Advertisement
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.
Advertisement

Purpose:

There is a perception in urology that female urologists encounter gender based role assignments and are often pigeonholed into caring for more female patients and female specific urological issues than their male colleagues. We assessed the influence of surgeon gender on patient gender demographics by exploring the surgical case logs of American urologists.

Materials and Methods:

Six-month case logs of certifying urologists from 2003 to 2012 were obtained from the ABU (American Board of Urology). We reviewed case logs based on CPT codes of common urological procedures, focusing on 6 index gender neutral and gender specific procedure groups, including treatment of nephrolithiasis, nephrectomy, resection of bladder tumors, treatment of stress urinary incontinence, elective sterilization and treatment of prostate cancer.

Results:

Among a cohort of 6,166 urologists 1,011,800 cases were logged. Female surgeons operated on a significantly higher percent of female patients than their male peers (54.4% vs 32.5%, p <0.01). Female surgeons performed significantly more female specific procedures, such as slings, than their male counterparts (18 vs 10 per year, p <0.001). Male urologists performed significantly more male specific procedures than their female colleagues, including 3 times as many vasectomies (32 vs 12 per year, p <0.001) and more than twice as many prostatectomies (15 vs 6 per year, p <0.001). These trends were consistent across all subspecialties and geographic regions (p <0.01).

Conclusions:

Female surgeon gender has a significant influence on patient gender demographics among index urological procedures. As the number of women in urology grows, increasing attention to gender biases is necessary to understand how these disparities will shape the clinical landscape.

References

  • 1 Association of American Medical Colleges: Total U.S. Medical School Enrollment by Race/Ethnicity and Sex. 2013-2014 and 2014-2015. Updated December 2014. Available at https://www.aamc.org/data/facts/. Accessed April 26, 2016. Google Scholar
  • 2 : Recent trends in the urology workforce in the United States. Urology2013; 82: 987. Crossref, MedlineGoogle Scholar
  • 3 : The journey of women in urology: the perspective of a female urology resident. Urology2013; 81: 3. Google Scholar
  • 4 : Female urologists: a growing population. J Urol1997; 157: 1854. LinkGoogle Scholar
  • 5 : A survey of women urology residents regarding career choice and practice challenges. J Womens Health2009; 18: 1867. Google Scholar
  • 6 : What makes a medical student avoid or enter a career in urology? Results of an international survey. J Urol2005; 174: 1953. LinkGoogle Scholar
  • 7 : Gender differences in compensation, job satisfaction and other practice patterns in urology. J Urol2016; 195: 450. LinkGoogle Scholar
  • 8 : Status of women in urology: based on a report to the Society of University Urologists. J Urol2005; 173: 560. LinkGoogle Scholar
  • 9 : Provider gender preference in obstetrics and gynecology: a military population. Obstet Gynecol Survey2001; 56: 338. Google Scholar
  • 10 : Effect of physician and patient gender concordance on patient satisfaction and preventive care practices. J Gen Intern Med2000; 15: 761. Google Scholar
  • 11 : Israeli Druze women’s sex preferences when choosing obstetricians and gynecologists. Israel J Health Policy Res2015; 4: 1. Google Scholar
  • 12 : Does physician gender affect satisfaction of men and women visiting the emergency department?. J Gen Intern Med2001; 16: 218. Google Scholar
  • 13 : Honoring gender-based patient requests for obstetricians: ethical imperative or employment discrimination?. J Womens Health Gend Based Med1999; 8: 1031. Google Scholar
  • 14 : The influence of gender on physician practice style. Med Care1995; 33: 407. Google Scholar
  • 15 : Satisfaction, gender, and communication in medical visits. Med Care1994; 32: 1216. Google Scholar
  • 16 : Gender in medical encounters: an analysis of physician and patient communication in a primary care setting. Health Psychol1994; 13: 384. Google Scholar
  • 17 : Physician gender effects in medical communication: a meta-analytic review. JAMA2002; 288: 756. Google Scholar
  • 18 : Race, gender, and partnership in the patient-physician relationship. JAMA1999; 282: 583. Google Scholar
  • 19 : Disparities in female urologic case distribution with new subspecialty certification and surgeon gender. Neurourol Urodyn2015; . doi: 10.1002/nau.22942. Google Scholar
  • 20 : Are patients more likely to see physicians of the same sex? Recent national trends in primary care medicine. Am J Med2004; 117: 575. Google Scholar
  • 21 : The sex of the general practitioner: a comparison of characteristics, patients, and medical conditions managed. Med Care1996; 34: 403. Google Scholar