How Much Does It Matter Who’s Holding That Scalpel?

There seems to be a difference in post-operative outcomes between patients of female surgeons and male surgeons. What might it mean?


Recent research has unveiled intriguing insights into surgeon sex and post-operative outcomes, suggesting that female surgeons may hold a hidden advantage in patient outcomes over their male counterparts.

Specifically, studies have shown that patients treated by female physicians tend to experience better post-operative outcomes compared to those treated by male physicians. The reasons behind this phenomenon are not completely understood, but are suggested to encompass differences in communication styles, practicing styles, and the physician-patient relationship between male and female physicians.

One notable observational study, led by Dr. Christopher Wallis from the University of Toronto’s Department of Surgery, Division of Urology, found that patients treated by female surgeons had a statistically significant decrease in 30-day mortality and other adverse surgical outcomes when compared to those treated by male surgeons. But, does this advantage persist beyond the initial 30 days?

To address this question, Wallis and colleagues embarked on a longer population-based retrospective cohort study to assess whether there was an association between surgeon sex and adverse post-operative outcomes at 90 days and one year following surgery. This study was published in JAMA Surgery at the end of August of this year.

The study examined a massive cohort of adult patients (older than 18 years) who underwent one to 25 common surgeries between 2007 and 2019 in Ontario. Over one million patients were analyzed, and the primary study outcome was adverse post-operative events, defined as death, readmission, or complications post-surgery.

The researchers found that after adjusting for various factors, including patient characteristics, surgeon experience, anesthesiologist involvement, and hospital-level factors, patients treated by male surgeons had a higher incidence of adverse post-operative outcomes both at 90 days (13.9%) and one year (25%) compared to those treated by female surgeons (12.5% and 20.7%, respectively).

Moreover, female patients treated by male surgeons had significantly higher rates of adverse post-operative effects at one year following surgery compared to male patients.

Overall, this study suggests that patients treated by female surgeons have significantly lower rates of adverse post-operative outcomes in the long term (90 days and one year post-surgery) compared to those treated by male surgeons. Nonetheless, it is essential to acknowledge the unequal distribution of female surgeons in this study (23%) and within the medical profession in general. This fact emphasizes the sex disparity and marginalizations that persist in the healthcare workplace.

Based on these findings, and to provide the best possible patient care, healthcare organizations should support and empower female physicians. Simultaneously, there is a pressing need to delve deeper into the underlying differences in surgical practices between male and female surgeons, which appear to contribute to the more favourable post-operative outcomes observed among female surgeons.

Ultimately, the goal is to ensure that patients receive the highest level of care, regardless of their surgeon’s biological sex.

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Alexandria (Alex) Samson is a PhD student in the Department of Psychology at the University of Toronto. She completed her BSc in Neuroscience from Dalhousie University. Alex is a strong believer in open science and is passionate about making scientific research accessible to all audiences.