GENDER DISCRIMINATION AS AN OPHTHALMIC SURGEON: AN EMPIRICAL INVESTIGATION AT EYE DEPARTMENT OF MAYO HOSPITAL, LAHORE, PAKISTAN

Main Article Content

Hafiza Sadia Imtiaz
Zahid Kamal Siddiqui
Shujah-Ur-Rehman
Memoona Rafique
Muhammad Sharjeel

Keywords

Gender Discrimination, Ophthalmology, Surgeon, Gender Preferences

Abstract

Objective: To determine gender preferences of medical personnel when selecting ophthalmologists for routine check-up and ophthalmic surgeries and also to determine the factors responsible for this gender-discrimination while selecting a surgeon.


Material and Methods: After getting ERB approval and taking informed consent from every participant, a cross-sectional study was conducted at Eye unit 3, Mayo Hospital, for a duration of 3 months using convenience sampling. The 100 participants of either gender, of age 18 years or above, who are medical personnel working in Eye department of Mayo Hospital, including doctors and non- doctors’ staff were included in this study. Data was recorded on specially designed questionnaire and further analyzed in SPSS version 25.0.


Results: The 100 participants were enrolled in this study, out of which 62% were male and 38% were female. Mean age recorded was 32±2.4 years. Majority of participants didn’t have any preference (50.2%) in total and among them the highest level of no preference was for regular checkups (66%) and for Emergency cases (55%). While for elective surgical procedures, majority have male preference for vitreoretinal cases (50%) and for complicated cases (48%). While female surgeons were preferred compared to males only in pediatric ophthalmology cases (33% versus 21%). Among the positive characteristics of a female surgeon, mostly agreed that females are more detail oriented, have patient centered communication style, more empathetic, and understand the psychological factors better and are well-qualified. Mostly agreed that male surgeons are more confident, have strong decision power, better in dealing with complex cases and intra-operative complications and also performing in emergency situation.


Conclusion: In conclusion, almost half of participants didn’t show any preference and among remaining participants, male surgeons were preferred over female surgeons. Male surgeons were preferred for being more confident, fearless, more experienced, competent in dealing with complicated cases, more decisive, and having better professional skill.


 

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References

1. De Simone S, Scano C: Discourses of sameness, unbalance and influence: dominant gender order in medicine. J Gend Stud. 2018, 27:914-27. 10.1080/09589236.2017.1357541
2. Hu YY, Ellis RJ, Hewitt DB, et al.: Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019, 381:1741-52. 10.1056/NEJMsa1903759
3. Ceppa DP, Dolejs SC, Boden N, et al.: Sexual harassment and cardiothoracic surgery: #UsToo?. Ann Thorac Surg. 2020, 109:1283-8. 10.1016/j.athoracsur.2019.07.009 2022 Alkhaldi et al. Cureus 14(8): e28017. DOI 10.7759/cureus.28017 8 of 10
4. Baptiste D, Fecher AM, Dolejs SC, Yoder J, Schmidt CM, Couch ME, Ceppa DP: Gender differences in academic surgery, work-life balance, and satisfaction. J Surg Res. 2017, 218:99-107. 10.1016/j.jss.2017.05.075
5. Salles A, Awad M, Goldin L, Krus K, Lee JV, Schwabe MT, Lai CK: Estimating implicit and explicit gender bias among health care professionals and surgeons. JAMA Netw Open. 2019, 2:e196545. 10.1001/jamanetworkopen.2019.6545
6. Bruce AN, Battista A, Plankey MW, Johnson LB, Marshall MB: Perceptions of gender-based discrimination during surgical training and practice. Med Educ Online. 2015, 20:25923. 10.3402/meo.v20.25923
7. Yaow CYL, Mok HT, Ng CH, Devi MK, Iyer S, Chong CS: Difficulties faced by general surgery residents. A qualitative systematic review. J Surg Educ. 2020, 77:1396-406. 10.1016/j.jsurg.2020.06.003
8. Khoushhal Z, Hussain MA, Greco E, et al.: Prevalence and causes of attrition among surgical residents: a systematic review and meta-analysis. JAMA Surg. 2017, 152:265-72. 10.1001/jamasurg.2016.4086
9. Wallis CJ, Ravi B, Coburn N, Nam RK, Detsky AS, Satkunasivam R: Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ. 2017, 359:j4366. 10.1136/bmj.j4366
10. Janssen SM, Lagro-Janssen AL: Physician's gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: a systematic review. Patient Educ Couns. 2012, 89:221-6. 10.1016/j.pec.2012.06.034
11. Cil TD, Easson AM: The role of gender in patient preference for breast surgical care - a comment on equality. Isr J Health Policy Res. 2018, 7:37. 10.1186/s13584-018-0231-2
12. Hoffman RL, Bauer PS, Chan T, et al.: Patient-provider gender preference in colorectal surgery. Am J Surg. 2020, 220:1253-7. 10.1016/j.amjsurg.2020.06.051
13. Hu YY, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, et al. Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. New England Journal of Medicine [Internet]. 2019 Oct 31;381(18):1741–52.
14. Cai CX, Janek Klawe, Ahmad S, Zeger SL, Wang J, Sun G, et al. Geographic variations in gender differences in cataract surgery volume among a national cohort of ophthalmologists. Journal of Cataract and Refractive Surgery. 2022 Mar 18;48(9):1023–30.
15. Wallis CJD, Jerath A, Coburn N, et al. Association of Surgeon-Patient Sex Concordance With Postoperative Outcomes. JAMA Surg. 2022;157(2):146-156. doi:10.1001/jamasurg.2021.6339
16. Alyahya G, Almohanna H, Alyahya A, Aldosari M, Mathkour L, Aldhibaib A, et al. Does physicians’ gender have any influence on patients’ choice of their treating physicians? Journal of Nature and Science of Medicine. 2019;2(1):29.
17. Janssen SM, Lagro-Janssen ALM. Physician’s gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: A systematic review. Patient Education and Counseling. 2012 Nov;89(2):221–6.
18. Lim WH, Wong C, Jain SR, Ng CH, Tai CH, Devi MK, et al. (2021) The unspoken reality of gender bias in surgery: A qualitative systematic review. PLoS ONE 16(2): e0246420. https://doi. org/10.1371/journal.pone.0246420
19. Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., Li, R., Tan, H., Kang, L., Yao, L., Huang, M., Wang, H., Wang, G., Liu, Z., & Hu, S. (2020). Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA network open, 3(3), e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
20. Alkhaldi L M, Alsulaimani A I, Altalhi W A, et al. (August 14, 2022) Population Preference of Surgeon's Gender for Surgical Care and Their Attitudes Toward Female Surgeons in Taif, Saudi Arabia. Cureus 14(8): e28017
21. Jia JS, Lazzaro A, Lidder AK, et al. Gender Compensation Gap for Ophthalmologists in the First Year of Clinical Practice. Ophthalmology. 2021;128(7):971-980. doi:10.1016/j.ophtha.2020.11.022
22. Hu YY, Ellis RJ, Hewitt DB, et al. Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. N Engl J Med. 2019;381(18):1741-1752. doi:10.1056/NEJMsa1903759
23. Stephens EH, Heisler CA, Temkin SM, Miller P. The Current Status of Women in Surgery: How to Affect the Future. JAMA Surg. 2020;155(9):876-885. doi:10.1001/jamasurg.2020.0312