Presented by: Natalie Passarelli BA
The Warren Alpert Medical School at Brown University

Introduction

There has been a slow rise in female surgeon participation in Robotic and Laparoscopic Surgery (RLS), generally and within urology. Also, there is mixed evidence on whether male and female patients have gender preferences for their urological providers.  We sought to evaluate, within RLS, if there are differences in gender distributions of patients for male vs. female surgeons.  

Materials

RL-related CPT codes were selected from the American Board of Urology case logs (2011-2022). CPT codes were: 50543, 50544, 50545, 50546, 50548, 55866, 57425, and S2900. Self-reported patient and physician genders were recorded. Gender rates of surgeons and their patients were calculated overall, and by subspecialty. The percentage of female physicians operating on female patients was recorded and analyzed overall, by subspecialty. 

Results

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Female providers performed 7.2% of RLS urological procedures (Table 1). Of these patients, 53.2% were female. Male providers had an average of 24.4% female patients, less than half of that of female physicians. Of note, female providers constituted 36.5% of Female Urology providers. Among subspecialties, female providers consistently had a higher percentage of female patients as compared to their male counterparts, with the exception of Pediatrics and Urolithiasis which showed equal representation (Table 2).

Conclusion

Female surgeons performing RLS treat a larger proportion of female patients relative to male surgeons, more than doubling the percentage of their male physician counterparts. Whether this tendency toward same gender physician-patient pairing comes from the patient, provider, or both; and whether it is driven by preference, bias or structural reasons; remains unclear. Additional research to elucidate this finding is warranted to understand referral and practice patterns to optimize quality, equity and inclusion.

Funding

Brown Urology Department Funding

Lead Authors

Natalie Passarelli, MD
The Warren Alpert Medical School at Brown University

Alexa Steckler, BA
The Warren Alpert Medical School at Brown University

Borivoj Golijanin, BS
Minimally Invasive Urology Institute, The Miriam Hospital; The Warren Alpert Medical School of Brown University.

Elias Hyams, MD
Minimally Invasive Urology Institute, The Miriam Hospital; The Warren Alpert Medical School of Brown University.

Co-Authors

Samuel Eaton, MD
Minimally Invasive Urology Institute, The Miriam Hospital; The Warren Alpert Medical School of Brown University

Vikas Bhatt,
Minimally Invasive Urology Institute, The Miriam Hospital; The Warren Alpert Medical School of Brown University

Gyan Pareek, MD
Minimally Invasive Urology Institute, The Miriam Hospital; The Warren Alpert Medical School of Brown University