Surgery: Patients operated on by women ‘fare better’ than those operated on by men, new studies reveal

Patients operated on by women “fare better” than those treated by men, according to two new studies.

Doctors in Canada and Sweden reviewed more than 1 million patient records and found that people seen by female surgeons had significantly better outcomes than those seen by male ones - with fewer post-op complications, shorter ward stays, and a lower chance of being re-admitted to hospital.

There was also a stark difference in death rates, the studies revealed, with patients treated by male surgeons 25% more likely to die one year after their operation than those treated by female surgeons.

Researchers are investigating potential reasons for the differences - but so far, records suggest female surgeons tend to operate more slowly and may achieve better results by taking their time in theatre. The results could also reflect differences in communication, style, and the doctor-patient relationships, the studies added.

Dr Christopher Wallis, who led one of the studies at Mount Sinai hospital in Toronto, Canada, said the findings should prompt male surgeons to reflect on their approach to operations - and consider how they could learn from their female counterparts. “As a male surgeon, I think this data should cause me and my colleagues to pause and consider why this may be,” he said.

Wallis’s team looked specifically at medical complications, readmission to hospital, and death rates after surgery in nearly 1.2 million Ontario patients between 2007 and 2019 - records which included 25 different surgical procedures on the heart, brain, bones, organs, and blood vessels.

The resulting study, published in the journal JAMA Surgery, found that 90 days after an operation, 13.9% of patients treated by a male surgeon had “adverse post-operative events”, compared with 12.5% treated by a female surgeon. Meanwhile, a year after surgery, adverse events were seen in 20.7% of patients operated on by women compared with 25% treated by men.

The study conducted in Sweden, also published in JAMA Surgery, reviewed 150,000 patient outcomes following surgery to remove the gallbladder. Again, fewer complications and shorter hospital stays were observed when patients were treated by women, with those treated by men more likely to suffer bleeding, bile duct injury, and abscesses.

Female surgeons were also found to be less likely to switch from keyhole to open surgery as they operated, and took more time in the theatre - with the study commenting that caution “might be a favourable quality”.

Dr My Blohm, one of the researchers at the Karolinska Institute in Stockholm, commented: “In some countries there is a general belief that male surgeons are superior to female surgeons. Interestingly, most previously published studies indicate that female surgeons are at least as good as male surgeons, or as in this case even slightly better.”

In England, women make up 15% of consultant surgeons, up from only 3% in 1991. Professor Scarlett McNally, a surgeon and president of the Medical Women’s Federation, told The Times that 91% of women surgeons had experienced sexism in their profession.

Commenting on the studies in Canada and Sweden, McNally also offered other possible reasons for the disparity. She said that the Centre for Perioperative Care, where she is deputy director, had evidence that the risk of many complications of surgery could be halved when patients prepared well for an operation - such as through daily exercise or stopping smoking or drinking.

“I think some patients feel more willing to ask questions of a woman surgeon,” she explained. This means they could go into a surgery with more knowledge and preparation, possibly contributing to the better outcomes.