Two new studies out of Canada and Sweden suggest that patients operated on by female surgeons are less likely to face future complications or require follow-up care than those treated by male surgeons.
The cohort study, published in JAMA Surgery, examined over one million records from two different medical registries of adult patients who underwent one in 25 common elective or emergency surgeries between 2007 and 2019.
Behind the research
The first study looked at patients in Ontario, Canada and found a total of 151,054 patients were treated by a female surgeon and 1,014,657 were treated by a male surgeon. Patients treated by male surgeons were 2.4 percent more likely to die within one year of surgery compared to 1.6 percent percent of patients who were operated on by a female surgeon.
The research also found that 90-days post operation,13.9 percent of patients operated on by a male surgeon experienced either re-admission to the hospital, post-operative complications or ‘adverse postoperative outcomes’ that included death. However, only 12.5 percent percent of patients treated by a female surgeon experienced similar outcomes.
Most research in surgery looks at short-term outcomes, Christopher Wallis, MD, PhD, and co-author of the study told MedPageToday. However, his team wanted to get a better understanding of the longer recovery trajectories.
“Our goal is not to blame,” Dr. Wallis told MedPage Today. “Our goal is to really understand surgical care delivery, so that we can improve care for all patients who are treated by all physicians. The first obvious statement to make is that we can’t just switch and have all surgery performed in the U.S. or Canada tomorrow be done by female surgeons. We just don’t have the workforce to do that. And so the real question is why?”
Why women surgeons have better patient outcomes
The differences in outcomes are not inherent to a physician’s gender, but rather connected to how they practice, says Dr. Wallis.
The second study examined 150,000 patients in Sweden who underwent surgery to remove their gallbladder, also known as a cholecystectomy. The study was composed of 849 female surgeons and 1,704 male surgeons, and found that patients who were operated on by female surgeons experienced ‘fewer surgical complications’ while also having ‘significantly longer operation times,’ than their male counterparts.
The study concluded that female surgeons operated at a slower rate than male surgeons. This was because they were less likely to switch from laparoscopic or the means of making small incisions with the aid of a camera to open surgery, which is a much more invasive approach.
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My Blohm, MD of Stockholm’s Karolinska Institute, who co-authored the Sweden study, wrote in the report that the findings suggest that surgical technique and risk-taking behaviors might explain some of the differences observed in surgical outcomes.
“In some countries, there is a general belief that male surgeons are superior to female surgeons,” Dr. Blohm wrote in JAMA Surgery. “Interestingly, most previously published studies indicate that female surgeons are at least as good as male surgeons, or as in this case even slightly better.”
But the study also noted that there are various explanations for gender disparities in medicine.
Previous studies have reported that female physicians adhere to guidelines more closely, use more patient-centered communication, are more willing to collaborate, and are more careful in selecting patients for their planned surgery. While the authors of this study noted that their findings suggest that female surgeons may perform safer operations and operate more slowly, they indicated that this caution might be a favorable quality. However, it is important to highlight that competitive and risk-taking behaviors were also seen among female surgeons.
“As for all observational studies these results should be interpreted with some caution,” Dr. Blohm wrote in JAMA. “We have tried to identify and include factors in our analysis that may confound the results, but there can still be unidentified factors. We hope that our study can contribute to an increased understanding of gender differences and promote gender equity within the surgical specialty.”
How to have a safer surgery
If you’re scheduled for surgery, here are steps you can take to ensure you have the best possible outcome, according to the Centers for Disease Control and Prevention, regardless of the gender of your doctor.
Communicate with your provider. Before your surgery, let your doctor know if you have any preexisting health conditions, such as diabetes, that may affect your recovery.
Quit smoking. In addition to many other health benefits, stopping smoking can lower your risk of an infection after surgery.
Follow all pre-op instructions. Be sure to follow your doctor’s recommendations before surgery, whether it’s to avoid eating or washing with a certain type of soap.
Wash your hands. After surgery, make sure to wash your hands before caring for the site of your surgical incision, and be sure that any health care providers caring for you do as well.
If you notice any signs of infection after surgery, reach out to your health care provider right away.
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