by New findings from a study published in The BMJ suggest that there is limited evidence to support the notion that patient-surgeon gender concordance leads to lower patient mortality rates post-surgery. While previous research has shown that gender concordance can improve patient care in other healthcare specialties, this study found mixed results when it came to concordance between patient and surgeon. The study revealed that gender concordance was associated with lower mortality rates for female patients, but higher mortality rates for male patients. Specifically, the lowest patient mortality rates were observed in female patients treated by female surgeons, while the highest mortality rates were seen in male patients treated by male surgeons.
The study also explored the influence of surgeon gender on patient mortality rates. The results showed that female surgeons had slightly lower patient mortality rates than male surgeons for elective surgeries, but there was no significant gender difference for non-elective procedures.
Dr. Yusuke Tsugawa, senior author of the study and associate professor of medicine at the David Geffen School of Medicine at UCLA, emphasized that the quality of surgical care provided by female surgeons in the United States is equivalent to, or in some cases, slightly better than that provided by male surgeons. Therefore, when selecting a surgeon, patients should consider factors beyond just the gender of the surgeon, as the difference in patient mortality rates between female and male surgeons was relatively small.
The researchers analyzed data from 2.9 million Medicare fee-for-service beneficiaries aged 65 years and older who underwent one of 14 different surgeries between 2016 and 2019. These surgeries included abdominal aortic aneurysm repair, appendectomy, cholecystectomy, colectomy, coronary artery bypass surgery, knee replacement, hip replacement, hysterectomy, laminectomy or spinal fusion, liver resection, lung resection, prostatectomy, radical cystectomy, and thyroidectomy.
Among the participants, 41% were male surgeon/patient pairs, 3% were female pairs, and 56% were pairs of different genders. The study’s outcome measure was the occurrence of death within 30 days of the surgical procedure.
After adjusting for various factors, such as patient and surgeon characteristics, the researchers found that the 30-day post-surgery mortality rates were 2.0% for male patient-male surgeon pairs, 1.7% for male patient-female surgeon pairs, 1.5% for female patient-male surgeon pairs, and 1.3% for female patient-female surgeon pairs.
It is important to note that the study has certain limitations, including potential undetected confounders from Medicare claims data, the inability to account for the contributory characteristics of other healthcare team members, and the possibility that the findings may not be applicable to younger patients.
However, these findings contribute to a better understanding of the factors that can improve overall care for patients. The researchers stress the importance of ongoing qualitative and quantitative research to further examine how factors such as surgeon and patient gender, race, and other shared identity aspects impact the quality of care and outcomes after surgery.
