Patients treated by female surgeons have significantly lower long-term adverse outcomes
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Key takeaways:
- Patients treated by male surgeons had higher rates of adverse postoperative outcomes at 90 days and 1 year.
- Researchers reported a similar trend for mortality at each time point.
Patients treated by female surgeons had lower rates of adverse postoperative outcomes, including death and major medical complications, at 90 days and 1 year compared with those treated by male surgeons, according to data in JAMA Surgery.
“The sociodemographic characteristics of physicians, including age and sex, are associated with patients’ health care outcomes,” Christopher J.D. Wallis, MD, PhD, of the division of urology at Mount Sinai Hospital, and colleagues wrote. “Across many medical contexts, female physicians have better patient outcomes than male physicians.”
They continued: “Understanding whether observations regarding the association between surgeon sex and surgical outcomes persist over a longer term is an important step in evaluating the broader implications of diversifying surgical practice in health care delivery.”
In a retrospective, population-based cohort study, researchers analyzed data from 1,165,711 patients who underwent one of 25 common surgeries performed by a male (76.7%) or female (23.3%) surgeon between January 2007 and December 2019. The common surgeries were from specialties including general surgery, cardiothoracic surgery, neurosurgery, obstetrics and gynecology, otolaryngology, orthopedic surgery, plastic surgery, thoracic surgery, urology and vascular surgery.
The primary outcome was an adverse event, defined as death, readmission or medical complication, at 90 days or 1 year after surgery.
Results showed 166,905 (14.3%) patients had at least one adverse postoperative outcome at 90 days: 2% died, 8.1% were readmitted and 6.6% had a major complication. At 1 year, 25% of patients experienced at least one adverse outcome: 4.3% died, 18.9% were readmitted and 7.9% had a major complication.
Multivariable-adjusted analysis showed patients treated by male surgeons had higher rates of adverse postoperative outcomes compared with female surgeons at 90 days (13.9%; 95% CI, 11.3-17.2 vs. 12.5%; 95% CI, 9.9-15.6; adjusted OR = 1.08; 95% CI, 1.03-1.13) and 1 year after surgery (25%; 95% CI, 22.4-27.9 vs. 20.7%; 95% CI, 17.2-24.8; aOR = 1.06; 95% CI, 1.01-1.12).
Researchers also noted a similar trend for mortality at 90 days (male = 0.8%; 95% CI, 0.4-1.6 vs. female= 0.5%; 95% CI, 0.3-1.1; aOR = 1.25; 95% CI, 1.12-1.39) and 1 year (2.4%; 95% CI, 1.2-4.8 vs. 1.6%; 95% CI, 0.8-3.1; aOR = 1.24; 95% CI, 1.13-1.36).
“Patients treated by female surgeons had significantly lower long-term rates of adverse postoperative outcomes than those treated by male surgeons,” Wallis and colleagues concluded. “These data add to the growing literature showing that patients cared for by female physicians (including surgeons) appear to fare better than those being cared for by male physicians.”
They continued: “Despite these data, women continue to be marginalized in the workplace in many ways. To provide the best patient care, organizations should support women physicians and learn how they accomplish these improved outcomes.”
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