Do fewer patients die with female surgeons?

23 October 2017: Patients may have better survival odds with female surgeons than with male surgeons, a recent Canadian study suggests.

Researchers examined data on 104,630 patients who underwent a variety of common procedures with a total of 3,314 different surgeons, including 774 females and 2,540 males.

Overall, patients treated by female surgeons were 12 percent less likely to die within 30 days, and they had similar complications rates and repeat hospital admissions, the study found.

“There are reasons to believe why female surgeons may have had these outcomes,” said senior study author Dr. Raj Satkunasivam, a researcher and surgeon at Houston Methodist Hospital.

“Surgery is a highly male dominated profession so that the cohort of females truly represents the ‘best of the best’ proportionately more skilled, motivated, and harder working surgeons who have had to perhaps pass a ‘higher bar’ to succeed,” Satkunasivam said by email.

Because the study wasn’t a controlled experiment designed to prove whether or how surgeons’ sex influences patient outcomes, however, it’s possible that factors such as the complexity of individual cases might have influenced the results, Satkunasivam noted.

Still, the study should help dispel any biases against female surgeons in the medical profession, since the women clearly didn’t perform worse than the men, Satkunasivam and colleagues note in the BMJ.

The study focused on outcomes for 25 common procedures including a variety of heart operations, weight-loss surgeries, knee and hip replacements, and cancer treatments.

Overall, 11.1 percent of patients treated by female surgeons died, experienced serious complications or had repeat admissions to the hospital within 30 days of their operations, compared to 11.3 percent with male surgeons, the study found.

This translated into 4 percent lower odds of either death, complications or repeat admissions with female surgeons.

Researchers also accounted for differences in outcomes for procedures that were scheduled in advance, when patients can often choose their surgeon, and emergency operations, when patients typically do not make this choice.

One limitation of the study is that researchers lacked some data on patients that might impact their odds of death or complications, such as other medical problems or socioeconomic factors like income.

While the findings should dispel any lingering biases against female surgeons, it’s unlikely that the sex of the surgeon would be a good way to predict how well patients will do after their operations, Derek Alderson, president of the Royal College of Surgeons of England, and past-president Clare Marx write in an accompanying editorial.

However, the results do support giving female surgeons the same career opportunities as their male counterparts, said Dr. Heather Logghe, author of a separate accompanying editorial and a researcher at Thomas Jefferson University in Philadelphia.

“Given the historical exclusion of women from surgical training and today’s glass ceiling in terms of leadership positions, academic promotion, and pay equity among surgeons, this study is hugely impactful,” Logghe said by email. “It demonstrates that based on clinical outcomes there should be parity in leadership, promotion, and pay for women surgeons.”