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Women in spine surgery: can we change the society?

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Abstract

Background

Although the number of educated women and physicians, and especially neurosurgeons, is increasing worldwide, the educational opportunities, careers, and beliefs concerning female neurosurgeon’s status and abilities are undermined. To date, reported studies have focused on the conditions of the work environment, work-life balance, and the academic career of female neurosurgeons. In this study, we aimed to report the patients’ viewpoint and how they choose spine physicians.

Methods

We conducted an international survey based on 19 questions in four languages (Bulgarian, Greek, English, and German). The responses of 413 individuals, unrelated to the medical field (sex, 315 female and 115 male individuals; one individual did not answer the question regarding the gender), were obtained. Except for the question regarding the patient’s preference for the physician sex, the survey aimed to examine the factors that might be contributing to this choice, including education, age, heard/read recommendations/advertisements, knowledge regarding the work of the neurosurgeons/orthopedists, and their difference regarding spine surgery.

Results

The majority of the participants responded that they prefer male surgeons to treat their spine. The results showed a significant correlation between the choice of a male spine surgeon and heard/read advertisements/recommendations and knowledge regarding the work of the neurosurgeon. Despite the fact that education was not related to physician selection, it was an indirect factor that led to the final choice.

Conclusion

Women in surgery, mainly in neurosurgery, are being treated by society in an unequal way. Female surgeons are still discriminated because of their gender. The most patients prefer female physicians to talk to, but still believe that they are incapable to perform spine surgery. We cannot stop this until we change our mindset and perception of reality.

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References

  1. Wirtzfeld DA (2009) The history of women in surgery. Can J Surg 52(4):317–320

    PubMed  PubMed Central  Google Scholar 

  2. Casillo SM, Venkatesh A, Muthiah N, McDowell MM, Agarwal N (2021) First female neurosurgeon in the United States: Dorothy Klenke Nash, MD. Neurosurgery 89(4):E223–E228. https://doi.org/10.1093/neuros/nyab246

    Article  PubMed  Google Scholar 

  3. Ciurea AV, Moisa HA, Mohan D (2013) Sofia Ionescu, the first woman neurosurgeon in the world. World Neurosurg 80(5):650–653. https://doi.org/10.1016/j.wneu.2013.02.031

    Article  PubMed  Google Scholar 

  4. Gilkes CE (2008) An account of the life and achievements of Miss Diana Beck, neurosurgeon (1902–1956). Neurosurgery 62(3):738–742. https://doi.org/10.1227/01.neu.0000317324.71483.e5. (discussion 738–42)

    Article  PubMed  Google Scholar 

  5. Zanon N (2011) Women in neurosurgery: a challenge to change historyeBrazil. São Paulo Childs Nerv Syst 27:337–340

    Article  Google Scholar 

  6. Balogun JA, Adebayo AM (2019) Perception (of) and willingness to choose a neurosurgery career among final-year medical students in Ibadan, Nigeria. World Neurosurg 126:e998–e1004. https://doi.org/10.1016/j.wneu.2019.03.020

    Article  PubMed  Google Scholar 

  7. Spetzler RF (2011) Progress of women in neurosurgery. Asian J Neurosurg 6(1):6–12. https://doi.org/10.4103/1793-5482.85627

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hdeib A, Elder T, Krivosheya D, Ojukwu DI, Wijesekera O, Defta D, Ben-Haim S, Benzil DL (2021) History of women in neurosurgery (WINS). Neurosurg Focus 50(3):E16. https://doi.org/10.3171/2020.12.FOCUS20944

    Article  PubMed  Google Scholar 

  9. Garozzo D, Rispoli R, Graziano F et al (2022) Women in neurosurgery: historical path to self-segregation and proposal for an integrated future. Front Surg 9:908540. https://doi.org/10.3389/fsurg.2022.908540

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Agaronnik N, Xiong GX, Uzosike A et al (2022) The role of gender in academic productivity, impact, and leadership among academic spine surgeons. Spine J 22(5):716–722. https://doi.org/10.1016/j.spinee.2021.12.003

    Article  PubMed  Google Scholar 

  11. Dineen HA, Patterson JMM, Eskildsen SM et al (2019) Gender preferences of patients when selecting orthopaedic providers. Iowa Orthop J 39(1):203–210

    PubMed  PubMed Central  Google Scholar 

  12. Dagostini CM, Bicca YA, Ramos MB, Busnello S, Gionedis MC, Contini N, Falavigna A (2022) Patients’ preferences regarding physicians’ gender: a clinical center cross-sectional study. Sao Paulo Med J 140(1):134–143. https://doi.org/10.1590/1516-3180.2021.0171.R1.08062021

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hoffman RL, Bauer PS, Chan T, Mohanty S, Hunt S, Silviera M, Mutch M, Wise P, Smith R (2020) Patient-provider gender preference in colorectal surgery. Am J Surg 220(5):1253–1257. https://doi.org/10.1016/j.amjsurg.2020.06.051

    Article  PubMed  Google Scholar 

  14. Hoke TP, Berger AA, Pan CC, Jackson LA, Winkelman WD, High R, Volpe KA, Lin CP, Richter HE (2020) Assessing patients’ preferences for gender, age, and experience of their urogynecologic provider. Int Urogynecol J 31(6):1203–1208. https://doi.org/10.1007/s00192-019-04189-0

    Article  PubMed  Google Scholar 

  15. Hancock EA, Hancock KJ, Wijay N, Andry D (2021) Does surgeon gender matter for aesthetic patients? Aesthet Surg J 41(9):NP1237–NP1241. https://doi.org/10.1093/asj/sjab201

    Article  PubMed  Google Scholar 

  16. Yaeger KA, Munich SA, Byrne RW et al (2020) Trends in United States neurosurgery residency education and training over the last decade (2009–2019). Neurosurgery 48:E6. https://doi.org/10.3171/2019.12.FOCUS19827

    Article  Google Scholar 

  17. Shi HH, Westrup AM, O’Neal CM, Hendrix MC, Dunn IF, Gernsback JE (2021) Women in neurosurgery around the world: a systematic review and discussion of barriers, training, professional development, and solutions. World Neurosurg 154:206-213.e18

    Article  PubMed  Google Scholar 

  18. Dossa F, Simpson AN, Sutradhar R et al (2019) Sex-based disparities in the hourly earnings of surgeons in the fee-for-service system in Ontario, Canada. JAMA Surg 154(12):1134–1142. https://doi.org/10.1001/jamasurg.2019.3769

    Article  PubMed  PubMed Central  Google Scholar 

  19. Jena AB, Olenski AR, Blumenthal DM (2016) Sex differences in physician salary in US public medical schools. JAMA Intern Med 176(9):1294–1304

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wolfert C, Rohde V, Mielke D, Hernández-Durán S (2019) Female neurosurgeons in Europe-on a prevailing glass ceiling. World Neurosurg 129:460–466. https://doi.org/10.1016/j.wneu.2019.05.137

    Article  PubMed  Google Scholar 

  21. Steklacova A, Bradac O, de Lacy P, Benes V (2017) E-WIN project 2016: evaluating the current gender situation in neurosurgery across Europe-an interactive. Multiple-Level Surv World Neurosurg 104:48–60. https://doi.org/10.1016/j.wneu.2017.04.094

    Article  Google Scholar 

  22. Gadjradj PS, Matawlie RHS, Voigt I, Harhangi BS, Vleggeert-Lankamp CLAM (2020) Gender differences between male and female neurosurgeons: is there equality for all? World Neurosurg 136:348–356. https://doi.org/10.1016/j.wneu.2019.11.178

    Article  PubMed  Google Scholar 

  23. Sweet JA, Holanda VM, Rao G, Kalkanis SN, Sharan AD, Benzil DL (2019) Letter: congress of neurological surgeons female international think tank report: much progress, still work to be done. Neurosurgery 85(3):E599–E606. https://doi.org/10.1093/neuros/nyz254

    Article  PubMed  Google Scholar 

  24. Bornstein BH, Marcus D, Cassidy W (2000) Choosing a doctor: an exploratory study of factors influencing patients’ choice of a primary care doctor. J Eval Clin Pract 6(3):255–262. https://doi.org/10.1046/j.1365-2753.2000.00256.x

    Article  CAS  PubMed  Google Scholar 

  25. Kelley SW, Schwartz RW (2005) A marketing-oriented perspective on physician selection. Surg Innov 12(4):357–363. https://doi.org/10.1177/155335060501200412

    Article  PubMed  Google Scholar 

  26. Purcarea VL (2019) The impact of marketing strategies in healthcare systems. J Med Life 12(2):93–96. https://doi.org/10.25122/jml-2019-1003

    Article  PubMed  Google Scholar 

  27. Hoerger TJ, Howard LZ (1995) Search behavior and choice of physician in the market for prenatal care. Med Care 33(4):332–349. https://doi.org/10.1097/00005650-199504000-00002

    Article  CAS  PubMed  Google Scholar 

  28. Kaiser Family Foundation/Agency for Health Care Policy and Research (1996) Americans as Health Care Consumers: the role of quality information. Rockville, MD and Menlo Park, CA: Kalser Family Foundation/Agency for Health Care Policy and Research

  29. Kaiser Family Foundation/Agency for Health Care Research and Quality [AHRQ] (2000) National Survey on Americans as Health Care Consumers: An Update on the Role of Quality Information. Rockville, MD and Menlo Park, CA: Kalser Family Foundation/Agency for Health Care Policy and Research

  30. Lupton D, Donaldson C, Lloyd P (1991) Caveat emptor or blissful ignorance? Patients and the consumerist ethos. Soc Sci Med 33(5):559–568

    Article  CAS  PubMed  Google Scholar 

  31. Kim HB, Choi S, Kim B, Pop-Eleches C (2018) The role of education interventions in improving economic rationality. Science 362(6410):83–86. https://doi.org/10.1126/science.aar6987

    Article  ADS  CAS  PubMed  Google Scholar 

  32. Klein J (1999) The relationship between level of academic education and reversible and irreversible processes of probability decision-making. Higher Educ 37(4):323–339

    Article  Google Scholar 

  33. Rosenbeger CA (2020) Does level of education make a difference? An examination in emotion-based decision-making. JASNH 17(1):1539–8714

    Google Scholar 

  34. Kerssens JJ, Bensing JM, Andela MG (1997) Patient preference for genders of health professionals. Soc Sci Med 44(10):1531–1540. https://doi.org/10.1016/s0277-9536(96)00272-9

    Article  CAS  PubMed  Google Scholar 

  35. Roter DL, Hall JA, Aoki Y (2002) Physician gender effects in medical communication: a meta-analytic review. JAMA 288(6):756–764. https://doi.org/10.1001/jama.288.6.756

    Article  PubMed  Google Scholar 

  36. Chitguppi C, Brar T (2018) Do otolaryngology patients show gender preference when choosing a surgeon?—A quantitative and qualitative analysis. Int Arch Otorhinolaryngol. 22(4):404–407. https://doi.org/10.1055/s-0038-1641165

    Article  PubMed  PubMed Central  Google Scholar 

  37. Dineen HA, Patterson JMM, Eskildsen SM, Gan ZS, Li Q, Patterson BC, Draeger RW (2019) Gender preferences of patients when selecting orthopaedic providers. Iowa Orthop J 39(1):203–210

    PubMed  PubMed Central  Google Scholar 

  38. Franklin A, Carrico CK, Laskin DM (2017) Societal preference for gender of surgeons performing patients’ surgery. J Oral Maxillofac Surg 75(3):458–461. https://doi.org/10.1016/j.joms.2016.10.024

    Article  PubMed  Google Scholar 

  39. Wallis CJD, Jerath A, Aminoltejari K, Kaneshwaran K, Salles A, Coburn N, Wright FC, Gotlib Conn L, Klaassen Z, Luckenbaugh AN, Ranganathan S, Riveros C, McCartney C, Armstrong K, Bass B, Detsky AS, Satkunasivam R (2023) Surgeon sex and long-term postoperative outcomes among patients undergoing common surgeries. JAMA Surg 158(11):1185–1194. https://doi.org/10.1001/jamasurg.2023.3744

    Article  PubMed  Google Scholar 

  40. Okoshi K, Endo H, Nomura S, Kono E, Fujita Y, Yasufuku I, Hida K, Yamamoto H, Miyata H, Yoshida K, Kakeji Y, Kitagawa Y (2022) Comparison of short term surgical outcomes of male and female gastrointestinal surgeons in Japan: retrospective cohort study. BMJ 28(378):e070568. https://doi.org/10.1136/bmj-2022-070568

    Article  Google Scholar 

  41. Koshinski JL, Xiong GX, Agaronnik N et al (2023) Report of the women in academic spine initiative. Spine (Phila Pa 1976) 48(8):515–518. https://doi.org/10.1097/BRS.0000000000004608

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Democritus University of Thrace, Alexandroupolis, Greece

    Alexandrina Nikova & Theodossios Birbilis

  2. Department of Neurosurgery, Asclipieio Voulas General Hospital, 16673, Athens, Greece

    Alexandrina Nikova

  3. Department of Occupational Therapy, Univeristy of West Attica, Athens, Greece

    Pinelopi Vlotinou

  4. Department of Cardiology, Sotiria Hospital, Athens, Greece

    Helena Michalopoulou

  5. Department of Statistics, Democritus University of Thrace, Alexandroupolis, Greece

    Grigorios Tripsianis

  6. Department of Surgery, Democritus University of Thrace, Alexandroupolis, Greece

    Michael Karanikas

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  1. Alexandrina Nikova
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Correspondence to Alexandrina Nikova.

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Nikova, A., Vlotinou, P., Michalopoulou, H. et al. Women in spine surgery: can we change the society?. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08187-9

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