Highlights
- •Female surgeons received fewer new patient referrals than their male peers.
- •Fewer new patient referrals may contribute to female surgeon under-employment.
- •Surgeon gender may be one of the factors contributing to this differential referral pattern.
Abstract
Background
The literature shows that female surgeons have lower operative volumes than male surgeons.
Since volume is dependent on new patient referrals for most surgeons, inequities in
referrals may contribute to this employment disparity.
Methods
Using 1997–2018 data from a large medical center, we examined the number of new patient
referrals for surgeons. Multivariate linear analysis was performed, adjusting for
surgeon race, calendar year, seniority, and clinical subspecialty.
Results
A total of 121 surgeons across 12,410 surgeon-months were included. Overall, surgeons
had a median of 14 new patient referrals per month (interquartile range (IQR) = 7,
27). On adjusted analysis, female surgeons saw 5.4 fewer new patient referrals per
month (95% CI -6.4 to −4.5).
Conclusion
Female surgeons, with equal training and seniority, received fewer new patient referrals
than their male peers, and this may contribute to female surgeon under-employment.
Surgeon gender may be one of the factors contributing to this differential referral
pattern.
Keywords
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References
- Underemployment: Psychological, Economic, and Social Challenges.Springer Science + Business Media, New York, NY2011
- Underemployment in the Early Careers of College Graduates Following the Great Recession. SSRN Scholarly Paper ID 2701188.Social Science Research Network, Rochester, NY2015https://papers.ssrn.com/abstract=2701188Date accessed: December 1, 2020
- Practice patterns and work environments that influence gender inequality among academic surgeons.Am J Surg. 2020; 220: 69-75
- Under-employment of female surgeons?.Ann Surg. 2020; (Epub ahead of print September 24)https://doi.org/10.1097/SLA.0000000000004497
- Interpreting signals in the labor market: evidence from medical referrals. Job Mark Pap.https://scholar.harvard.edu/sarsons/publications/interpreting-signals-evidence-medical-referralsDate accessed: May 20, 2020
- Women are underrepresented as top surgical performers as assessed by case volumes in the state of New York.Am J Surg. 2018; 216: 666-671
- Variation in amputation risk for Black patients: uncovering potential sources of bias and opportunities for intervention.J Am Coll Surg. 2018; 226: 641-649.e1
- Patient and caregiver considerations and priorities when selecting hospitals for complex cancer care.Ann Surg. 2020; (Manuscript submitted under review)
- Reasons for choice of referral physician among primary care and specialist physicians.J Gen Intern Med. 2012; 27: 506-512
- General practitioners referring patients to specialists in tertiary Healthcare: a qualitative study.BMC Fam Pract. 2019; 20: 165
- Referral of patients to specialists: factors affecting choice of specialist by primary care physicians.Ann Fam Med. 2004; 2: 245-252
- Patient, physician, and community factors affecting referrals to specialists in ontario, Canada: a population-based, multi-level modelling approach.Med Care. 2003; 41: 500-511
- Exploring the color of glass: letters of recommendation for female and male medical faculty.Discourse Soc. 2003; 14: 191-220
- The Motherhood Penalty vs. The Fatherhood Bonus. The New York Times.(September 6)2014https://www.nytimes.com/2014/09/07/upshot/a-child-helps-your-career-if-youre-a-man.html(Accessed September 22, 2020)Date accessed: September 6, 2014
- Female lawyers face widespread gender bias, according to new study. Forbes.https://www.forbes.com/sites/kimelsesser/2018/10/01/female-lawyers-face-widespread-gender-bias-according-to-new-study/Date accessed: September 22, 2020
- “I think it, therefore it’s true”: effects of self-perceived objectivity on hiring discrimination.Organ Behav Hum Decis Process. 2007; 104: 207-223
- Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities.J Gen Intern Med. 2013; 28: 1504-1510
Article info
Publication history
Published online: March 01, 2021
Accepted:
February 16,
2021
Received in revised form:
February 16,
2021
Received:
October 30,
2020
Identification
Copyright
© 2021 Published by Elsevier Inc.
