Abstract
Surgery is traditionally a male-dominated field, and gender differences exist despite the growing numbers of female surgeons. A handful of studies have evaluated the condition in Asian societies. We aimed to examine the difference between female and male surgeons in urology, general surgery, and gynecology by analyzing a nationwide, population-based database. We identified surgeons with a clinical experience of six to thirteen years between 1995 to 2013 from the National Health Insurance Research Database. We collected patient numbers and revenue per month in outpatient and inpatient care, as well as monthly numbers of surgeries conducted by female and male surgeons in urology, general surgery, and gynecology, for analysis. Original student’s t-test and wilcoxon rank sum test was used to compare the differences between female and male surgeons, and p values less than 0.05 were considered statistically significant. Female urologists and general surgeons had a significantly higher ratio of female patients in Taiwan. Female urologists had patient numbers, revenues, and numbers of surgeries comparable to male urologists. In contrast, female general surgeons had significantly less involvement in outpatient and inpatient care and had low monthly revenues. Female general surgeons contradictorily performed more oncological surgeries per month than males. However, the difference in numbers of oncological surgeries was not significant after excluding breast cancer surgeries. Female gynecologists had a similar amount of outpatients and outpatient revenue but significantly less inpatient care and numbers of surgeries per month. A gender-based gap exists among surgeons in Taiwan. The gap between females and males appeared narrower in urology than in general surgery and gynecology. Management of diseases related to female sex organs, including breast, were more common among female surgeons. Efforts should be made to decrease gender stereotypes, to ensure that patients receive the best care regardless of the sex of the surgeons.
Highlights
A significantly large number of females have entered the field of medicine in the past few decades
The differences in numbers of patient care and revenue as well as numbers of surgeries performed between female and male surgeons in urology, general surgery, and gynecology are listed in Tables 1, 2, and 3
The ratio of female outpatients and inpatients treated by female urologists was significantly higher than those treated by male urologists
Summary
A significantly large number of females have entered the field of medicine in the past few decades. In Taiwan, 36.6% of total new medical graduates were female in 2018. Taiwan Medical Association estimates that female physicians compose nearly 20% of the total healthcare workforces[1]. As the growing population in the field of medicine, female physicians have their advantages and limitations in clinical practices. Sex segregation still presents[4] and influences the choice of specialties as their career for females physicians. A previous study has pointed out that female physicians were less likely to specialize in surgery than m ales[5], and the gap in practice pattern and salaries have been. We assessed the gender gap among surgeons by analyzing a nationwide, population-based database in Taiwan and focused on three sub-specialties that included the management of disease of female sex organs: urology, general surgery, and gynecology
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