Study claims women are more likely to die when operated on by male surgeons

If you are a woman, you should really consider having your surgeon as well; could save your life.

This is because women have a 32% more likely to die when operated on by male surgeons compared to female surgeons, according to a recent study.

Although the sex of the surgeon made little difference for male patients, the study also found that women were more likely to experience complications and be readmitted to the hospital within 30 days if your surgeon had been a man. But why?

The doctor who directed the study (published in the specialized journal JAMA Surgery), Christopher Wallis, is not sure.

Wallis told the BBC that they still do not have an explanation for these findings, but that they are working on it.

So we asked several female surgeons what they think about why a woman could be safer in her hands.

Pain perception

The study analyzed more than 1.3 million patients treated by 2.937 surgeons in Ontario, Canada, between 2015 Y 2019.

It claims to be “the first study to address the question of the association between gender concordance between surgeon and patient and the surgical results”.

Does not make definitive statements about why Female patients may fare worse with male surgeons, but she points out possible explanations from other available medical literature.

One suggestion from the study that could explain the findings is that there is a significant difference in pain perception: male physicians “underestimate the severity of symptoms in female patients.”

Oneeka Williams, urologist at Tufts University School of Medicine in Boston, USA, agrees.

“I think there is a male bias to despise female complaints. They are likely to think that women are more anxious and hysterical and therefore pay less attention to postoperative complaints. Complaints are dismissed, pain is minimized and the severity of the disease is often dismissed and ignored”, he told the BBC.

Jennifer Svahn, a vascular surgeon at Northwell Health University in New York, agrees .

Svahn thinks that the high mortality rate may be due to the fact that “male surgeons are more likely to invalidate or marginalize the concerns and symptoms of a female patient”.

Attitudes

Nancy Baxter, a colorectal surgeon at St. Michael’s College Hospital, University of Toronto, also believes that “people tend to underestimate pain in women more than pain in men“, but suggests that other factors may also be at play.

“When you see the patient, what kind of decisions do you make as a surgeon? Who are you taking to the operating room? There is a possibility that there are differences between surgeons in terms of their gender and how they treat male and female patients,” he told the BBC.

He cited literature evaluating patients with heart problems which shows that female cardiologists manage patients better than male cardiologists, which results in better results.

But then it also points out the differences in attitudes towards male and female surgeons.

“During the operation, we know that women surgeons are punished for bad results, if they get bad results. It is more likely that they will have a decrease in their references, it is less likely that they will be forgiven for a bad result”, he pointed out.

“And the bad results are attributed to their ability, while in the male surgeons, poor results are attributed to chance, to bad luck”, he added.

“So female surgeons have to perform better to be considered equal”.

Communication

Another underlying explanation could be “women’s stronger emotional intelligence, empathy and communication skills”, as Williams put it.

Kim Templeton, an orthopedic surgeon at the University of Kansas Medical Center, believes the way her female colleagues approach their patients may help explain the differences.

The doctor-patient relationship is necessary for people to feel comfortable disclosing information that could be critical to make a diagnosis and recommend treatment, he said.

“Allows for more dialogue about concerns about surgery and addressing them early.”

Indeed , previous studies found that the doctor-patient relationship and interaction may suffer if the patient is a woman and the doctor is a man.

However, it is possible that communication problems do not depend solely on the doctor.

The Ontario study notes that women may underestimate postoperative pain and complications in men, and Svahn agrees.

“Patients possibly feel less intimidated by female surgeons. Therefore, they are more likely to communicate openly and comply more with instructions”, he said.

Dr. Jennifer Svahn, a vascular surgeon, says male surgeons are less likely to pay attention to a female patient’s concerns and symptoms. (Photo: JENNIFER SVAHN)

“I see myself as a surgeon”

Gender discrimination in a field that is dominated by men has long been recognized and can be a factor for women to leave the profession.

In 2015, the surgeons took to Twitter to challenge this situation with the slogan “#ILookLikeaSurgeon” (# meveocomosurgeon). Still today, the hashtag has many messages about how women in the profession are routinely mistaken for a different role, with almost anything other than a female surgeon.

Williams says that female surgeons are constantly remembers her gender.

“Most patients and staff assume I’m anything but the surgeon,” she said. “The most frequent assumptions are that I am the medical assistant, secretary, dietitian and, if I am lucky, the nurse.”

“In the most obvious cases, even after Having introduced myself to the patient, discussed the diagnosis, the surgical approach, and the risks and benefits, the patient will ask: ‘Who is going to do my surgery?’”

Williams believes that female surgeons need “ perform much more to prove their capabilities“and suggests that this could also be a factor to explain the study findings.

“I think that patients still have the stereotyped belief that male surgeons are superior . We are very self-aware and approach each patient with the added pressure of dispelling perceptions that we are inferior to male surgeons. We cannot afford to make mistakes”, he maintained.

Gender imbalance

Although Wallis, the main author of the study, emphasizes that this shows a trend in the population and does not mean that a patient will necessarily do worse with a male surgeon, it also illustrates the harsh reality of surgery: in the more than 1.3 million procedures analyzed, the patient was a woman more than 57% of the time, but the surgeon less than 11% of the occasions.

This relative lack of female surgeons is something that Svahn regrets.

“The treatment of any patient by of a female surgeon shouldn’t be limited by the fact that there just aren’t enough women in that field,” she said.

“If it is true that at Patients consistently and predictably do better with female surgeons, for whatever reason… we need female surgeons in all surgical fields to be available and accessible to patients.”

Fiona Myint, Vice President of the Royal College of Surgeons of England, recognizes the need to improve the gender balance in surgery.

“In the United Kingdom, more men than women choose to start training in surgery. The women represent the 33% of this specialty in the initial stage, but only the 30% of the top trainees and the 14% of the consultants”, he points out.

It is likely that women who remain confronted with sexism in the workplace; Williams says it’s an almost everyday experience for her.

Late one night, she remembers being called to the emergency room to see a male patient. To make him feel comfortable, the nurse joked with him and advised him to “control himself and not flirt with her”.

“He had reduced me to an object in the most misogynistic way and invited this I was patient so that she did not see me as the surgeon, but as a woman who could be disrespected and whose limits could be violated”, she said.

Overcoming sexism and gender bias will be crucial in attracting more women to the profession and convincing them to stay.

But for now, it seems that Baxter is right when he points out that “when the people think of surgeons, they think of men”.

You may be interested:

Subject to more from 20 surgeries to look like a Bratz doll