Sexism May Play Role in Who Performs Your Surgery

November 11, 2021
Robert Preidt

Male doctors are much more likely to refer patients to male surgeons, rather than send them to female surgeons with equal qualifications and experience, a new study finds.

"During my 20 years in practice, I always had the sense it was easier for my male surgical colleagues to get referrals than it was for me, and the patients they were referred were more likely to need surgery," said senior study author Dr. Nancy Baxter. She is a researcher at Li Ka Shing Knowledge Institute at St. Michael's Hospital in Toronto.

"Our work demonstrates that my observations were not unique, but reflect gender bias that affects the lives and livelihoods of all female surgeons," Baxter said in a hospital news release.

For the study, her team analyzed data on nearly 40 million referrals to 5,660 surgeons in the Canadian province of Ontario between 1997 and 2016.

While 78% of those surgeons were male, they received 87% of referrals from male physicians and 79% of referrals by female physicians, the findings showed.

Female physicians were 1.6% more likely to refer patients to a female surgeon, but male physicians were 32% more likely to refer patients to a male surgeon.

The differences were greatest in specialties with the highest representation of female surgeons, such as gynecology and plastic surgery.

Even though more women became surgeons during the 10-year study period, the difference in male physicians' referral patterns didn't change, according to the report published online Nov. 10 in JAMA Surgery.

"There is an often made assumption that sex-based inequities in medicine will naturally improve as more women enter medicine and acquire experience," said co-lead author Dr. Fahima Dossa, a general surgery resident at St. Michael's Hospital.

"In contrast, our study demonstrates that inequities will not improve without active intervention," Dossa added.

In a previous study, Baxter and Dossa found that female surgeons in Ontario earn 24% less per hour while operating than male surgeons, and that female surgeons performed fewer of the highest-paid primary procedures than male surgeons.

"The time is now ripe to enact change," Dossa said. "Our work points toward a mechanism that directly contributes to the sex-based pay gap in medicine. Focused efforts at reducing the effects of implicit and explicit biases on referrals to physicians are now needed."

More information

AARP offers tips on choosing a surgeon.

SOURCE: St. Michael's Hospital, news release, Nov. 10, 2021

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