A large new U.S. study has found that patients operated on by female surgeons experience better long-term outcomes than those treated by male surgeons—particularly among female patients. Using Medicare claims data from between 2016 and 2019, the cross-sectional study analyzed over 2.2 million surgical cases across 14 major procedures, offering powerful insights into the impact of surgeon gender on postoperative recovery and survival.
Key Findings
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Female surgeons had significantly lower 90-day and 1-year mortality rates compared to their male counterparts for both male and female patients.
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Female patients treated by female surgeons had reduced 90-day and 1-year readmission and complication rates compared to those treated by male surgeons.
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No difference in readmission or complication rates was observed among male patients, regardless of the surgeon's gender.
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These patterns were observed only for elective surgeries, suggesting that surgeon-led preoperative management may play a major role in patient outcomes.
Study Details
Researchers analyzed 2,288,279 Medicare beneficiaries aged 65–99 years who underwent 1 of 14 common elective or emergent surgeries, including hip and knee replacements, coronary artery bypass grafting, colectomies, and hysterectomies. Only 5.7% of these surgeries were performed by female surgeons, reported Ryo Ikesu, MD, of the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, and colleagues.
After adjusting for patient demographics, comorbidities, hospital characteristics, and surgeon experience:
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90-day mortality was 2.6% for female surgeons versus 3.0% for male surgeons.
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1-year mortality was 3.9% for female surgeons versus 4.4% for male surgeons.
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Female patients treated by female surgeons also experienced lower rates of readmission (7.3% versus 7.7%) and complications (12.2% versus 12.8%) at 90 days.
Clinical Implications
This research reinforces previous findings that female physicians may deliver more guideline-adherent, patient-centered care, and suggests that communication styles, surgical technique, and postoperative monitoring might differ subtly—but meaningfully—by surgeon gender.
"Previous studies have shown that female surgeons had lower short-term (eg, 30-day) mortality rates than male surgeons across a wide range of surgical procedures (for both female and male patients)," noted Dr. Ikesu and colleagues.
The study also highlights ongoing inequities: despite delivering superior outcomes, female surgeons remain underrepresented; they make up only 24% of general surgeons in the U.S. and receive lower referral rates for elective procedures than male surgeons.
Invited Commentary
"These effects of both physician sex and patient-physician sex concordance are pervasive across medicine," wrote Christopher J.D. Wallis, MD, of the Divisions of Urology at three universities in Ontario, and colleagues. "We must acknowledge that who we are, the identities we hold, and the lived experiences that have shaped us contribute to how we interact with our patients, the care they receive, and the outcomes they experience."
The authors added, "These data clearly demonstrate that diversification of the health care workforce to better represent the patients we care for offers a tangible opportunity to improve care."
Limitations
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Results may not generalize to younger patient populations or surgeries outside the 14 studied.
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The observational nature of the study limits conclusions about causality.
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Medicare FFS data may not fully capture total surgeon volume or private payer patients.
Bottom Line
The findings add to the growing evidence that diversity in surgical practice improves patient care quality. Surgical teams, hospitals, and referring physicians should take these results into account when considering pathways to optimize postoperative recovery.
Disclosures can be found in the published study.