JAMA Surg
Are women better surgeons than men?
The findings of this large retrospective cohort Canadian study suggest that patients treated by female surgeons have lower rates of adverse postoperative outcomes, including death, at 90 days and 1 year after surgery compared with those treated by male surgeons (Wallis, 2023).
- Among 1,165,711 included patients, 151,054 were treated by a female surgeon and 1,014,657 by a male surgeon.
- Overall, 14.3% of the patients had 1 or more adverse postoperative outcomes at 90 days and 25.0% had 1 or more adverse postoperative outcomes 1 year following surgery.
- Multivariable-adjusted rates of the composite endpoint—defined as the composite of death, readmission, or complication—were higher among patients treated by male than female surgeons at both 90 days (13.9% vs 12.5%; adjusted odds ratio [AOR], 1.08) and 1 year (25.0% vs 20.7%; AOR, 1.06).
- Findings were similar for mortality at 90 days (0.8% vs 0.5%; AOR 1.25) and 1 year (2.4% vs 1.6%; AOR 1.24).
Another large cohort Swedish study also examining gender differences finds that female surgeons have more favorable outcomes and operate more slowly than male surgeons, specifically in elective and acute care cholecystectomies.
- A total of 150,509 patients, with 97,755 (64.9%) undergoing elective cholecystectomies and 52,754 (35.1%) undergoing acute care cholecystectomies, were operated on by 2,553 surgeons, including 849 (33.3%) female surgeons and 1,704 (67.7%) male surgeons.
- Patients operated on by male surgeons had more surgical complications (odds ratio [OR], 1.29) and total complications (OR, 1.12), as well as more bile duct injuries in elective surgery (OR, 1.69), but no significant difference was observed in acute care operations.
- Patients treated by female surgeons had shorter hospital stays than those treated by men and were less likely to be converted to open surgery during an operation.
- Finally, female surgeons had significantly longer operation times with a mean difference in operating time for male vs. female surgeons of -7.96 minutes for all operations, -6.59 minutes for elective surgery, and -9.27 minutes for acute care surgery.
Sources:
Wallis, C., et al. JAMA Surg. (2023, August 30). Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries. https://pubmed.ncbi.nlm.nih.gov/37647075/
Blohm, M., et al. JAMA Surg. (2023, August 30). Differences in Cholecystectomy Outcomes and Operating Time Between Male and Female Surgeons in Sweden. https://pubmed.ncbi.nlm.nih.gov/37647076/