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She’s My Surgeon – Female vs. Male Surgical Outcomes

November 13, 2017

Spoon Feed
Female surgeons had small but significantly improved 30-day mortality and other surgical outcomes over male surgeons, all other factors being equal.

Why does this matter?
Girls always told me in grade school they could do anything I could do, only better…turns out they were spot on regarding surgical mortality and other surgical outcomes (among many other things).  In a prior study, female internists had better 30-day mortality rates for medical patients over their male peers.  This study looked at surgical outcomes.

I’d like her to operate on me, please.
In over 100,000 patients in Ontario, with over 3,000 different surgeons, overall 30-day mortality was statistically better for patients who had a female vs. male surgeon.  In fact, odds of death at 30-days was reduced 12% simply by having a female surgeon.  Other surgical quality metrics, such as length of stay, repeat admission, and complications were also better for female surgeons.  This was a retrospective study and may have had unrecognized confounders.  But they, “matched patients for age, sex, and general comorbidity that had the same surgical procedure by a female or male surgeon of the same age with comparable annual surgical volume in the same hospital.”  The other issue was similar to the critique of the article linked above about internists; namely, the surgeon was part of a very large team of people caring for the patient, all of whom had an influence on the outcome.  Regardless of this objection, I think the results are valid.  What I would like to know is why?  What is it that, in the aggregate, female vs male surgeons are doing that improves outcome, and how can we all adopt these techniques for our patients’ benefit?  Maybe the next study could be a detailed qualitative observation of female vs male surgeons to find out.

Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study.  BMJ. 2017 Oct 10;359:j4366. doi: 10.1136/bmj.j4366.

Another Spoonful
This was an excellent editorial on the #ILookLikeASurgeon campaign celebrating women in surgery –  “the hashtag underlines the need to create a new surgeon ‘ideal’—not one that tries to make all surgeons like women, or indeed like a single image, but instead recognises the need for many images.”

Peer reviewed by Thomas Davis, MD.

What are your thoughts?