Worse female outcomes with male surgeons

[CHARLESTONMMM]

https://www.anesthesiologynews.com/Online-First/Article/05-22/Female-Patients-More-Likely-to-Fare-Worse-When-Operated-on-by-Men-Large-Study-Shows/66830?sub=9523F71AFC34F616D9C6B033283EE6C0152CC5CAE64833DBA22D4215592E691&enl=true&dgid=&utm_source=enl&utm_content=1&utm_campaign=20220429&pos=1&utm_medium=button

32% more likely to die. 15% more likely to have complications.

I thought this was interesting.

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[Gern Blansten]

The next step is to include trans surgeons and patients and see if the findings hold up. Sounds like the first study made a lot of assumptions on gender.

 

[DD214]

How was this study completed when even a Supreme Court Justice is completely incapable of defining what a woman is?

Did they have 24/7 access to biologists to help them figure this out??

 

[GassYous]

Yeah I require all of my doctors to be my exact age, demographic and sexual orientation or the tylenol just doesn't work the same.

 

[agammaglobulin]

This article is obviously discriminatory by intentionally leaving out genderqueer patients and surgeons. Shame on JAMA.

 

[coffeebythelake]

Same patient complexity? Maybe male surgeons are more willing to take the difficult, more high risk cases?

 

[DD214]

Questioning the study in any way is at least a microaggression, possibly a milliaggression depending on your rank in the patriarchal hegemony

 

[Fart Daddy Smooth]

Same patient complexity? Maybe male surgeons are more willing to take the difficult, more high risk cases?

The pattern was consistent across 21 different operations and multiple surgical subspecialties studied. [...]
The study builds on an earlier report in the British Medical Journal (2017;359:4366), led by the same authors from the University of Toronto, that showed female surgeons had better patient outcomes than male surgeons.

To follow up on the 2017 study, the investigators examined outcomes in patients undergoing operations in Ontario’s public health system between 2007 and 2019. Investigators controlled for variables such as patient age, type of surgery, comorbidities, and surgeon volume and years in practice.

The study included 1.32 million patients who were treated by 2,937 surgeons. In all, 82% of surgeons were male and 18% were female. Female surgeons were younger and had lower annual surgical volumes than their male colleagues.

Investigators said they could not account for case complexity, but noted that no evidence indicated male surgeons were performing on more complex subsets for each procedure.

Seems like a robust study. Thanks for posting OP.

 

[drmwvr]

Surgeons who reviewed the paper said even without a full understanding of the reasons for the disparity, the finding highlights the need for more women in the surgical workforce. (We don't know what the findings mean, they just mean we need more women surgeons)

“The association between surgeon–patient sex discordance and outcomes sounds the alarm for urgent action ,” wrote surgeons Andrea N. Riner, MD, MPH, and Amalia Cochran, MD, FACS, FCCM, of the University of Florida, in Gainesville, in an invited commentary. Calling the findings “troubling,” they said action should be taken immediately to address a lack of female surgeons. (Women are dying at the hands of men)

Investigators said they could not account for case complexity, (the single greatest factor that would meaningfully affect the findings of the study) but noted that offered no evidence (that) indicated male surgeons were performing on more complex subsets for each procedure.

Sounds pretty typical of what's coming out of Canada these days.

 

[pgg]

Most published research is wrong, and I don't see any evidence that this study is more or less likely to be wrong than the average publication.

Investigators said they could not account for case complexity, but noted that no evidence indicated male surgeons were performing on more complex subsets for each procedure.

How LOL can someone even LOL write a sentence like this LOL with a straight LOL face? Hoo boy.

 

[ambiturner]

Interesting study. By using percentages in the header paragraph the anesthesiology news article made the statistics sound somewhat more dire than they were but there indeed was a difference. Reading the baseline characteristics what stands out to me is the male surgeons seem much busier and older, and the female patients were sicker but younger, and given how few female surgeons there were the study is pretty lopsided. Not sure if any of those things played a role, assuming they adjusted correctly their results should be valid though. I’d be interested to see unadjusted odds, I don’t think they were in the paper.

Biggest issue to me is these are not big effect sizes and are large confidence intervals for how much data they had. Having done studies with databases like this, the results are almost always going to have a significant p value given how big they are, but these are not large differences in odds even if they are significant.

 

[nimbus]

I don’t understand the point of this study. What are they trying to accomplish? Will they study other surgeon characteristics? Race, age, height, religion, mallampati score?

 

[Dr. Rude]

I don’t understand the point of this study. What are they trying to accomplish? Will they study other surgeon characteristics? Race, age, height, religion, mallampati score?

The point of the study was to get the authors’ names in the national media. Might be a career booster.

Studying other surgeon characteristics? Depends on how this study is received.

 

[aneftp]

How about this. Level 1 trauma centers have more complications than level 2 trauma center. Level 2 trauma centers have more complications than community hospitals. Let’s all go to our posh local suburban hospitals and have our complex re do cbag/redo valves with cardiac surgeons who are used to do healthier hearts. And avoid the trauma and tertiary care hospitals. Cause those surgeons are better? Right?

Selection bias folks with outcome studies folks. Same with the women surgeons.

 

[Ronin786]

The point of the study was to get the authors’ names in the national media. Might be a career booster.

Studying other surgeon characteristics? Depends on how this study is received.

Bingo. DEI is the easiest path to promotion in academics nowadays.

You get to make up a bunch of stuff (valid or not, the field didn't exist two years ago), headline a bunch of meetings and get promoted for little to no work.

 

[RemyMcswain]

NEJM published some truly awful papers at the height of the racial reckoning these past 2 years. I’m all for inclusion/level playing field/mindfulness, but there was some legit non scientific nonsense being published.

I recall reading an article and being so shocked by their statements that I went and looked up the references cited. Opening up the cited articles revealed high school level articles. I lost a lot of respect for that journal after seeing what they were publishing.

 

[markneil]

I don’t understand the point of this study. What are they trying to accomplish? Will they study other surgeon characteristics? Race, age, height, religion, mallampati score?

Wokeness

 

[DocVapor]

Did they account for the anesthesiologist's sex?

If not...

Any med students out there wanna write up that study and put my name on it?

 

[nimbus]

Did they account for the anesthesiologist's sex?

If not...

Any med students out there wanna write up that study and put my name on it?

We need a study showing patients have better outcomes when their anesthesiologists are paid >90%ile MGMA.

 

[GassYous]

We need a study showing patients have better outcomes when their anesthesiologists are paid >90%ile MGMA.

But if everyone is paid >90% mgma...

I guess that's basically how ceo compensation works