A Canadian study of 1.3 million people indicated that women who underwent common elective or emergency surgeries with male surgeons had a 15% higher chance of dying, experiencing a major complication, and/or being readmitted to the hospital within 30 days than they did if a woman performed their surgery, reports Medical Xpress. In contrast, men experience similarly good outcomes regardless of their surgeon’s sex, the study showed. Why such “sex discordance” exists is not fully understood, and the study wasn’t designed to answer this question. “We hypothesize, based on prior work regarding communication between patients and physicians, that this may underpin the observation,” said study author Dr. Christopher Wallis, an assistant professor of urology at the Mount Sinai Hospital and University Health Network in Toronto. Previous studies have shown that female doctors tend to listen more, and their patients may fare better as a result. “Patients should seek to find surgeons that they trust and communicate well with,” Wallis said. “As a surgical community, we should seek to better understand the factors underpinning these observations such that we can understand the processes of care that lead to optimal outcomes so all surgeons can use these and all patients can benefit.” The study included more than 1.3 million patients who had 21 common elective and emergency surgeries between 2007 and 2019. Of these, close to 15% experienced one or more bad outcomes in the month after surgery including death, readmission, and/or a complication. Nearly 46% of patients were the same sex as their surgeon. Female patients treated by male surgeons fared worse after surgery, but female surgeons experienced similarly good outcomes whether they operated on men or women, the study showed. The research took place in Canada, but the findings are likely relatable to the United States, Wallis said. There aren’t as many female surgeons, said Dr. Amalia Cochran, a professor of surgery at the University of Florida College of Medicine. While there is finally sex equality in medical school, it is not yet showing up in surgical ranks: women made up just 22% of U.S. general surgeons in 2019, the editorial published in JAMA Surgeryn noted. Women should not be at a disadvantage, and the study is “yet another reason why as a profession we must be intentional about having a workforce that is representative of the patients we care for and in which we foster belonging for all workforce members,” Cochran said. Dr. Cassandra Kelleher, a pediatric surgeon at Massachusetts General Hospital in Boston, said the findings probably don’t relate to differences in surgical prowess or technical skill between male and female surgeons. “It’s likely due to something more nuanced such as how surgeons listen to people after surgery and the way that they involve family or caregivers, or listen to nurses on the floor who express concern,” said Kelleher, who was not involved in the new study. Other factors may include how approachable the surgeon is, and the level of risk he or she is willing to assume.
https://medicalxpress.com/news/2021-12-poor-outcome-patient-female-surgeon.html
