Women surgeons pay tougher consequences than male colleagues for bad health outcomes

Physicians are more apt to doubt a female surgeon’s ability after a patient's death than a male counterpart, a factor measured in a sharper drop in referrals, according to a new working paper.

That was just one way that gender plays a role in surgeon referrals, according to research (PDF) by Heather Sarsons, a Ph.D. candidate at Harvard University, who studied the issue of gender bias.

On the flip side, physicians also become more optimistic about a male surgeon’s ability after a good patient outcome, indicated by a larger increase in the number of referrals the male surgeon receives, the research showed.

After a bad experience with one female surgeon, doctors also become less likely to refer to new female surgeons in the same specialty, Sarsons said. There are no similar spillovers to other male surgeons after a bad experience with one male surgeon, she said.

The paper looked at ways a person’s gender influences the way others interpret information about his or her ability and documented the implications for gender inequality. “Using data on physicians’ referrals to surgical specialists, I find that the referring physician views patient outcomes differently depending on the performing surgeon’s gender,” Sarsons concluded.

Physicians reacted most strongly to an adverse even when they were beginning to refer patients to a surgeon, the research found. In addition to receiving fewer referrals, female surgeons also received less difficult procedures and less risky patients following a patient death. That affects both their accumulation of surgical skills with fewer difficult surgeries and their pay, since procedure risk is tied to payments, Sarsons said. Women surgeons lose 60% of their Medicare billings from the referring physician per quarter when they experience a bad patient outcome, where male surgeons lose 30%, she said.

While they face bias, female surgeons may produce slightly better outcomes for patients after surgery, one study found, but the findings show the need for further research into what improves the postoperative outlook. Another study found older patients who are hospitalized have a better chance for survival and are less likely to return to the hospital after discharge if they receive care from female internists.

Previous studies have documented both racial and gender bias in medical academics. Women are less likely than men to be selected to speak during grand rounds, give lectures that share new research and participate in setting guidelines within clinical groups, according to a one study. Another study found gender bias when evaluating medical residents.