Biqi Zhang1, Maggie L Westfal2, Cornelia L Griggs3, Ya-Ching Hung4, David C Chang5, Cassandra M Kelleher6. 1. Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. 2. Department of Surgery, Massachusetts General Hospital/Harvard Medical School, 165 Cambridge Street, Suite 403, Boston, MA, USA; Department of Pediatric Surgery, Massachusetts General Hospital for Children, 55 Fruit Street, Boston, MA, USA. 3. Department of Pediatric Surgery, Columbia University College of Physicians & Surgeons, New York, NY, USA. 4. Department of Surgery, Sinai Hospital of Baltimore, Baltimore, MD, 21215, USA. 5. Department of Surgery, Massachusetts General Hospital/Harvard Medical School, 165 Cambridge Street, Suite 403, Boston, MA, USA. 6. Department of Surgery, Massachusetts General Hospital/Harvard Medical School, 165 Cambridge Street, Suite 403, Boston, MA, USA; Department of Pediatric Surgery, Massachusetts General Hospital for Children, 55 Fruit Street, Boston, MA, USA. Electronic address: ckelleher3@partners.org.
Abstract
BACKGROUND: Practice pattern and work environment differences may impact career advancement opportunities and contribute to the gender gap within highly competitive surgical specialties. METHODS: Using a 2000-2015 New York statewide dataset, we compared board-certified pediatric surgeons by specialist case volume and Herfindahl-Hirschman Index (HHI), which quantifies surgeon focus within specialist case mix. RESULTS: 51 pediatric surgeons were analyzed for 461 surgeon-years. Female surgeons had lower case volume (159 cases/year versus 214, p < 0.01), lower shares of specialist cases (14.1% versus 16.7%, p = 0.04), and less focused practices (HHI 0.16 versus 0.20, p = 0.03). Female surgeons' networks had fewer colleagues (7.2 versus 12.1, p < 0.01), and lower annual total (388 versus 726, p < 0.01) and specialist case volume (83 versus 159, p < 0.01), even after accounting for career length. However, female surgeons performed more cases within their networks (49% versus 36%, p = 0.04) and worked at major teaching hospitals as often as men (76% versus 76%, p = 0.97). CONCLUSION: The challenges that female surgeons face may be reflective of organizational inequities that necessitate intentional scrutiny and change.
BACKGROUND: Practice pattern and work environment differences may impact career advancement opportunities and contribute to the gender gap within highly competitive surgical specialties. METHODS: Using a 2000-2015 New York statewide dataset, we compared board-certified pediatric surgeons by specialist case volume and Herfindahl-Hirschman Index (HHI), which quantifies surgeon focus within specialist case mix. RESULTS: 51 pediatric surgeons were analyzed for 461 surgeon-years. Female surgeons had lower case volume (159 cases/year versus 214, p < 0.01), lower shares of specialist cases (14.1% versus 16.7%, p = 0.04), and less focused practices (HHI 0.16 versus 0.20, p = 0.03). Female surgeons' networks had fewer colleagues (7.2 versus 12.1, p < 0.01), and lower annual total (388 versus 726, p < 0.01) and specialist case volume (83 versus 159, p < 0.01), even after accounting for career length. However, female surgeons performed more cases within their networks (49% versus 36%, p = 0.04) and worked at major teaching hospitals as often as men (76% versus 76%, p = 0.97). CONCLUSION: The challenges that female surgeons face may be reflective of organizational inequities that necessitate intentional scrutiny and change.