Edited by Megan Cambruzzi
Between November 2020 and March 2021, a University of Toronto study analyzed a group of common elective and emergent surgeries in Ontario that occurred between 2007 to 2019. This study looked at the postoperative outcome for male patients with male surgeons, female patients with male surgeons, male patients with female surgeons, and female patients with female surgeons. It was identified that within the female patient with male surgeon combination, female patients were 15% more likely than any other doctor-patient combination to suffer an adverse postoperative outcome. These were death, readmissions to the hospital, or a complication within 30 days after surgery.
The mechanism for why female patients who have male surgeons are more likely to suffer an adverse outcome has not yet been identified, thus, this subject requires much more research. However, Angela Jerath, an associate professor at the Dalla Lana School of Public Health and a cardiac anesthesiologist at Sunnybrook Health Sciences Centre stated that the issues causing this imbalance can be explained using behavioural science. Jerath notes, “we believe that the issues that are causing this gap are extremely complicated…we need to understand these issues and fill the gap in care for female patients”.
It is interesting that these discrepancies are occurring amongst a variety of procedures including cardiothoracic surgery, neurosurgery, orthopaedic surgery, otolaryngology, plastic surgery, thoracic surgery, urology, vascular surgery, and general surgery.
Christopher Wallis is a urologic oncologist within the urology department at Mount Sinai Hospital and University Health Network and states that as a male surgeon himself “these findings really highlight a learning opportunity for me personally and for our profession”. Further, 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”.
Wallis provides some more insight as to why this imbalance is occurring and notes that social and cultural factors may be to blame when a male surgeon is caring for a female patient. Furthermore, researchers for this study believe there is a benefit to understanding how both patients and surgeons of opposite and the same sexes create trust. Jerath believes that it would also be useful to understand the differences in how male and female patients communicate with their surgeons because knowing this information may improve surgical outcomes.
Although this information is astonishing, both Wallis and Jerath agree that when meeting with a surgeon male or female, the patient should be able to establish trust and communicate their concerns. If anything, this study displays the benefit of diversification within surgical specialities and “the importance of increasing the number of female surgeons”.
References
Female patients operated on by male surgeons more likely to die, suffer complications: U of T Study. University of Toronto News. (n.d.). Retrieved January 26, 2022, from https://www.utoronto.ca/news/female-patients-operated-male-surgeons-more-likely-die-suffer-complications-u-t-study
Wallis CJD, Jerath A, Coburn N, et al. Association of Surgeon-Patient Sex Concordance With Postoperative Outcomes. JAMA Surg. Published online December 08, 2021. doi:10.1001/jamasurg.2021.6339