Surgeon Gender Not Predictive of Outcomes, Study Finds

WASHINGTON—Contrary to previously reported findings from the Canadian healthcare system, surgeon gender is not prognostic of clinical outcomes in U.S. practice, according to findings presented at the 2024 annual meeting of the American Surgical Association. With data encompassing nearly 5 million patients and more than 39,000 surgeons, the study represents the largest analysis of this question to date.

“This question came to the attention of my research group because of a New York Times article from February 2022 [bit.ly/46diXWV] that featured some really interesting work from investigators in Ontario,” noted Salvatore Scali, MD, a professor of surgery in the Division of Vascular Surgery and Endovascular Therapy at the University of Florida, in Gainesville, who presented the findings. “They looked at a cross-section of over a million patients and noticed a 12% reduction in mortality favoring female surgeons. We wanted to see if we could identify a similar signal in the [United States].”

Dr. Scali and his co-investigators—a diverse team of male and female surgeons nationally recognized for leadership and research, he noted, in view of the sensitivity of the question under scrutiny—sought to exceed the Canadian study in breadth of data collection and depth of analysis. “We used a larger data set because if there were an association, even a subtle one, we’d be able to detect it more easily,” he said. “The United States also has a much larger population than Canada and a lot more heterogeneity in our healthcare system, so we wanted to analyze a correspondingly larger sample.”

To that end, in addition to analyzing data from five times as many patients and more than 12 times as many surgeons (the Canadian study included just under 3,000), the investigators studied data from more procedures. Where the Canadian study examined data from 25 procedures, the present analysis included 39, specifically those identified by the CDC’s National Healthcare Safety Network as the most common high-impact operations.

Applying a diverse battery of statistical analyses, Dr. Scali and his co-investigators sought to ferret out any association between self-reported surgeon gender and surgical outcomes. “We looked at the data set in aggregate, as well as at the specialty level and the procedure level,” Dr. Scali noted. “We generated dozens of different prediction models to understand whether or not there was, in fact, any association.”

Ultimately, the investigators identified different statistical associations between surgeon gender and outcomes; however, the absolute differences in clinical events rates were very small.

“It’s a testament to our training programs in the United States that comparable outcomes can be anticipated independent of surgeon gender,” Dr. Scali said. “Patients should feel reassured that they can focus on individual surgeon- and center-based outcomes when choosing a provider.”