The Impact of a Plastic Surgeon's Gender on Patient Choice

Gender and Patient Preferences: Unraveling the Decision-Making Process for Blepharoplasty Among Males and Females

Background

Blepharoplasty is a popular facial cosmetic surgery, but research on how gender may influence motivations for this eyelid procedure remains limited. Understanding differences can improve patient counseling.

Objective

This study examined gender variances in key factors driving blepharoplasty decisions.

Methods

Medical records of 100 blepharoplasty patients (50 males, 50 females) were analyzed for demographics and patient-reported reasons underlying surgery choice. Face-to-face surveys further assessed satisfaction and experiences.

Results

Social embarrassment concerns declined with patient age but were more commonly reported by men (63.6%) than women (36.4%). Looking younger was overwhelmingly a female motivation (89.3% women vs 10.7% men), especially prevalent among those ages 30-35 (78.6%). Eye heaviness was a shared concern among this age bracket (57.1%), suggesting functional factors. Marriage considerations, though uncommon (3%), remained relevant to younger subgroups (66.7% ages 25-30).

Conclusion

Key factors showed both gender divergences and convergences, with men emphasizing functional/social issues and women cosmetic youthfulness. Understanding nuances can help surgeons tailor blepharoplasty patient education.

Gender and Geographic Trends Among Foot and Ankle Surgeons: Where Are We and Where Do We Need to Improve?

INTRODUCTION

Women have historically been underrepresented in orthopaedics. This study analyzes the geographic distribution of female orthopaedic foot and ankle (OFA) surgeons, as well as geographic patterns between their training locations and current practices.

METHODS

American Orthopaedic Foot and Ankle Society (AOFAS) data regarding fellowship completion from 1988 to 2021 were analyzed. Internet searches were then performed to identify medical school, residency, and current practice locations of individual surgeons. States were categorized into regions and divisions based on US Census Bureau guidelines.

RESULTS

Of the 1088 OFA surgeons analyzed, 166 (15.26%) were women and 922 (84.74%) were men. The South has a higher number of female OFA surgeons; however, this region and the Midwest have the lowest percentages of female representation. The West and Northeast had significantly higher percentages of female representation and higher retention rates for women. There was high variability in the number and percentage of female OFA surgeons in divisions both within and between regions.

CONCLUSION

Although the number of female OFA surgeons has increased, their representation remains low. Geographically, the East South Central division of the United States consistently had the least number of OFA surgeons, whereas the South Atlantic division had the highest.Level of Evidence: Not applicable.

A Cross-Sectional Study on Patient Preferences for Selecting Surgeons for Joint Replacement Surgery in India

Introduction This study aims to investigate the complex decision-making process of patients in India when choosing surgeons for joint replacement surgery, with a focus on both clinical and non-clinical factors influencing their preferences. Methods This was a cross-sectional observational study conducted at the KIMS-Sunshine Hospitals, Hyderabad, a high-volume tertiary care institute in India, in which patients with end-stage osteoarthritis requiring primary total knee arthroplasty were evaluated using a self-administered questionnaire, which assessed both patient-related and surgeon-related factors in choosing their joint replacement surgeon. Results A total of 210 participants were surveyed among whom the majority were females with an average age of 60.2 years with the majority belonging to the upper-middle-class socioeconomic status (48.6%, N=102). Fifty-nine percent preferred surgeons with over 20 years of experience, and 63.8% were willing to travel out-of-state for recognized expertise. Family recommendations (33.8%) and surgeon reputation (24.3%) were primary factors in surgeon selection. A vast majority (73.3%) preferred surgeons who were skilled in robotic surgery and had foreign training (32.9%). However, the majority (67.6%) did not express any gender preference. The survey highlighted a broad range of informational sources affecting decisions, including financial consideration (63.8%), personal referrals, and online platforms (17.1%). Preferences were also shaped by hospital reputation and insurance options (10.5%), illustrating a nuanced interplay of quality, cost, and personal connections in the selection process. Conclusion The findings of this survey illuminate the intricate and diverse preferences exhibited by patients when selecting a surgeon for joint replacement surgery. A significant rise in patient expectations is evident, underscoring a demand for more personalized, contemporary, and high-quality healthcare services. Importantly, geographical proximity appears to be a diminishing concern in their decision-making process. This trend presents an opportunity for centers of excellence to extend their influence and attract patients on both a regional and national level.

Do breast cancer patients have a gender preference when choosing a breast surgeon?

Introduction

There is a paucity of data on breast cancer (BC) patients' gender preferences when it comes to choosing their surgeon, unlike in other specialties like gynaecology and obstetrics, where women tend to prefer a female physician. The aim of this trial was to examine if there are any gender preferences in women with BC at the time of choosing their breast surgeon.

Material and methods

A cross-sectional, observational and descriptive study with 528 patients, older than 18 years, at the Breast Department 'Servicio Oncológico Hospitalario del Instituto Venezolano de los Seguros Sociales', from January to June 2022. We applied an anonymous questionnaire to evaluate patients' gender preferences when it comes to choosing their breast surgeon.

Results

The average age of the patients was 56 ± 11 years. 89.4% did not have gender preferences, whereas 6.5% and 4.1% chose to be treated by female surgeons and male surgeons, respectively. The most important characteristics chosen by the patients when they decided to choose their breast surgeon were experience (75%), knowledge (54%) and hospital-based (41%).

Conclusion

Personal and professional skills are the most important factors when it comes to patients choosing their breast surgeon, gender does not have any impact on expertise or competence.

Patient Perceptions and Preferences When Choosing a Surgeon: A Cross-Sectional Study, Qassim Region, Saudi Arabia

Background The patient-physician relationship is changing, and patients are taking more responsibility in their decision-making. Many patients use the Internet as an important source of information regarding their health. Physician-rating websites provide essential information about the quality of care from patients' perspectives. However, choosing the appropriate healthcare provider is still complicated for any patient. Many patients find choosing a surgeon stressful because they cannot change the treating surgeon once the surgery is underway. Understanding a patient's preferences in choosing the right surgeon is essential to forming a patient-surgeon relationship and shaping practice. Nevertheless, little is known about the factors influencing patients' choices for elective surgeries in the Qassim region. Objectives This study aims to explore factors and the most common manners patients use to reach their appropriate surgeon in the Qassim Region, Saudi Arabia. Methods A cross-sectional study was conducted among target people over 18 years old in Qassim Region, Saudi Arabia, using a snowball sample study from October 2022 to February 2023. The data were collected online using Google Forms using a self-administered, valid Arabic questionnaire distributed to respondents via WhatsApp, Twitter, and Telegram. The questionnaire consists of two sections: participants' sociodemographic status, including age, gender, nationality, residence, occupation, and monthly income; and a section to evaluate factors influencing patient decision-making when choosing a surgeon for elective surgery. Results The factors that were significantly associated with elective surgery were: gender of the doctor (adjOR = 1.62, 99% CI: 1.29-2.04); age (adjOR = 1.31, 99% CI: 1.13-1.53); gender of the study patient (adjOR = 1.64, 99% CI: 1.28-2.10); nationality (adjOR = 0.49, 95% CI: 0.26-0.88); and employment (adjOR = 0.89, 95% CI: 0.79-0.99). Conclusions The cultural background in the Kingdom of Saudi Arabia plays a significant role in influencing gender in the choice of the surgeon for elective surgery. Recommendations from friends and family members play a less significant role in the choice of the surgeon for elective surgery. Patients in employment and pensioners seem to have a significant preference in the choice of surgeon for elective surgery.

Retrospective study of the differences in patient characteristics and revenue between male and female surgeons in Taiwan

Surgery is traditionally a male-dominated field, and gender differences exist despite the growing numbers of female surgeons. A handful of studies have evaluated the condition in Asian societies. We aimed to examine the difference between female and male surgeons in urology, general surgery, and gynecology by analyzing a nationwide, population-based database. We identified surgeons with a clinical experience of six to thirteen years between 1995 to 2013 from the National Health Insurance Research Database. We collected patient numbers and revenue per month in outpatient and inpatient care, as well as monthly numbers of surgeries conducted by female and male surgeons in urology, general surgery, and gynecology, for analysis. Original student’s t-test and wilcoxon rank sum test was used to compare the differences between female and male surgeons, and p values less than 0.05 were considered statistically significant. Female urologists and general surgeons had a significantly higher ratio of female patients in Taiwan. Female urologists had patient numbers, revenues, and numbers of surgeries comparable to male urologists. In contrast, female general surgeons had significantly less involvement in outpatient and inpatient care and had low monthly revenues. Female general surgeons contradictorily performed more oncological surgeries per month than males. However, the difference in numbers of oncological surgeries was not significant after excluding breast cancer surgeries. Female gynecologists had a similar amount of outpatients and outpatient revenue but significantly less inpatient care and numbers of surgeries per month. A gender-based gap exists among surgeons in Taiwan. The gap between females and males appeared narrower in urology than in general surgery and gynecology. Management of diseases related to female sex organs, including breast, were more common among female surgeons. Efforts should be made to decrease gender stereotypes, to ensure that patients receive the best care regardless of the sex of the surgeons.

Sex Differences in the Pattern of Patient Referrals to Male and Female Surgeons

Importance

Studies have found that female surgeons have fewer opportunities to perform highly remunerated operations, a circumstance that contributes to the sex-based pay gap in surgery. Procedures performed by surgeons are, in part, determined by the referrals they receive. In the US and Canada, most practicing physicians who provide referrals are men. Whether there are sex-based differences in surgical referrals is unknown.

Objective

To examine whether physicians' referrals to surgeons are influenced by the sex of the referring physician and/or surgeon.

Design, Setting, and Participants

This cross-sectional, population-based study used administrative databases to identify outpatient referrals to surgeons in Ontario, Canada, from January 1, 1997, to December 31, 2016, with follow-up to December 31, 2018. Data analysis was performed from April 7, 2019, to May 14, 2021.

Exposures

Referring physician sex.

Main Outcomes and Measures

This study compared the proportion of referrals (overall and those referrals that led to surgery) made by male and female physicians to male and female surgeons to assess associations between surgeon, referring physician, or patient characteristics and referral decisions. Discrete choice modeling was used to examine the extent to which sex differences in referrals were associated with physicians' preferences for same-sex surgeons.

Results

A total of 39 710 784 referrals were made by 44 893 physicians (27 792 [61.9%] male) to 5660 surgeons (4389 [77.5%] male). Female patients made up a greater proportion of referrals to female surgeons than to male surgeons (76.8% vs 55.3%, P < .001). Male surgeons accounted for 77.5% of all surgeons but received 87.1% of referrals from male physicians and 79.3% of referrals from female physicians. Female surgeons less commonly received procedural referrals than male surgeons (25.4% vs 33.0%, P < .001). After adjusting for patient and referring physician characteristics, male physicians referred a greater proportion of patients to male surgeons than did female physicians; differences were greatest among referrals from other surgeons (rate ratio, 1.14; 95% CI, 1.13-1.16). Female physicians had a 1.6% (95% CI, 1.4%-1.9%) greater odds of same-sex referrals, whereas male physicians had a 32.0% (95% CI, 31.8%-32.2%) greater odds of same-sex referrals; differences did not attenuate over time.

Conclusions and Relevance

In this cross-sectional, population-based study, male physicians appeared to have referral preferences for male surgeons; this disparity is not narrowing over time or as more women enter surgery. Such preferences lead to lower volumes of and fewer operative referrals to female surgeons and are associated with sex-based inequities in medicine.

Women in academic surgery over the last four decades

Objective

As the number of female medical students and surgical residents increases, the increasing number of female academic surgeons has been disproportionate. The purpose of this brief report is to evaluate the AAMC data from 1969 to 2018 to compare the level of female academic faculty representation for surgical specialties over the past four decades.

Design

The number of women as a percentage of the total surgeons per year were recorded for each year from 1969–2018, the most recent year available. Descriptive statistics were performed. Poisson regression examined the percentage of women in each field as the outcome of interest with the year and specialty (using general surgery as a reference) as two predictor variables.

Setting

Data from the American Association of Medical Colleges (AAMC).

Participants

All full-time academic faculty physicians in the specialties of obstetrics and gynecology (OB/GYN), general surgery, ophthalmology, otolaryngology (ENT), plastic surgery, plastic surgery, urology, neurosurgery, orthopaedic surgery and cardiothoracic surgery as per AAMC records.

Results

The percentage of women in surgery for all specialties evaluated increased from 1969 to 2018 (OR 1.04, p<0.001). Compared with general surgery, the rate of yearly percentage change increased more slowly in neurosurgery (OR 0.84; P = .004), orthopaedic surgery (OR 0.82; P = .002), urology (OR 0.59; P < .001), and cardiothoracic surgery (OR 0.38; P < .001). There was no significant difference in the rate of yearly percentage change for plastic surgery (OR 1.01; P = .840). The rate of yearly percentage change increased more rapidly in OB/GYN (OR 2.86; P < .001), ophthalmology (OR 1.79; P < .001) and ENT (OR 1.70; P < .001).

Conclusions

Representation of women in academic surgery is increasing overall but is increasing more slowly in orthopaedic surgery, neurosurgery, cardiothoracic surgery and urology compared with that in general surgery. These data may be used to inform and further the discussion of how mentorship and sponsorship of female students and trainees interested in surgical careers may improve gender equity in the future.

It's not you, It's me: The influence of patient and surgeon gender on patient satisfaction scores

BACKGROUND

Surgeons face the unique challenge of being responsible for both clinical encounters and surgical outcomes. We aim to explore how patient evaluations of surgeons may be influenced by patient and provider factors.

METHODS

Patient responses from the 2016 CGCAHPS survey at a single institution were identified. A Poisson regression model was used to identify patient/provider factors associated with ratings.

RESULTS

11,007 surveys of 134 surgeons were included. After adjustment, higher overall surgeon ratings were associated with older patient age (p < 0.001) and male patient gender (p = 0.001). Lower ratings were associated with higher patient education (p < 0.001) and lower patient self-health ratings (p < 0.001). Although female surgeons tended to have higher communication scores, overall scores did not differ based on any surgeon factors.

CONCLUSIONS

Patient satisfaction scores of surgeons are more closely correlated with patient variables than surgeon factors. This may have implications for physician performance evaluation in value-based care models.

Gender Bias in the Integrated Plastic Surgery Residency: A Snapshot of Current Trends

According to the American Society of Plastic Surgeons, the male to female ratio of plastic surgeons is approximately 5:1. As more surgical specialties are recruiting female residents, there has been an increase in the amount of females. We set out to examine the current trends in residency recruitment and whether a quantifiable gender bias exists.

Methods

A review of all the integrated plastic surgery programs within the United States was conducted. Data were collected regarding department or division status, the gender of the chairman and the program directors, the number of residents per year and gender of residents per year. The ratio of male to female residents was calculated.

Results

A total of 62 residency programs were identified. The vast majority had a male program director with only 8 female program directors identified. The mean ratio of female/male (F/M) residents overall was 1/1.2. Female program directors selected residents in the same ratio as their male counterparts [F/M ratio: 1/1.26 versus 1/1.18, p:0.813]. A linear logistic regression failed to identify the geographic location, department status, gender of the department chairman or the number of residents selected per year as predictors of higher F/M ratio.

Conclusions

There are still fewer female program directors and residents in plastic surgery overall. However, neither was more likely to select a resident of their own gender. This analysis does not rule out the possible self-selection factor.

Assessing patients' preferences for gender, age, and experience of their urogynecologic provider

INTRODUCTION AND HYPOTHESIS

Understanding patient preferences regarding provider characteristics is an under-explored area in urogynecology. This study aims to describe patient preferences for urogynecologic care, including provider gender, age, experience, and presence of medical trainees.

METHODS

This was a multicenter, cross-sectional, survey-based study assessing patient preferences with a voluntary, self-administered, anonymous questionnaire prior to their first urogynecology consult. A 5-point Likert scale addressing provider gender, age, experience, and presence of trainees was used. Descriptive statistics summarized patient characteristics and provider preferences. Chi-squared (or Fisher's exact) test was used to test for associations.

RESULTS

Six hundred fifteen women participated from eight sites including all geographic regions across the US; 70.8% identified as white with mean age of 58.5 ± 14.2 years. Urinary incontinence was the most commonly reported symptom (45.9%); 51.4% saw a female provider. The majority of patients saw a provider 45-60 years old (42.8%) with > 15 years' experience (60.9%). Sixty-five percent of patients preferred a female provider; 10% preferred a male provider. Sixteen percent preferred a provider < 45 years old, 36% preferred 45-60 years old, and 11% of patients preferred a provider > 60 years old. Most patients preferred a provider with 5-15 or > 15 years' experience (49% and 46%, respectively). Eleven percent preferred the presence of trainees while 24% preferred trainee absence.

CONCLUSION

Patient preferences regarding urogynecologic providers included female gender and provider age 45-60 years old with > 5 years' experience. Further study is needed to identify qualitative components associated with these preferences.

Social Media Impact on Aesthetic Procedures Among Females in Riyadh, Saudi Arabia

Aesthetic procedures represent one of the most commonly performed procedures in the medical field. Such procedures have been growing in popularity. Social media is a term used to describe electronic platforms that promote the dissemination of information to targeted users. These platforms play a critical role in promoting aesthetic procedures. Objective The objective of this study was to assess the impact of social media on aesthetic procedures among the female population in Riyadh, Saudi Arabia. Methods A cross-sectional study was performed. A validated online questionnaire, consisting of 26 questions, was distributed among females visiting the facial plastic clinic at King Abdulaziz Medical City, in Riyadh, Saudi Arabia. Results Out of 1449 participants, 81% were aged between 25 and 34 years. The majority (78.8%) were aware of the complications that may follow aesthetic procedures. The decision to undergo such procedures was affected by the price in 77%. Overall, 97% thought that cosmetic specialized accounts on social media are helpful, yet 77.8% believed that such accounts do not provide sufficient information. The influence of social media upon participants was 68%; 31.9% claimed that social media had no influence. Instagram was the most influential application followed by Snapchat and then Twitter; 50% of the participants routinely apply Snapchat filters and 42% decided to undergo facial changes after applying Snapchat filters. Conclusion Social media is an important source of information with Instagram being the most influential platform. Facial filters have led to an increase in the number of aesthetic procedures carried out.

Gender Preferences of Patients When Selecting Orthopaedic Providers

BACKGROUND

Orthopaedic surgery is a male-dominated specialty associated with many stereotypes, despite the increased representation of females compared to 30 years ago. Numerous studies have examined medical student and resident perceptions regarding females in orthopaedic surgery to explain the disparity, but there are few studies that analyze whether patients have a gender preference in their orthopaedic surgeon. Our study sought to determine whether patients have a preference for the gender of their orthopaedic surgeon, and what traits in orthopaedic surgeons are important to their patients.

METHODS

A total of 191 new patients seen in the emergency department and orthopaedic urgent care clinic were administered a 22-question survey regarding preferences in their orthopaedic provider. Patients were asked questions regarding preferred gender of their provider, as well as preferences in characteristics exhibited.

RESULTS

The majority of patients did not have a preference for the gender of their orthopaedist (83.9%); however, 14.5% of patients preferred a female surgeon and 1.6% of patients preferred a male surgeon. Female patients had a preference for the same gender compared to male patients and preferred females (p=0.04). Of the patients that had a preference, 90% preferred a female provider. There were trends towards preference for gender that varied depending on subspecialty. There was a statistically insignificant trend towards preference for male providers in total joint replacements and spine surgery, and conversely a preference for female providers in hand surgery and pediatric orthopaedics. 48.6% of patients cited the single most important trait to be board certification, followed by years in practice (27.1%), then reputation or prestige (16.7%). Over one-third of patients found physical appearance, gender, racial background and age to be important traits.

CONCLUSIONS

The majority of patients did not have a preference for the gender of their orthopaedic surgeon. 16.1% of patients had a preference, and the majority of these patients preferred female surgeons. Preferences for a specific gender were seen that varied based on the subspecialty. Efforts at increasing gender diversity in orthopaedics should continue to be a major goal.Level of Evidence: III.

The role of gender in patient preference for breast surgical care - a comment on equality

Gender preference among patients seeking medical care is an issue that is not well understood. It warrants exploration, particularly for patients undergoing sensitive physical exams. In a recent IJHPR article, Groutz et al. reported a survey study that explored patient preferences in selecting a breast surgeon. They found that a third of patients preferred a female surgeon for their breast examination. However, surgical ability was the primary factor in selecting a surgeon for their breast surgery. This commentary discusses these findings in the context of patient-centered care and issues of gender equality in medical education.Gender equality is considered an important societal movement in achieving human rights for everyone based on their ability, rather than their gender and opportunity. This commentary argues that the goal of gender equality is why women should be encouraged to enter surgical professions, recognizing that patient preferences will be shaped by societal norms. Gender preferences for the performance of sensitive physical examinations by some patients are likely multifactorial and they warrant more exploration to deliver ideal patient centered care.