Women more likely to suffer death or complications if operated on by a man

[PostingForTheFirstTime]

www.dailymail.co.uk/health/article-10305997/Women-15-likely-die-suffer-complications-surgery-operated-man.html

Interesting. It's definitely a topic that merits looking into.

That's interesting. I wonder if these findings cluster around particular surgeons. Or is it something else.

Hm. Yes, more research, please.

I can believe that it's probably a combination of things.
When I worked with cardiac surgeons there was still a few of the big balls I'm God egos around, ones who didn't appear to want to help people but actually did it for glory. One in particular had a book out and was "famous" yet a lot of the cardiologist (Cardiac consultants who don't do open heart surgery) refused to refer patients to him and gradually froze him out. Because he was brash and arrogant he'd often operate on people with abnormal blood results and underlying infections of some kind rather than wait a few weeks or come up with a plan to manage them. He also used the excuse that he took the worst cases were as actually others may have stopped planned then gone ahead.

I knew many great Doctors as well and the next generation are much less arrogant. Also in a lot of medicine men have always been the baseline there was some work and studies going on as to women and cardiac conditions as they often present different but also require different interventions.

Lots of drugs, interventions use males in their studies so best practice may not be right for females. Even surgical instruments were designed around larger male anatomy.

It's well known women are often not listened to our believed when discussing symptoms or pain so I imagine that plays a part.

Women are considered by men as 'lesser than', inferior humans, it's absolutely no surprise that this extends to the operating table.

'Self-reflection is warranted on the way in which we provide care. Surgeons likely believe they provide the same quality of care to patients irrespective of identity,' she continued.

Plus, if it's all about identity, then female patients can just identify as men for the duration.

@Sickoffamilydrama

I can believe that it's probably a combination of things. When I worked with cardiac surgeons there was still a few of the big balls I'm God egos around, ones who didn't appear to want to help people but actually did it for glory. One in particular had a book out and was "famous" yet a lot of the cardiologist (Cardiac consultants who don't do open heart surgery) refused to refer patients to him and gradually froze him out. Because he was brash and arrogant he'd often operate on people with abnormal blood results and underlying infections of some kind rather than wait a few weeks or come up with a plan to manage them. He also used the excuse that he took the worst cases were as actually others may have stopped planned then gone ahead.

I knew many great Doctors as well and the next generation are much less arrogant. Also in a lot of medicine men have always been the baseline there was some work and studies going on as to women and cardiac conditions as they often present different but also require different interventions.

Lots of drugs, interventions use males in their studies so best practice may not be right for females. Even surgical instruments were designed around larger male anatomy.

It's well known women are often not listened to our believed when discussing symptoms or pain so I imagine that plays a part.

But if it was down to the character of the surgeon, then there would be no discrepancy in the harm to the patients, based on sex. It's seems it's not about the surgeons' characters, it's about the sex of the people they're operating on.

Obviously, sexism is a characteristic which would result in different results based on sex tho.

Lots of drugs, interventions use males in their studies so best practice may not be right for females. Even surgical instruments were designed around larger male anatomy.

This seems to play a part certainly in other parts of medicine.

And identifying as a man in the hope of getting better healthcare during treatment might end in more helpful and careful social care, recognising and managing pain, (couple of paracetamol for that open abdominal surgery you had four hours ago Mrs Jones? Now up you pop and see to baby) and listening - which is definitely an issue for female people in medical care, the practical impact of the lesser consideration of female anatomy and using the male body as default is not something any female can escape via identification.

Sadly it's another situation in which we see that sex matters, and identity changes very little about it.

Lots of drugs, interventions use males in their studies so best practice may not be right for females. Even surgical instruments were designed around larger male anatomy.

True, unfortunately, but that doesn't explain why women surgeons don't perform worse on women.

I wonder if a breakdown by age of the male surgeons would show any trends?

Particularly awful set of BTL comments on this piece. Ugh.

@ErrolTheDragon

Particularly awful set of BTL comments on this piece. Ugh.

They are awful but also incredibly stupid. It's almost as though those commenting didn't read the article.

Obviously, sexism is a characteristic which would result in different results based on sex tho.

Yes. Misogyny is rife and medics are not immune.

The first thing that sprang to my mind is that women's hearts are smaller than men's and female surgeon's hands may also be smaller and possibly more dextrous than male surgeon's hands, leading to better success for female surgeons operating on women. Just a thought.

@Prestel

The first thing that sprang to my mind is that women's hearts are smaller than men's and female surgeon's hands may also be smaller and possibly more dextrous than male surgeon's hands, leading to better success for female surgeons operating on women. Just a thought.

That would be likely to show some difference in their results for male patients too though.

Firstly more men are surgeons. Also, not everything is due to a reason, consider some things can be coincidental.

So.... men can't operate on men or women and women can't operate on women or men. Simples

Idiots. There are a lot more men surgeons, it's not rocket science.

Mail comments. Those three came one after the other. Guess I should thank them for bringing some humour to this, I had a good giggle when I got to “it’s not rocket science.”

I’m not surprised at all, I’ve seen the exact same story before about other fields of medicine (women die more with male doctors, no disparities with female doctors.)

But the implications of it are so horrible when you think about it. The male surgeons are not intrinsically less competent or they’d also kill men more. They’re killing women because of their attitude to women. And it’s not even noticed until someone does a study because whatever those attitudes are, they are normalised.

That would be likely to show some difference in their results for male patients too though

I don't quite follow why that would be. The smaller hand would not make the same difference on a larger heart, so other skill factors would be more equal when male and female surgeons operate on men. Although I agree there is a huge problem with gender bias in medicine and medical research in general, my understanding is that this translates into poorer outcomes for female patients regardless of the sex of the treating physician, so it seems something more is possibly happening in this particular case. It certainly calls for further research.

There is also this controversial article that suggests that female physicians out-perform men in other areas too not related to the sex of the patient. It's clearly a very complicated area.
www.health.harvard.edu/blog/does-your-doctors-gender-matter-2017012611062

Well yeah I can totally get this.

Was fobbed off by really irritated male doctor at the early pregnancy unit that I was 'most likely' having a miscarriage. gave me an internal which had me crawling up the bed. Told the nurse to get me some paracetamol and left.

2 mins later I was crawling in to the corridor shouting for help as I was about to pass out with pain. My ectopic pregnancy had ruptured and I was rushed in to theatre.

The female doctor that came running was such a hero to me. She got me on the bed and gave me two shots of morphine immediately. Honestly I cried when she come to see me on the ward.

So yes I agree with this

my understanding is that this translates into poorer outcomes for female patients regardless of the sex of the treating physician

A lot of the bias happens at the level of research and funding, clinical testing, teaching - men being the default, women's conditions not getting funding. That's all systemic and unrelated to the sex of the physician. So yes there are poorer outcomes for women generally.

But in this particular case the systemic bias isn't as relevant, because this is a case of "all else being equal." These are men and women with the same conditions getting the same treatment. And, all else being equal, there is a clear, lethal effect of misogyny among male heart surgeons. I don't think there are any other credible explanations for it, sorry. Especially given that the same effect exists in other parts of medicine.

I think you're making a false assumption that because most of the bias against women in medicine is systemic, none of it can be explained by misogyny at the level of individuals.

Here''s a very large previous study with similar findings. www.pnas.org/content/115/34/8569

I wonder if it's to do with male surgeons ignoring, minimising and dismissing (e.g. as anxiety etc) women's post op complication and infection symptoms until damage or death has already occurred?

As the surgeon is the gatekeeper to the woman receiving care for post op infection and complications, a misogynistic surgeon dismissing a woman's pain and symptoms will result in treatment delay until it's possibly too late.

Similar phenomenon with baby survival rates. Black babies are more likely to die if the doctor is white. It's horrific.

When cared for by white doctors, black babies are about three times more likely to die in the hospital than white newborns.

This disparity halves when black babies are cared for by a black doctor.

Strikingly, the biggest drop in deaths occurred in complex births and in hospitals that deliver relatively more black babies, suggesting institutional factors may play a role.

www.theguardian.com/world/2020/aug/17/black-babies-survival-black-doctors-study

I find this utterly fascinating.

You cannot get away from it being contempt for women at some level because if it were about women presenting differently or not being listened to the issue would be across the board.

We know that non white patients also have poorer outcomes too.

Its hard to get away from it being a male surgeon attitude problem.

@PicsInRed

I wonder if it's to do with male surgeons ignoring, minimising and dismissing (e.g. as anxiety etc) women's post op complication and infection symptoms until damage or death has already occurred?

As the surgeon is the gatekeeper to the woman receiving care for post op infection and complications, a misogynistic surgeon dismissing a woman's pain and symptoms will result in treatment delay until it's possibly too late.

Or women not feeling able to confide in male hcps if they have a problem for whatever reason. Even if the doctor is open minded.

We know trust and feeling we can be open and honest plays a huge role in the doctor patient relationship.

Thus the argument here is strongly that if you have a woman stating a preference for a female doctor, you probably should try and accommodate it, because it will have an impact on this relationship and result in better outcomes. Theres nothing inherently sexist in this - its a consequence of women's fear of men which they cannot help.

Or women not feeling able to confide in male hcps if they have a problem for whatever reason. Even if the doctor is open minded.

No, I mean women speaking up about pain and signs of infection and being ignored or dismissed on the post op ward and when under post op care.

The problem is that women DO speak up about excessive pain and illness. Their concerns are ignored.

@PicsInRed

Or women not feeling able to confide in male hcps if they have a problem for whatever reason. Even if the doctor is open minded.

No, I mean women speaking up about pain and signs of infection and being ignored or dismissed on the post op ward and when under post op care.

The problem is that women DO speak up about excessive pain and illness. Their concerns are ignored.

I think its possibly both tbh.