Many surgeons make mistakes, but one gender may pay a higher price

Mandy Velez
Contributing Writer
New research may point to significant gender bias regarding the consequences when female surgeons make mistakes versus their male counterparts. (Photo: Getty Images)

Female surgeons don’t have it easy. They not only have to navigate all the potential downfalls that come with working in a male-dominated field, like unfair work-life balance pressures and sexual harassment, but also a new paper finds they’re punished more than their male counterparts when making the exact same mistakes.

Heather Sarsons, an economics PhD candidate and doctoral fellow in the Inequality and Social Policy program at Harvard University, conducted research that found evidence that a person’s gender influences the way others interpret their ability. Specifically, Sarsons’s research unveiled a pretty disturbing truth among medicine’s most elite practitioners: Primary care physicians (PCP) trust female surgeons’ abilities a lot less and give men much more room to make mistakes — with gender being the only differentiating factor.

To identify potential gender bias, Sarsons identified and matched “observably similar” male and female surgeons who performed the same tasks, and she compared their referral data from PCPs.

“Following a bad patient outcome (a patient death), PCPs lower their beliefs about a female surgeon’s ability more than they do for male surgeons,” she wrote in the paper. In fact, referrals from PCPs dropped by 54 percent after the bad outcome if the surgeon was female. Males only experienced a slight stagnation after a bad outcome.

Sarsons also examined what would happen if the operation was a success. She found that PCPs’ confidence in male surgeons spiked after a positive outcome, as their referrals would double. Female surgeons’ referrals after a good experience increased by only 70 percent.

These biases on part of the PCP fade over time, after they’ve gotten to know the surgeon — if they make it past the threshold. However, Sarsons found the consequences of this bias to be damaging.

“I find that in addition to receiving fewer referrals, women also receive less difficult procedures and less risky patients after a patient death,” she wrote. “This change in the types of referrals female surgeons receive affects both skill accumulation and surgeon pay.” In other words, one mistake can alter a female surgeon’s career pay and trajectory early on, while men can make a mistake and have their trajectories fairly unscathed.  

There is no evidence to suggest male surgeons are more deserving of the preferential treatment, either. A study published in the BMJ (formerly the British Medical Journal) in October found that patients are less likely to die within a month if a female surgeon operates. The University of Toronto team looked back over 104,630 patients treated between 2007 and 2015. The risk of dying within 30 days following an operation was 12 percent less if it was performed by a woman.

“We don’t know the mechanism that underlies better outcomes for patients treated by female surgeons,” the study’s researcher Raj Satkunasivam, MD, told Yahoo. “Although it might be related to delivery of care that is more congruent with guidelines, more patient-centered, and involves superior communication.”

Despite this, women make up only 19 percent of all surgeons. Sarsons’s research — that female surgeons still have to prove themselves so much more, with much less room for career-altering mistakes — helps to explain why this is. Hopefully with the problem out in the limelight, things can change.

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