Divna Wheelwright MA, CCLS
Adjunct Professor, Erikson Institute & Nova Southeastern University
Patients treated by female surgeons are less likely to experience adverse outcomes 90 days to one year after surgery, according to a study published Aug. 30 in JAMA Surgery (Bean, 2023).
Researchers in the U.S. and Canada analyzed data on 1.2 million adults who underwent common surgeries between 2007 and 2020 in Ontario, Canada. Both at 90 days and one year out, patients were 25% less likely to die if their surgeon was female as opposed to male. Patients were also less likely to experience hospital readmission or major medical complications under the care of a female surgeon. This association was seen across nearly all subgroups defined by patient, surgeon, hospital, and procedure characteristics (Wallace, Jerath, Coburn, 2023).
For female patients, the odds of experiencing an adverse outcome were 15% higher when their surgeon was male compared to female. Male patients had similar outcomes irrespective of whether their surgeon was male or female (Wallace, Jerath, Coburn, 2023).
Data suggests that the underlying causes of this disparity and the efficacy of child life intervention relate to the same phenomenon: how well clinicians listen to patients and select the appropriate care. As opposed to differences between male and female surgeons’ technical skills in the operating room, researchers speculate it is the relationship between patient and clinician, and, more specifically, the differences the clinician exhibits around communication and understanding of patient preferences, that contribute to disparities in care. For child life, a field that points to the relational quality of the provider as one of the greatest predictors of promoting patient agency, this study validates what we already know: strong patient-clinician relationships drive healthier outcomes.
Another connection lies in the matter of representation. Women remain significantly underrepresented in the surgical profession, just as men and BIPOC, remain significantly underrepresented in child life. Studies show that if patients share sociocultural traits with the clinician the patient is more trusting, and the provider is more understanding (Sullivan, 2015). As demonstrated in the context of this study and in the literature that precedes it, measures of trust contribute to life-or-death outcomes, particularly for marginalized groups (Trent, Dooley, Douge, 2019).
All science should be approached with nuance, and these findings are not offered as an inference on individual practice. The clinical world is replete with male clinicians who excel at listening to their patients and female clinicians who fall short.* That said, a study such as this intimates something powerful at the macro level that has direct application to child life practice- the very people who are most likely to get pushed out are the exact people patients need most.
Who controls the resources? Who controls the narratives? Who has power over whom? Keep grappling.
*ACLP acknowledges there are also gender-diverse clinicians whose patient outcomes were not studied.
References
Bean, M. (n.d.). Female surgeons’ patients have better long-term outcomes: Study. Becker’s Hospital Review. https://www.beckershospitalreview.com/or/female-surgeons-patients-have-better-long-term-outcomes-study.html#:~:text=Patients%20treated%20by%20female%20surgeons,and%202020%20in%20Ontario%2C%20Canada.
Michelle MiJung Kim [@michellekimkim]. (2023, Oct 9). Retrieved from https://www.instagram.com/p/CyMFnfav6po/?hl=en&img_index=1.
Sullivan, E. (2017, May 8). Strong patient-provider relationships drive healthier outcomes. Harvard Business Review. https://hbr.org/2015/10/strong-patient-provider-relationships-drive-healthier-outcomes
Trent, M., Dooley, D. G., Dougé, J. (2019). The Impact of Racism on Child and Adolescent Health. Pediatrics, 144(2), e20191765. https://doi.org/10.1542/peds.2019-1765
Wallis CJD, Jerath A, Coburn N, et al. Association of Surgeon-Patient Sex Concordance With Postoperative Outcomes. JAMA Surg. 2022;157(2):146–156. doi:10.1001/jamasurg.2021.6339