By: Anna DeFreitas
“Women cannot seriously pursue medical careers (…) unless they stop being women: due to physiological laws, women doctors are ambiguous, hermaphrodite or sexless creatures, monsters at any rate. Let those who fancy such a distinction try to acquire it.”
This affirmation by the French physician Lucas-Championnaire shows the long and arduous path women had to take to become doctors and surgeons. The practice of Medicine required masculine qualities, according to the 19th-century view:
“In order to be a physician, one needs a sharp and open mind, a solid and varied education, a serious and strong character, a great deal of self-control, a mix of benignity and stamina, a complete command over one’s feelings, moral vigor and, when necessary, muscular strength. (…) Isn’t feminine nature just the opposite?”
The Journal of Medicine and Surgery Practice stated: “Let us add that it seems obvious that in France women would be exposed to utter failure concerning the final outcome.”
After two centuries, it seems these predictions were wrong: women not only became physicians and surgeons without losing their femininity, but according to two recent studies, women surgeons achieve better results than their male colleagues. Patients cared for by female surgeons are less likely to experience complications and need follow-up care than when males brandish the scalpel, according to two major studies in Toronto and Sweden.
The Canadian Study
A Canadian research team analyzed data from about 1.2 million patients in Ontario spanning from 2007 to 2019, focusing on medical complications, hospital readmissions, and mortality rates following surgery. The study covered 25 diverse surgical procedures involving the heart, brain, bones, organs, and blood vessels.
The analysis, published in the JAMA Surgery, revealed that 90 days after an operation 13.9% of patients treated by a male surgeon had “adverse post-operative events”, including death and medical complications such as major infections, heart attacks, and strokes, compared to 12.5% rate for patients seen by female surgeons.
Long-term outcomes were also better with female surgeons: 20.7% of the patients had an adverse postoperative event, contrasted with 25% of those seen by males. Particularly striking is the finding regarding post-surgical mortality: patients under the care of male surgeons had a 25% higher likelihood of death within one year after surgery compared to those treated by their female colleagues.
The Sweden Research
A second study of 150,000 patients in Sweden, also published in JAMA Surgery, found that patients treated by female surgeons for elective and acute care cholecystectomies suffered fewer complications and had shorter hospital stays than those treated by men, suggesting that surgical technique and risk-taking might explain some of the differences observed.
Operate Like a Woman
As a result, some specialists now recommend that male surgeons learn from their female peers by adopting some practices that are more common among them to improve outcomes for the patients, like trying not to rush the surgery and taking fewer risks. Attention to detail and involvement in the post-op could make a difference, too.
We have come a long way since the French doctor Richelot declared “The accoutrement (blood-stained overalls), the appalling rooms, the human body parts and remains, the hard work contrast most crudely with feminine curves. (…) These young women lose the graciousness, the gentleness, the charm of their sex. They are neither women nor men.”
As female surgeons, we all have our experiences of patients thinking we are the nurses, or asking to talk to the doctor, but it happens in other specialties, too. I am glad I did not have any special challenge among my male colleagues for being a woman physician. We have walked a long path to arrive at the point where we are valued as doctors.
Kudos to every woman physician and surgeon who made our work possible.
REFERENCES
- Lucas-Championnaire, Just, “article 9997” J. méd. chir. prat., June 1875 issue. p. 241-242.
- Richelot, G. La Femme-Médecin (Women Doctors), Paris: E. Dentu, 1875, p.43.
- “Feuilleton”, Gaz, hebd. med. chir., n°38, Sept 20, 1872, pp. 409-421.
- Pigeard-Micaulta, Natalie. History of Women’s Entrance into Medicine, Paris X, EA 373 Histoire de la philosophie, Histoire des sciences.
- Wallis CJD, Jerath A, Aminoltejari K, et al. Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries, JAMA Surg. 2023;158(11):1185–1194.
- Blohm M, Sandblom G, Enochsson L, Österberg J. Differences in Cholecystectomy Outcomes and Operating Time Between Male and Female Surgeons in Sweden, JAMA Surg. 2023;158(11):1168–1175.
Ana De Freitas is a surgeon and a published writer and researcher, with works in Medicine, Neuroscience, and Bioethics. She has Medical Residencies in General and Pediatric Surgery and is a member of the American Health Lawyers Association and the American College of Healthcare Executives. Ana loves delving into medical research and health law. Outside of work, she enjoys reading, writing poetry, and playing volleyball. You can find her blog at https://medium.com/@acdfreitas13.