In a male dominated industry, female surgeons spend more time in the operating room and their patients endure fewer postoperative complications.
That’s the conclusion of two research studies published Wednesday in JAMA Surgery. Researchers found better outcomes for patients treated by female surgeons in the sweeping reviews of millions of procedures in Canada and Sweden.
In the first study, 17 researchers in the U.S. and Canada followed the outcomes for 1.2 million patients in Canada undergoing common surgeries between 2007 and 2020.
The study authors found that at both 90 days and one year following surgery, patients treated by female surgeons were less likely to experience adverse postoperative issues, including death. The outcome differences were modest, but consistent.
Even after statistically accounting for characteristics that may affect surgical outcomes, such as patient age and overall illness, surgeon experience and volume, hospital setting, and measures of case complexity, the authors reached the same conclusion. The study also found that when male surgeons treat female patients, outcomes are slightly worse.
The findings reveal that patients’ outcomes aren’t just about what happens in the operating room, said Dr. Angela Jerath, an author on the study and anesthesiologist and associate professor at the department of anesthesiology and pain medicine at the University of Toronto.
“Picking up problems early is where you start to save patients,” she said.
Jerath said the differences aren’t about technical skill, but about listening to patients and choosing appropriate care. Previous studies point to differences in the way that female physicians communicate and engage with patients.
Patients treated by male surgeons had postoperative complications about 14% of the time versus 12.5% of the time for female surgeons 90 days post surgery. And at one year post surgery, male-treated patients had adverse postoperative events 25% of the time, versus 20% of the time for female-treated patients.
Overall, patients experienced complications 9% of the time when treated by female surgeons and 10.2% of the time when treated by male surgeons.
Ashish Jha, dean at Brown University School of Public Health in Providence, R.I., who has separately studied sex differences in patient outcomes, said it is important that hospital systems look at their own data and practices to see what underlies the phenomenon.
“It’s not realistic or desirable that we only have female surgeons,” he said. “We want everyone to get better.”
Surgical professions are still largely dominated by men. In 2021, 22.6% of general surgeons in the U.S. were women, and orthopedic surgery had the lowest representation of female surgeons (5.9%), according to the Association of American Medical Colleges.
“Surgery is not a friendly place for women in general. The women who are getting into surgery are highly skilled,” said Christopher Wallis, lead author on the study, a urologic oncologist and assistant professor of urology at the University of Toronto.
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