomes were followed for a year, “those treated by a female surgeon were less likely to experience death, hospital readmission or major medical complication,” wrote a team led by Dr. Christopher Wallis, of Mount Sinai Hospital in Toronto.
Another study—this time focused on gallstone removal, one of the most commonly performed surgeries—also found female surgeons outperforming males, on average, when it came to outcomes.
Both studies were published online Aug. 30 in JAMA Surgery.
Why the gender gap? According to Dr. Martin Almquist, who wrote an accompanying editorial in the journal, it might come down to differences in attitudes towards risk-taking, the surgeon’s ability to collaborate with others, and being “patient-centered” when it comes to making decisions around surgery.
In both studies, female surgeons tended to be more methodical and take longer to complete a surgery compared to their male colleagues, the researchers noted.
“Being accurate and careful most likely beats risk-taking and speed when it comes to consistently achieving good outcomes for the patient,” concluded Almquist, a surgeon at the Skane University Hospital in Lund, Sweden.
Almquist conceded that it’s not yet proven how women outperform men in the OR.
“Perhaps personality traits more common among women contribute to better outcomes?” he said.
Regardless of the reasons, “Surely, the ideal of the surgeon as the [male] ‘lonesome cowboy’ belongs to an era long gone,” Almquist added.
The surgical profession remains a largely male domain, however.
For example, in the Canadian study—which looked at 25 different types of surgeries conducted between 2007 and 2019—only about 151,000 of a total of nearly 1.2 million procedures had been conducted by women.
In the study, Wallis and his colleagues tracked 90-day and one-year outcomes for all patients.
Data was first compiled on a “composite outcome” that included deaths, hospital readmissions and/or complications. According to the study, nearly 14% of patients treated by male surgeons experienced at least one of these events within 90 days, compared to just 12.5% of people operated on by a woman.
At one year post-surgery, 25% of the patients of male surgeons had experienced such an event, compared to just under 21% of those treated by women. When it came to deaths, 2.4% of patients who’d been operated on by a man were deceased by one year post-surgery, compared to 1.6% of those who’d had a female surgeon.
The second study, focused on gallbladder operations, was led by Dr. My Blohm, a surgeon at Mora Hospital in Sweden.
It focused on more than 150,500 patients who underwent elective or emergency gallbladder surgeries between 2006 and 2019. Patient outcomes were tracked for 30 days after their procedures.
Again, the team found that female surgeons tended to spend more time on a surgery—an average 100 minutes for an elective procedure versus an average of 89 minutes for men.
Maybe that extra time and attention paid off for patients: For elective procedures, patients operated on by male surgeons had 28% longer hospital stays and a 66% higher odds for bleeding complications, compared to patients operated on by a female surgeon, Blohm’s team reported.
So why would a surgeon’s gender matter?
“Personal characteristics and attitudes are difficult to study, but probably affect outcomes,” the Swedish group wrote.
“This study’s important finding that female surgeons may perform safer operations and operate more slowly indicates that caution might be a favorable quality,” they added.
However, women still comprise a small minority of surgeons in Sweden and elsewhere, the team noted. They hope that their new findings “will encourage young female physicians to choose a surgical specialty.”
Wallis’ group in Toronto agreed. Despite data showing that women equal or even surpass men as surgeons, “women continue to be marginalized in the workplace in many ways,” they concluded. “To provide the best patient care, organizations should support women physicians and learn how they accomplish these improved outcomes.”
Christopher J. D. Wallis et al, Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries, JAMA Surgery (2023). DOI: 10.1001/jamasurg.2023.3744
My Blohm et al, Differences in Cholecystectomy Outcomes and Operating Time Between Male and Female Surgeons in Sweden, JAMA Surgery (2023). DOI: 10.1001/jamasurg.2023.3736
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