Throughout the United States, the number of female urologists is growing, but they still represent a small portion of the field. “Only about 8% of urologists in the U.S. are women,” says Daniel T. Oberlin, MD. “The field has been lacking in gender equality, and there may be unmet needs with regard to access to female urologists.” According to recent data, the percentage of female urology residents has grown from 5% of the field in 1989 to about 23% in 2011.
While there have been anecdotal reports of women preferring female urologists, few studies have explored the influence of surgeon or patient gender on surgical practice patterns. To address this research gap, Dr. Oberlin and colleagues assessed the influence of surgeon gender on patient gender demographics by exploring the surgical case logs of American urologists.
For a study published in the Journal of Urology, the authors looked at 6-month case logs of more than 6,000 urologists from 2003 to 2012. They reviewed case logs of common urological procedures, including treatment of nephrolithiasis, nephrectomy, bladder tumor resections, treatment of stress urinary incontinence, elective sterilization, and treatment of prostate cancer. “Our analysis included more than 1 million cases that were either gender-neutral or gender-specific procedure groups,” says Dr. Oberlin. “These data represented more than two-thirds of all urologists in the U.S.”
Data from the study suggests that female urological patients may gravitate to female urologists. “Female surgeons operated on a 54.4% of female patients, compared with a 32.5% rate that was seen for male surgeons,” Dr. Oberlin says. “Notably, female urologists performed a higher proportion of gender-neutral procedures—surgeries which are not specific to men or women—on female patients than male urologists.”
Female surgeons performed significantly more sling operations than their male counterparts whereas male urologists performed significantly more male-specific procedures than their female colleagues, including three times as many vasectomies and more than twice as many prostatectomies. “These trends were consistent across all subspecialties and geographic regions,” adds Dr. Oberlin.
As the number of women in urology grows, greater attention to gender biases will be needed to understand how these disparities may shape the clinical landscape. “In many medical specialties there is a discrepancy between men and women in the field, but urology has one of the largest gender disparities,” Dr. Oberlin says. “There is a misconception that urology tends to manage mainly male issues. However, there are a significant number of conditions affecting women managed by urologists. We need to embrace the findings from our study and encourage more women to pursue urology.”
Daniel T. Oberlin, MD, has indicated to Physician’s Weekly that he has no financial disclosures to report.
Readings & Resources (click to view)
Oberlin DT, Vo AX, Backrach L, Flury SC. The gender divide: the impact of surgeon gender on surgical practice patterns in urology. J Urol. 2016 May 10 [Epub ahead of print]. Available at: http://www.jurology.com/article/S0022-5347(16)30386-X/abstract.
Pruthi RS, Neuwahl S, Nielsen ME, Fraher E. Recent trends in the urology workforce in the United States. Urology. 2013;82:987-993.
Spencer ES, Deal AM, Pruthi, NR, et al, Gender differences in compensation, job satisfaction, and other practice patterns in urology. J Urol. 2016;195:450-455.
Grimsby GM, Wolter CE. The journey of women in urology: the perspective of a female urology resident. Urology. 2013;81:3-6.