Female patients were more likely to die or experience complications after being operated on by a male – as opposed to a female – surgeon, according to a new study by researchers in the University of Toronto’s Temerty Faculty of Medicine.
The paper, recently published in JAMA Surgery, looked at 1.3 million adult patients in Ontario over a period of 12 years. It suggests women were 15 per cent more likely to experience a bad outcome if their surgeon was a man.
There was also a 32 per cent greater chance that a female patient would die in the 30 days after a procedure.
The researchers say their findings underscore the need to understand the reasons for the apparent disparity.
“To deny the results of this study is both non-scientific and a marker of our own implicit bias,” says Angela Jerath, an associate professor at Temerty Medicine’s department of anesthesiology and pain medicine, who worked on the study with Christopher Wallis, an assistant professor at Temerty Medicine’s division of urology.
The study also indicated female patients treated by a male surgeon had a 16 per cent increase in major complications following their surgery and an 11 per cent increase in the likelihood of re-admission, compared with having the same procedure done by a female surgeon.
“We believe that the issues that are causing this gap are extremely complicated, and likely to enter behavioural science. We need to understand these issues and fill the gap in care for female patients,” says Jerath, who is alsostaff cardiac anesthesiologist at Sunnybrook Health Sciences Centre.
The study focused on 21 types of surgery, including procedures in cardiothoracic surgery, neurosurgery and orthopedic surgery.
The data also factored in procedures in otolaryngology, plastic surgery, thoracic surgery, urology and vascular surgery, as well as general surgery.
“Overall, male patients have comparable results when treated by either male or female surgeons while female patients have worse outcomes when treated by male surgeons than female surgeons,” says Wallis, who is also a
“As a male surgeon, these findings really highlight a learning opportunity for me personally and for our profession,” he adds. “An operating surgeon’s sex shouldn’t affect a female patient’s outcomes. We need to do more work to understand why these discrepancies are happening.”
“There are social and cultural factors that may get in the way of providing the best care for female patients, and we need to investigate that further.”
Of the study of sample of more than 2,900 surgeons, 82 per cent were male while 18 per cent were female.
“Beyond performing the actual surgical procedure, t
Jerath, who is also a scientist at Sunnybrook Research Institute and adjunct scientist at ICES, says she was “astonished” by the findings.
She says further research will hopefully examine if there are some practices among female surgeons that are leading to better outcomes, especially for female patients.