Surgery is a male-dominated profession, and for years it has been debated that “implicit sexual bias” could be behind the results. In Europe, almost nine out of ten tenured surgeons are men. Several investigations have even revealed that women who are operated on by a male surgeon are much more likely to die, experience complications and be readmitted to the hospital than when a woman performs the procedure.
The study. Research published in the medical journal JAMA Surgery indicates that women are 15% more likely to have a poor outcome and 32% more likely to die when a man performs the surgery instead of a woman. Overall, patients also had a 16% increased risk of complications; an 11% higher risk of readmission; and 20% more likely to have to stay in the hospital longer. This was not the other way around.
To arrive at those results, the study authors analyzed the records of 1,320,108 patients in Ontario who underwent 21 common surgical procedures performed by 2,937 surgeons. These ranged from hip and knee replacements and weight-loss surgery to removal of an appendix or gallbladder and more complicated operations such as a bypass cardiac arrest, aneurysm repair, and brain surgery.
Why? Technical differences between male and female surgeons are unlikely to explain the findings, as both sexes receive the same technical medical training. However, the research suggests that one possible explanation may be “implicit sexual bias,” in which surgeons “act on deep-seated, subconscious biases, stereotypes, and attitudes.”
Differences in men’s and women’s communication and interpersonal skills evident in surgeons’ conversations with patients before the operation is performed may also be a factor. And differences between the work style, decision making and judgment of male and female doctors.
Other explanations. Several surgeons have tried to explain in this BBC report some of the reasons that may also be behind it. Oneeka Williams, a urologist at Tufts University, USA, doesn’t make definitive statements about why female patients may fare worse with male surgeons, but notes that “men think women are more anxious and hysterical and, as As such, they pay less attention to postoperative complaints. It also suggests that there may be a significant difference in pain perception: “male doctors underestimate the severity of symptoms in female patients.”
Discrimination in the work area. They also point to differences in attitudes towards male and female surgeons. “During the operation, we know that women surgeons are punished for poor results. They are more likely to have a drop in their referrals, are less likely to be forgiven for a poor result, and these are attributed to their skill, while in male surgeons, poor results are attributed to chance, to bad luck. So women have to perform better to be considered equal, “they point out.
A profession full of men. 86% of senior surgeons are men. Surgery is still a long way from having gender balance in its workforce. Women make up 41% of early-stage surgeons, but only 30% of senior trainees and 14% of consultants. Lack of flexibility in surgical training schedules and shifts may explain why many women do not become consultant surgeons.
Controversy. Gender discrimination in a field that is dominated by men has long been recognized and can be a factor in women leaving the profession. In 2015, female surgeons took to Twitter to challenge this situation with the slogan #ILookLikeaSurgeon (#meveocomocirujano). Still today, the hashtags it has a lot of messages about how women in the profession are routinely mistaken for a different role, with almost anything other than a surgeon.
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