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Women are at a potentially fatal disadvantage on the operating room table, according to a “troubling” new study of more than 1.3 million patients treated by 2,937 doctors.
Gender presents a life-or-death risk for women the study finds, with females 15% more likely to die or incur serious complications if operated on by a male surgeon, medical researchers at Vanderbilt University in Nashville, Tennessee and University of Toronto in Ontario, Canada reported.
They based their joint analysis — conducted from November 2020 to March 2021 and published this month in JAMA Surgery — on data from 1,320,108 patients who received both elective and medically necessary surgeries between 2007 and 2019.
Of that group, 717,548 were “sex discordant” — meaning the surgeon and patient were of different genders (more than 180,000 of those being women with male surgeons — and adverse outcomes). However, average rates of patient mortality and related complications improved about equally among all other scenarios, whether women operated on women, women on men or men on men.
“What is surprising and troubling is that negative outcomes, including complications and death, were linked to sex discordance,” said Florida surgeon Dr. Amalia Cochran in a published research letter tied to the study. “Unfortunately, this association disproportionately affected female patients. The association between surgeon-patient sex discordance and outcomes sounds the alarm for urgent action.”
The research team co-led by Dr. Cochran and Dr. Andrea N. Riner also accounted for age, health and other conditions that could give way to surgical complications.
Study authors said more research is needed to determine the root of the results, but Cochran suggested a greater need to promote more women going into medicine, as men by far dominate the field, with male doctors still outnumbering female doctors, 64 percent to 36 percent, according to data from the Kaiser Family Foundation.
“In 2019, only 22% of general surgeons in the US were women, and orthopedic surgery had the lowest representation of female surgeons at 5.8%,” Dr. Cochran said, citing a statistics from the Association of American Medical Colleges.
“However, self-reflection is warranted on the way in which we provide care,” she added. “Surgeons likely believe they provide the same quality of care to patients irrespective of identity. However, these data underscore an under-appreciated phenomenon and highlight a measurable repercussion of implicit bias.”
Meanwhile, past studies suggest that women may actually make more ideal doctors. Similar research published in 2018 found that death rates among 580,000 heart patients in Florida emergency rooms were overall lower if treated by female doctors compared to when men wore the white coats.
The difference was marginal in another 2016 study — a margin of 32,000 lives, that is. More than 1.5 million hospitalized Medicare patients were found less likely to die at the hospital or be readmitted after seeing a female doctor. The difference was only a half percentage point overall, but made tens of thousands of lives were the difference.
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