Dr. Wallis on the importance of diversifying the surgical work force

In this video, Christopher J.D. Wallis, MD, PhD, shares take-home messages from the study, “Surgeon sex and long-term postoperative outcomes among patients undergoing common surgeries,” for which he served as the lead author. Wallis is a urologic oncologist at Mount Sinai Hospital and University Health Network and an assistant professor of surgery at the University of Toronto in Toronto, Ontario, Canada.

Video Transcript:

The take-home message here is that [the data] needs to be contextualized. We need to see the greater context of surgery and women in surgery. We've seen [recent] data out of the UK highlighting how surgery is an environment that is difficult for many women. There's been data looking at rates of sexual assault in the workplace for women in surgery. That is just 1 example among many, and perhaps a relatively dramatic example, demonstrating how the culture of surgery is a bit averse or difficult for many women, and that shapes how we see these data.

So, I think firstly, these data, if anything, highlight the absolute need for diversification in surgery. We need women in surgery. We know that our patients need women in surgery and need women as surgeons. And I really think that the first step that doesn't require any more data or any more understanding is to emphasize how critical it is that we have a diverse surgical work force. We know in this paper we're looking at surgeon sex, but there's lots of data that similar concepts apply to race. The better our health care work force represents the patients we're trying to take care of, the better care we'll deliver and the better outcomes our patients will have. That's the first key takeaway.

The second, obviously, is that the data are suggesting that patients who have a female surgeon get better outcomes, and we need to dive deeper into what the processes of care are, that are underpinning that so that we can really improve care for all patients treated by all surgeons. When I sit back today and think about how I would counsel a patient to act on these data, I think the key takeaway would be not that you need to find a female surgeon. You need to find a surgeon who you trust, who you can communicate with, and who is able to address your concerns to your satisfaction. I really think when we look at what's known about differences between male and female physicians, that communication difference really comes out consistently. So, it almost inevitably plays into how these data come to be, and I think that's critical for patients as they're looking for a surgeon and are expecting to undergo surgery.

One of the notions that I think is important to understand here is, there's been a big push for this idea of a meritocracy. If you are good enough, you will fit in. I think ideally, that is nice and it's appealing, but it doesn't recognize all the cultural barriers that exist. It is harder for women and for people of color, as well as people with other life circumstances that make career advancement more difficult. People who come from lower income statuses, people with disabilities, all sorts of other factors, but it's hard to gain for example, a CV that matches someone else who didn't face the same barriers. While we have this notion that people should advance based on their merit, we really need to understand the barriers everyone is overcoming. In the context of this study there are many more barriers for women pursuing a career in surgery than there are for the average man pursuing a career in surgery. Understanding that and recognizing that is important as we consider the advancement of the profession of surgery and those people who represent surgeons and what it means to be a surgeon.

This transcription has been edited for clarity.