Does the sex of your surgeon matter? A new study says yes

Close up of a surgeon's gloved hands suturing a patient's incision during an operation. Other members of surgical team in background.

In case your physician recommends surgical procedure, there’s so much to consider and plenty of inquiries to reply. Do I really want this surgical procedure? Ought to I get a second opinion? Will my insurance coverage cowl my operation? How lengthy will my restoration take?

However right here’s one thing you won’t have thought-about: does the intercourse of your surgeon have an effect on the probabilities that your operation will go effectively? Based on a examine in JAMA Surgical procedure, it simply may.

How a surgeon’s intercourse may have an effect on surgical outcomes

The examine checked out info drawn from greater than 1.3 million adults and almost 3,000 surgeons who carried out certainly one of 21 frequent elective or emergency surgical procedures in Canada between 2007 and 2019. The vary of surgical procedures included appendectomies, knee and hip replacements, aortic aneurysm repairs, and spinal surgical procedures.

The researchers in contrast how usually unfavorable outcomes (surgical issues, readmissions to the hospital, or demise) occurred inside 30 days of surgical procedure amongst 4 affected person teams:

  • male sufferers operated on by a male surgeon (39% of operations)
  • feminine sufferers with a male surgeon (50% of operations)
  • feminine sufferers with a feminine surgeon (7% of operations)
  • male sufferers with a feminine surgeon (4% of operations).

Right here’s what they discovered:

  • About 15% of all sufferers skilled unfavorable outcomes.
  • There was a 9% greater danger of issues reminiscent of main bleeding, coronary heart assault, or kidney failure, and a 7% greater danger of demise, when the intercourse of the surgeon and the affected person differed (in comparison with sufferers whose intercourse was the identical as their surgeon).
  • Many of the elevated danger of getting a surgeon whose intercourse was completely different was skilled by feminine sufferers. In contrast with ladies who had a feminine surgeon, ladies with a male surgeon had an 11% greater price of readmission to a hospital, a 16% greater price of issues, and a 32% greater danger of demise.
  • Smaller variations had been seen for male sufferers, however their outcomes nonetheless favored feminine surgeons. Male sufferers had a 13% decrease demise price and a 6% decrease readmission price if their surgeon was feminine slightly than male.

The examine was not designed to find out why these outcomes had been noticed. Nonetheless, its authors advised that future analysis ought to examine particular variations in care, patient-surgeon relationships, measures of belief, and types of communication between the 4 affected person teams. It’s additionally doable feminine surgeons observe commonplace pointers extra carefully than their male counterparts. Physicians differ extensively in how carefully they adhere to pointers, although it’s unclear whether or not this may range by doctor intercourse. 

Does different analysis counsel the intercourse of a physician and affected person matter?

This isn’t the primary examine to counsel doctor intercourse issues on the subject of the standard of medical care. Different examples embrace a earlier examine of frequent surgical procedures, analysis relating to aged sufferers admitted to the hospital, and sufferers with coronary heart assaults. Every examine discovered that sufferers of feminine physicians tended to fare higher than these of male physicians. Comparable outcomes had been reported for a evaluation of analysis on sufferers with heart problems.

On this newest analysis there’s an added twist: a lot of the distinction in outcomes was amongst feminine sufferers cared for by male physicians. So, there’s purpose to take a superb laborious have a look at why this can be the case. What are feminine surgeons doing otherwise — particularly with their feminine sufferers — that results in higher outcomes in contrast with male surgeons?

It’s a delicate topic

Let’s face it: even elevating the risk {that a} surgeon’s intercourse issues may make some docs defensive, notably these whose sufferers had worse outcomes. Most docs possible imagine that they supply high-quality care to all of their sufferers, no matter a affected person’s intercourse. To counsel in any other case will predictably invite greater than the standard quantity of scrutiny and criticism of the analysis.

After all, it’s honest to boost questions and to be skeptical of a single examine. For instance, is it doable that male surgeons took on or had been assigned extra complicated instances? Or, maybe the non-surgeon members of the surgical groups, reminiscent of nurses, trainees, and doctor assistants who present care earlier than, throughout and after surgical procedure, had one thing to do with the outcomes. Whereas this examine tried to account for these and different components, it was an observational examine, for which it’s usually not possible to fully management for confounding components.

The underside line

There’s little likelihood to do a lot planning in case your surgical procedure is an emergency. Even when your surgical procedure is elective, in lots of international locations — together with Canada, the place this examine happened — most surgeons are male. That’s true even in locations the place medical faculties have related numbers of female and male college students. Any potential benefit could disappear if there’s little likelihood of receiving care from a feminine surgeon.

A surgeon’s experience and expertise with particular procedures matter most. It’s impractical to select your surgeon solely by intercourse, even in mild of this newest analysis.

But when the sufferers of feminine surgeons really have higher outcomes than sufferers operated on by male surgeons, it’s crucial to grasp why. Finding out what feminine surgeons are doing effectively (or what male surgeons aren’t doing as effectively) is a worthy objective that would enhance outcomes for all sufferers, no matter their intercourse and that of their docs.

Comply with me on Twitter @RobShmerling

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