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Including more women on hospital teams leads to better surgical outcomes
Last reviewed: 02.07.2025
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A new study published in the British Journal of Surgery has found that being treated in hospitals with higher gender diversity of surgical teams is associated with better post-operative outcomes for patients.
Across industries, including business, finance, technology, education, and law, many believe that gender diversity is important not only for equality but also because it enriches teams with the diversity of experiences and perspectives of their members. However, there is limited evidence on the value of gender diversity in healthcare teams. Most published reports focus on individual physician characteristics and their association with outcomes (e.g., how patients respond to female physicians). There is limited evidence on the role of gender diversity in healthcare teams and their outcomes.
Gender diversity of the team likely impacts patient outcomes due to the differences that male and female physicians bring to the workplace. Both groups have different skills, knowledge, experiences, beliefs, values, and leadership styles. Despite the benefits of gender and sexual diversity for team performance, female physicians remain rare in the operating room. The number of female anesthesiologists and surgeons has increased by only 5% over the past 10 years.
The researchers conducted a population-based retrospective cohort study using administrative health data in Ontario, Canada, where 14 million residents receive health care through a single-payer public system. They studied adult patients undergoing major elective surgery with hospitalization between 2009 and 2019 to assess major postoperative complications.
The study included 709,899 surgeries performed at 88 hospitals during the study period, of which 14.4% had a major complication within 90 days of surgery. The median proportion of female anesthesiologists and surgeons at hospitals per year was 28%. Overall, female surgeons performed 47,874 (6.7%) surgeries, and female anesthesiologists performed 192,144 (27.0%) surgeries.
The study found that hospitals with more than 35% female surgeons and anesthesiologists had better postoperative outcomes. In such hospitals, surgeries were associated with a 3% lower likelihood of patients experiencing serious complications within 90 days of surgery. The researchers noted that the 35% threshold observed in their study echoed findings in other industries in countries including the United States, Italy, Australia, and Japan, which also saw better outcomes when women made up about 35% of the total team.
"These findings represent an important step in understanding how diversity impacts the quality of perioperative care," said lead author Julie Hallett. "Ensuring a critical mass of female anesthesiologists and surgeons on OR teams is not only important for equity; it seems essential to optimizing outcomes. We wanted to challenge the binary discussion of female versus male physicians and highlight the importance of diversity as a team resource for improving quality of care."
"Ensuring gender diversity on OR teams will require targeted efforts to develop systematic strategies for recruiting and retaining female physicians, structural interventions such as minimum representation on teams, and monitoring and reporting on team composition to increase accountability in existing systems."