Study: Patients of female surgeons experience fewer complications, lower long-term readmission

Editor's Note

Female surgeons achieve better long-term outcomes for surgical patients—especially for female patients—according to a large national study published April 23 in JAMA Surgery.

Using US Medicare data from over 2.2 million older adults, researchers found that patients of female surgeons had lower mortality rates and, for women, fewer complications and readmissions than those treated by male surgeons.

Patients ranged from 65 to 99 years old and underwent one of 14 common elective or emergent surgeries. Only 5.7% of these patients were operated on by female surgeons. Researchers examined the influence of surgeon gender and patient-surgeon gender concordance (whether patient and surgeon were the same gender) on 90-day and 1-year mortality, readmission, and complication rates, adjusting for a wide range of patient, surgeon, and hospital characteristics. Among other findings, the research revealed the following:

• Patients treated by female surgeons had lower 90-day mortality (2.6% female surgeons vs 3.0% with male surgeons) and 1-year mortality (3.9% vs 4.4%).
• For female patients, those treated by female surgeons had lower 90-day readmission (7.3% vs 7.7%) and lower 90-day complication rates (12.2% vs 12.8%). These differences were not seen among male patients, whose readmission and complication rates did not differ by surgeon gender.
• Patterns were consistent for 1-year outcomes and mainly seen in elective surgeries, not urgent/emergent procedures.
• Female surgeons were more likely to perform weekend or emergent operations and had less surgical experience and lower case volumes than male peers. Nonetheless, they still achieved better outcomes.

Researchers suggest that factors such as guideline-based care, communication style, patient rapport, and more careful operative technique may explain these differences. For female patients, the benefits of gender concordance may stem from greater comfort, more open communication, and a reduced risk of symptoms being underestimated. Although these findings add to growing evidence, researchers cite limitations including possible unmeasured confounders and lack of generalizability to younger or non-US patients.