“Why Can’t a Man Be More Like a Woman” – Revisited

In a previous News Blog [1] I reorganised Henry Higgins’s famous line from ‘My Fair Lady’ in response to a paper in JAMA based on MediCare records showing that SMRs (standardised mortality rates) following acute medical admissions were slightly lower when the admitting physician was a woman rather than a man.[2] So what about surgery then? Same pattern I am afraid blokes! Slightly lower adjusted odds ratio (0.96) for harm.[3] True? Probably, since women outperform men on many tasks requiring a combination of care and cognition, as per the above News Blog. But results of this sort may be ephemeral – gender based predilections are notoriously labile as different selection and cultural effects play out in society. For example, the proportion of women studying and excelling in STEM (Science, Technology, Engineering and Mathematics) subjects has been rising steadily.[4] The proportion of women who become boxers or get incarcerated is also rising.[5][6] It seems that women and men are becoming more like each other! But will they ever become the same as each other? The effect of gender on surgical outcomes has been heavily debated and was the topic of the Editor in Chief’s editorial,[7] yet this point about change in the attributes of men vs. women over time was not discussed.

— Richard Lilford, CLAHRC WM Director

References:

  1. Lilford RJ. Are Female Doctors Better Than Male Doctors? NIHR CLAHRC West Midlands News Blog. 13 January 2017.
  2. Tsugawa Y, Jena AB, Figueroa JF, et al. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med. 2017; 177(2): 206-13.
  3. Wallis CJD, Ravi B, Coburn N, et al. Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ. 2017; 359: j4366.
  4. WISE. Women in Science, Technology, Engineering and Mathematics: The Talent Pipeline from Classroom to Boardroom. UK Statistics 2014. Bradford: WISE; July 2015.
  5. Sport England. Record Number of Women Get Active. 8 December 2016.
  6. Swavola E, Riley K, Subramanian R. Overlooked: Women and Jails in an Era of Reform. New York, NY: Vera: Injustice of Justice. August 2016.
  7. Marx C. Improving patient outcomes after surgery. BMJ. 2017; 359: j4580.
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