Patients treated by female surgeons are less likely to die

October 1, 2023 5:16 PM

Patients treated by female surgeons are less likely to die. Patients treated by female surgeons have better chances of effective recovery and are "less likely to experience death," according to a new study that raises further questions on the underlying causes. The study of over one million people, published recently in the journal JAMA Surgery, found patients treated by female surgeons have a lower likelihood of adverse outcomes at 90 days and a year following their surgical procedures.
posted by chariot pulled by cassowaries (19 comments total)

Units, pop-sci writers, UNITS are pretty damn important

sorry folks, the time-unadjusted likelihood of 'experiencing death' is 100%
posted by lalochezia at 5:32 PM on October 1, 2023 [7 favorites]

The units are included in the article and the post? Ninety days and one year, it's right there.
posted by deadwax at 5:41 PM on October 1, 2023 [7 favorites]

The original study
posted by justsomebodythatyouusedtoknow at 5:45 PM on October 1, 2023 [2 favorites]

Without reading the article, is it what it usually is? It's hard to become a surgeon, harder to become a female surgeon, female surgeons have to be twice as good?
posted by subdee at 5:54 PM on October 1, 2023 [24 favorites]

My partner and I have both worked in construction, obviously historically male dominated, and have noted that any female workers that are around tend to be excellent.

Our tentative conclusion on the reason for this is that all the average and mediocre women are driven off by the culture and sexism. It's not a low effort work option for any of them in the way it might be for a twenty year old bloke that isn't sure what to do and so might as well go and do some labouring. Those that stick around are thick skinned, motivated and quite aware that fuck ups will be hung on them more than they might otherwise be.

The article suggests other reasons for the discrepancy, which might be right, but ignoring plain old sexism seems like an oversight.
posted by deadwax at 5:54 PM on October 1, 2023 [19 favorites]

I think subdee has it right. "In this research of 1,165,711 included patients, 151,054 were treated by female surgeons and 1,014,657 were treated by male surgeons." I'd bet the 151,054 patients treated by the best male surgeons did quite well. But if the worst male surgeons were replaced by the most talented group of women who didn't become surgeons, net outcomes would improve. And certainly things are trending that way: the share of women is much higher among new doctors than old doctors.
posted by Mr.Know-it-some at 6:00 PM on October 1, 2023 [11 favorites]

From the summary of the original article:
"After accounting for patient, procedure, surgeon, anesthesiologist, and hospital characteristics"

It sounds like they adjusted for the surgeon characteristics somehow to just isolate gender. Can't access the full text to find out what specifically they adjusted for though.

But this part makes me very cautious about overinterpreting results:

"more carefully select patients for surgery"

It may just be that male doctors are more willing to operate on risky patients which could be a good thing (ie: not obsessed with a victorious record over trying to help people).

I'd be very curious to see how this washes out and if any more sophisticated analysis will done.
posted by srboisvert at 6:26 PM on October 1, 2023 [7 favorites]

yeah by a similar token, when we wanted to apply for permanent residency in Japan the way I chose a lawyer to help us out was to select the first female lawyer I saw, figuring that in a line of work as Brozone as law, in a country as casually sexist as Japan, any given woman working in the industry would have to be twice as competent to be considered half as good
posted by DoctorFedora at 6:27 PM on October 1, 2023 [20 favorites]

While I’d never discount sexism, we shouldn’t rule out natural advantages in the female body, like small hands.
posted by cardboard at 6:54 PM on October 1, 2023

Apparently for women undergoing an operation, having a female surgeon improves their chances of a successful outcome, according to the study in this article.

Did I see something about this on the blue before?
posted by Jane the Brown at 7:44 PM on October 1, 2023 [3 favorites]

From what I’ve witnessed secondhand from someone I know who went into surgery, I have absolutely no doubt that sexism requiring female surgeons to be better than their average male counterpart is at least a significant part of the discrepancy in patient outcomes for male vs female surgeons.
posted by eviemath at 7:47 PM on October 1, 2023 [2 favorites]

On a similar tangent for GPs, there's a difference recorded in time spent per consult, where female GPs record 15.9 minutes per patient (95% CI 15.4-16.2) vs 14.3 minutes per patient (95% CI 14.0-14.6) for male GPs. However trying to pin down the causality is difficult.

For example on theory is that, female patients might prefer to see a female doctor for reproductive or mental issues both of which are more complex to treat, hence the higher time needed per consult, while males patient might not have a specific gender bias, so on average female doctors get burdened with more complex cases while being paid the same so they earn less.
posted by xdvesper at 8:13 PM on October 1, 2023 [1 favorite]

From the jamanetwork.com abstract: Multivariable-adjusted rates of the composite end point were higher among patients treated by male than female surgeons at both 90 days (13.9% vs 12.5%; adjusted odds ratio [AOR], 1.08; 95% CI, 1.03-1.13) and 1 year (25.0% vs 20.7%; AOR, 1.06; 95% CI, 1.01-1.12).
The effect is significant but not huge? If the lower end of 95% CI = confidence interval is less than 1.00 then there is probably nothing to see here. For example, you might not drive 500 miles to be treated by a female surgeon, but may decide that flying there doesn't add to your risk.
posted by BobTheScientist at 12:35 AM on October 2, 2023 [4 favorites]

the time-unadjusted likelihood of 'experiencing death' is 100%

Your point is totally correct and I heartily agree, but if I can add a niggling remark at a phenomenological tangent (and after all, this is Mefi, home of niggling technical caveats), I don’t think anyone actually experiences their own death. Which might be kind of comforting in a general way.
posted by Phanx at 5:37 AM on October 2, 2023 [3 favorites]

While I’d never discount sexism, we shouldn’t rule out natural advantages in the female body, like small hands.

It would be nice, but that's not the case.

One size does not fit all: Impact of hand size on ease of use of instruments for minimally invasive surgery (2023)

Addressing Women’s Needs in Surgical Instrument Design (2006)

Oversized and overlooked: Women surgeons struggle to find equipment that fits (2022)
posted by kimberussell at 6:00 AM on October 2, 2023 [4 favorites]

Anything to do with the listening to the patient and good follow up post surgery?
posted by tiny frying pan at 7:25 AM on October 2, 2023

Perhaps we haven't reached equality until this gender gap goes away. (Seriously - would that mean that the worst male surgeons are getting replaced by less bad female surgeons?)
posted by madcaptenor at 7:33 AM on October 2, 2023

I go to a clinic that specifically trains residents, which means that all of the doctors are young, and and most of them are immigrants and WOC. Seriously just the best bedside manner, consistently, of anywhere I've ever been, even though the residents rotate and so I'm generally talking to a stranger. Women are just less likely to blow patients off when they're talking about their symptoms, and they're particularly less likely to blow other women off. Because they know what it's like, personally and anecdotally, in a way men often don't, because they have experienced that bias as patients.

So yeah, it doesn't surprise me that female surgeons tend to go slower, be more careful, and take a more patient-centered approach, as per the article. It's not just that they're technically better, though they probably don't get to fail upward like some of the legacy-admission dudes do.
posted by Nibbly Fang at 3:45 PM on October 2, 2023 [2 favorites]

Related: These Women Matched at Stanford. Twitter Responded with Misogyny and Racism.
posted by kat518 at 3:47 PM on October 2, 2023 [2 favorites]