Are There Differences in Surgical Outcomes Among Patients Operated on By Female Versus Male Surgeons in North America? (A Systematic Review)

Abstract

Study Objective There continues to be concern about gender bias in the surgical profession especially in subspecialties such as general surgery that are male dominated. The purpose of this systematic review was to synthesize data comparing the outcomes of patients operated on by male surgeons to that of female surgeons. Design We followed PRISMA guidelines in conducting this systematic review including registration of the review in PROSPERO. Our search initially yielded 46 articles. After detailed screening, we found two articles that reported on surgical outcomes of patients operated on by female versus male surgeons. The data from these two articles were then abstracted and synthesized using the DistillerSR software. Setting N/A Patients or Participants N/A Interventions N/A Measurements and Main Results The two articles synthesized together covered all surgical subspecialties, and were both population based retrospective cohort studies. Both studies used commercially available databases containing hospital discharge data. They both employed matching at level of the surgeon and together involved patients across four regions (Ontario, New York, Florida, Pennsylvania). Their analyses incorporated a total of 74,759 patients operated on by female surgeons and 75,709 patients operated on by male surgeons. For operative mortality, there was no difference between female and male surgeons (pooled RR=0.97; 95% CI=0.89-1.06). For ‘any postoperative complication’ there was no difference between male and female surgeons (pooled RR=0.97; 95% CI=0.94-1.00). Conclusion This quantitative systematic review shows that patients operated on by female surgeons are no more likely to experience operative mortality or postoperative complications, than patients operated on by male surgeons. This study provides further evidence that patients should not consider gender when choosing their surgeon. The authors of this study also hope that our results will help reduce gender bias and stereotypes.