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What is already known on this topic:
Female and male physicians differ in their practice of medicine in ways that might substantially affect patient outcomes. Outcomes after surgery depend on the technical and cognitive skills of treating physicians, so findings from medical specialties might not apply to surgical specialties.
What this study adds:
This large, population-based, matched cohort analysis found small differences in surgical outcomes between patients treated by female and male surgeons, with the former having a small but statistically significant decreased risk of short-term postoperative death.
5 Comments
Great idea to highlight the paper that mirrors previous american publications. It will invite discussion…..
DISCLOSURES: 1. male surgeon, and 2. member of gender-desegregated water polo university team (Imperial College Medics), advocate of absolute gender desegregation in all ways of life, especially sports.
Without a trace of irony, it appears that the esteemed authors’ methodology in establishing the primary discriminator (surgeon gender) does not accommodate all possible variations. I expect results of transgender and ambiguous gender colleagues to be the defining sub-dataset.
Further initial reading of the learned paper suggests to me that the subjects are not randomized, (as Baron Rutherford of Nelson would have said, if you do not randomize, you should not draw conclusions to affect people’s lives easily, or stigmatise for that matter……)
I would welcome a suitably powered RCT, robust on defining the lead surgeon (e.g. male attending guided in parts of decision making or/and cutting by female senior counts as a female surgery) and modelling all possible genders, patient gender, emergent/urgent/elective etc., international risk scores (APACHE, Euro SCORE e.g.), intention to treat gender, COMPLICATIONS, patient perceptions and expectations, and so on. I expect the RCT to saw no difference in results, as no robust causation of a difference will EVER be established…..
I do not find the adjective ‘similar ‘ defining case mix as scientifically robust enough to draw meaningful clinical conclusions…
BMJ has a defined policy on diversity, and it is conceivable that the learned Ontario effort may fall short of the gender equality clause, especially the title verges on sexist…
Once again, the line between scientific truth, political correctness and temptation to sensationalize can be a blurred one……..
Again many thanks to Joel for bringing this publication to the readership.
See also comment by a colleague I have never met : http://www.bmj.com/content/359/bmj.j4366/rr-0
Greetings.
Don’t surgeons choose which patients they want to operate on, and which ones they’d rather not?
Maybe women choose the safer patients. It is established that men are less risk-averse than women (or “reckless”, if you’re a feminist and want to make men look bad).
Any research or even thinking into that direction in the paper?
Cheers.
http://voxeu.org/article/risk-tolerance-men-and-women