Fewer post-op complications for patients of female surgeons, studies find

People operated on by female surgeons have less chance of problems after the procedure than if they were operated on by men, studies suggest.

Based on the records of a million patients, those operated on by women were less likely to die, be readmitted or suffer a major medical complication within 90 days or a year after surgery, researchers found.

Further investigation is needed to determine the reasons for these differences, but records suggest that women take more time on procedures, which may be a factor. Dr Christopher Wallis, who led the study, told The Guardian the results should give male surgeons pause for thought, and they should look to see if there were lessons to be learnt from their female colleagues.

According to the study, 13.9% of patients had adverse post-operative events when a male carried out the procedure, while this number was 12.5% if the surgeon was female. At a year post-surgery these figures stand at 25% and 20.7% respectively.

A second study adds credence to the suggestion that a slow and steady approach taken by female surgeons may be beneficial to patients. Based on the records of 150,000 patients in Sweden undergoing gallbladder surgery, those with male surgeons were more likely to have surgical complications, and were more likely to need longer hospital stays. Male surgeons were also more likely to convert to open surgery from keyhole.

Evidence suggests that female surgeons are more likely to use patient-centred decision-making, are more likely to collaborate, and take more care with the patients they select for surgery.

But the chance of being operated on by a female surgeon is less than a male as they are outnumbered. Just a fifth of surgeons in the US are female, for example. The gallbladder study showed that, for this specialty at least, women were more highly represented in private practice, however.

The reasons for this imbalance are multiple – the profession can be unforgiving in terms of hours, and difficult to manage around family life, which makes it harder for women who may be juggling both roles. There are also systemic challenges, with a recent UK survey finding that 29.9% of female surgeons have been sexually assaulted in the workplace, while patient attitudes towards female surgeons are also problematic.

Gender bias is well recognized as a contributing factor in unequal health outcomes between men and women. This includes the relationships between patients and healthcare professionals, as well as more systemic issues related to policies and approaches. Medical research is also subject to a significant gender bias, with males dominating testing cohorts for many pharmaceuticals and devices.

This has been demonstrated with a number of studies. Men with chronic pain are viewed as “brave” and “stoic”, according to one 2018 study, while women were seen as “emotional” or “hysterical”, for example. The study also found that doctors were more likely to treat women’s pain as a mental health issue, rather than something caused by a physical condition.

Health is one component of the World Economic Forum’s Global Gender Gap Report 2023, which shows that, globally, the gender divide in health and survival is one of the narrowest measured. It stands at 96% closed, against a global average of 68.4% closed when all metrics are taken into account.

Research by the Forum and McKinsey, which will be published at the Forum’s 2024 Annual Meeting in Davos, suggests that care delivery biases can have a significant role to play in the health gap. Based on analysis of over 800 academic papers, women are more likely to face diagnostic delays and suboptimal treatment due to limited understanding of gender-based differences in clinical outcomes.

Healthcare systems around the world continue to struggle with the fall-out from the pandemic, which has not only had an impact on patient outcomes, but is also affecting staffing. Workloads and changes in working patterns have led to large numbers leaving the medical profession, with women seemingly leaving in higher proportions than men.