When more than a third of the anesthesiologists and surgeons in a hospital are female, postoperative complications drop in the initial 90-day healing window, according to new research in the British Journal of Surgery.

Canadian researchers looked at sex diversity on operating room teams and found that the care in hospitals where more than a third of the anesthesiologists and surgeon team members were female had a 3% reduction in complications in the first three months following surgery. The researchers, who were from the University of Toronto, Sunnybrook Research Institute and the Institute for Clinical Evaluative Sciences, said their work built on earlier research that looked at “the impact of individual surgeon and anesthesiologist characteristics on patient outcomes.”

“We wanted to challenge the binary approach of comparing female and male clinicians and rather highlight the importance of diversity as a team asset or bonus in enhancing quality care,” lead author Dr. Julie Hallet, associate professor in Temerty Faculty of Medicine’s department of surgery, said in a news release.

The findings were based on an analysis of data from nearly 710,000 adults who had major inpatient surgery in Canada between 2009 and 2019.

Diverse voices and skills

It’s possible that when women surgeons and anesthesiologists are badly outnumbered, they don’t speak up, the researchers said.

“These results are the start of an important shift in understanding the way in which diversity contributes to better quality care around the time of surgery,” Hallet said. “Ensuring a critical mass of female anesthesiologists and surgeons in operative teams is crucial to performance. Below a critical mass, female clinicians may withhold their perspectives, such that the benefits of diversity can only be achieved once minimum representation is reached.”

The researchers said they hope that the study will help hospitals decide to “intentionally foster sex diversity in operating room teams to reduce poor health outcomes, which in turn can improve patient satisfaction and promote sustainability of health systems,” said Dr. Gianni R. Lorello, staff anesthesiologist at Toronto Western Hospital and an associate professor with Temerty Medicine’s department of anesthesiology and pain medicine.

What other research found

Other studies have shown benefits of female doctors, as NBC News reported. “A study published last month found that women treated by female physicians were less likely to die or be readmitted to the hospital compared to those treated by male physicians. The same was true for elderly hospitalized patients treated by female internists, according to a 2017 study.”

Per NBC, “There may be several reasons for the trend: Female doctors tend to have longer visits with patients than their male colleagues do, and to interrupt them less often. In theory, this extra communication could lead to more accurate diagnoses and treatments or ensure that medical complications aren’t missed or ignored. Research also suggests that female doctors are more likely to give preventive care, adhere to clinical guidelines and engage in shared decision-making with patients.”

CBS News cited a study by Harvard’s T.H. Chan School of Public Health that aimed to assess whether women physicians were more effective. It looked at more than 1 million patients, “all Medicaid beneficiaries who were hospitalized for strokes, heart attacks and other fairly common conditions, for which they all received treatment by general internists. Patients who received care from a female physician were at a 4% lower risk of dying within 30 days, and a 5% lower risk of hospital readmission in the same period, compared with patients who received their care from male physicians.”

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The article cited Dr. Ashish Jha, who is now dean of Brown University’s School of Public Health and was a professor of health policy and director of the Harvard Global Health Institute. He said the study, published in 2016, suggested it was important to know what women physicians might be doing differently to better the outcomes their patients experienced. And he added that the study authors — all male — were “interested in finding out better why these differences exist, but we don’t know why yet.”

The new study doesn’t mean female doctors are actually better than men at the job, Hallet said. Rather, diverse surgical teams seem to prompt better overall hospital care. Dr. Andrea Riner, a surgery resident at University of Florida Health, agreed, telling NBC it’s an “oversimplification” to think gender makes one a better physician. And seeing a study “doesn’t necessarily influence who I’m going to seek care from.” But she said the research helps remove bias against female doctors.

The Wall Street Journal last year reported that the vast majority of surgeons are male; fewer than 23% are female.