Study in Canada reveals possible gender bias in physician-to-surgeon referrals
A new study has uncovered potential gender bias in physician-to-surgeon referrals.
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Nov. 10 (UPI) -- Male physicians are more likely to refer patients who need surgery to male surgeons, a study published Wednesday by JAMA Surgery found.
In the analysis of nearly 40 million physician-to-surgeon referrals made by roughly 45,000 physicians in Ontario, Canada, between 1997 and 2016, male physicians referred patients to male surgeons 87% of the time, the data showed.
In comparison, female physicians referred patients to male surgeons 79% of the time, the researchers said.
About 78% of surgeons practicing in Ontario, which includes major cities such as Toronto and Ottawa, at the time of the analysis were male, according to the researchers.
The numbers mean that male physicians were 32% more likely to refer patients to male surgeons than female ones, while female physicians were just under 2% more likely to refer patients to female surgeons.
"For surgeons, factors that should affect referrals should be related to ensuring patients have timely access to high quality of care -- things like experience, ability, patient satisfaction, etc.," study co-author Nancy Baxter told UPI in an email.
"What our study shows is that how referrals actually happen is in part influenced by the 'old boys club,' [meaning] male referring doctors preferentially refer to male surgeons," said Baxter, head of the School of Population and Global Health at the University of Melbourne in Australia.
In the United States, males make up 78% of all general surgeons, as well as 91% of all neurosurgeons and 94% of all sports medicine and orthopedic surgeons nationally, the Kaiser Family Foundation estimates.
Males also account for more than 80% of plastic surgeons, among other specialty surgeons, across the country, according to the foundation.
Previous research has suggested that gender plays a significant role in referral patterns in the United States as well, negatively impacting the practices of female physicians and potentially contributing to the gender-based pay gap nationally.
In addition, studies have shown that female surgeons perform procedures that generate lower compensation and reimbursement rates than their male peers.
"In the U.S. as in Canada, most practicing physicians are men," wrote the authors of a commentary published with the new study.
The new study focused on physician-to-surgeon referrals in Ontario, Canada, due to province's fee-for-service system in which referrals are "unrestricted by contracts, insurance schemes or employment."
As a result, physicians are free to refer patients to any specialist who accepts new patients, making it an "ideal setting to explore sex bias in referral networks," the researchers said.
In other words, if male physicians refer to male surgeons more frequently, it is possible that gender bias plays a role, given that there are no restrictions that limit their decisions, such as insurance requirements.
Females accounted for 77% of the patients referred to female surgeons and 55% of those referred to male surgeons, the data showed.
"Our study demonstrates that the bias male referring physicians have for male surgeons isn't limited to their male patients, so this isn't driven by patients themselves," Baxter said.
"Underutilizing one group -- female surgeons -- because of their gender means that patients will be more limited in terms of timely access to high-quality care [because] the best surgeon for your problem may be a woman, but you won't see her if you don't get referred to her," she said.
Nov. 10 (UPI) -- Male physicians are more likely to refer patients who need surgery to male surgeons, a study published Wednesday by JAMA Surgery found.
In the analysis of nearly 40 million physician-to-surgeon referrals made by roughly 45,000 physicians in Ontario, Canada, between 1997 and 2016, male physicians referred patients to male surgeons 87% of the time, the data showed.
In comparison, female physicians referred patients to male surgeons 79% of the time, the researchers said.
About 78% of surgeons practicing in Ontario, which includes major cities such as Toronto and Ottawa, at the time of the analysis were male, according to the researchers.
The numbers mean that male physicians were 32% more likely to refer patients to male surgeons than female ones, while female physicians were just under 2% more likely to refer patients to female surgeons.
"For surgeons, factors that should affect referrals should be related to ensuring patients have timely access to high quality of care -- things like experience, ability, patient satisfaction, etc.," study co-author Nancy Baxter told UPI in an email.
"What our study shows is that how referrals actually happen is in part influenced by the 'old boys club,' [meaning] male referring doctors preferentially refer to male surgeons," said Baxter, head of the School of Population and Global Health at the University of Melbourne in Australia.
In the United States, males make up 78% of all general surgeons, as well as 91% of all neurosurgeons and 94% of all sports medicine and orthopedic surgeons nationally, the Kaiser Family Foundation estimates.
Males also account for more than 80% of plastic surgeons, among other specialty surgeons, across the country, according to the foundation.
Previous research has suggested that gender plays a significant role in referral patterns in the United States as well, negatively impacting the practices of female physicians and potentially contributing to the gender-based pay gap nationally.
In addition, studies have shown that female surgeons perform procedures that generate lower compensation and reimbursement rates than their male peers.
"In the U.S. as in Canada, most practicing physicians are men," wrote the authors of a commentary published with the new study.
The new study focused on physician-to-surgeon referrals in Ontario, Canada, due to province's fee-for-service system in which referrals are "unrestricted by contracts, insurance schemes or employment."
As a result, physicians are free to refer patients to any specialist who accepts new patients, making it an "ideal setting to explore sex bias in referral networks," the researchers said.
In other words, if male physicians refer to male surgeons more frequently, it is possible that gender bias plays a role, given that there are no restrictions that limit their decisions, such as insurance requirements.
Females accounted for 77% of the patients referred to female surgeons and 55% of those referred to male surgeons, the data showed.
"Our study demonstrates that the bias male referring physicians have for male surgeons isn't limited to their male patients, so this isn't driven by patients themselves," Baxter said.
"Underutilizing one group -- female surgeons -- because of their gender means that patients will be more limited in terms of timely access to high-quality care [because] the best surgeon for your problem may be a woman, but you won't see her if you don't get referred to her," she said.
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