Public Preferences for Surgeon Gender in Saudi Arabia: A Cross-Sectional Analysis
Abstract
:1. Introduction
2. Methods
2.1. Study Setting and Participants
2.2. Sample Size Calculation
2.3. Data Analysis
2.4. Ethical Considerations
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- PAHO/WHO|Pan American Health Organization. Gender Equality in Health. Available online: https://www.paho.org/en/topics/gender-equality-health (accessed on 19 March 2024).
- Torrente-Jimenez, R.S.; Feijoo-Cid, M.; Rivero-Santana, A.J.; Perestelo-Pérez, L.; Torres-Castaño, A.; Ramos-García, V.; Bilbao, A.; Serrano-Aguilar, P. Gender differences in the decision-making process for undergoing total knee replacement. Patient Educ. Couns. 2022, 105, 3459–3465. [Google Scholar] [CrossRef] [PubMed]
- Pinto, F.J. Gender Equity: Time to Act. Int. J. Cardiovasc. Sci. 2021, 34, 340–341. [Google Scholar] [CrossRef]
- Xue, H.; Liu, G.; Shi, Y.; Nie, J.; Auden, E.; Sylvia, S. How does physician gender influence primary care quality? evidence from a standardised patient audit study in China. Lancet 2018, 392, S66. [Google Scholar] [CrossRef]
- Roter, D.L.; Hall, J.A.; Aoki, Y. Physician Gender Effects in Medical Communication. JAMA 2002, 288, 756. [Google Scholar] [CrossRef] [PubMed]
- Govind, G.; Mahendran, A. SP11.7 Do women surgeons have autonomy in the operating theatre? Exploring the lived experience of female surgical trainees. Br. J. Surg. 2023, 110 (Suppl. S6), znad241.135. [Google Scholar] [CrossRef]
- Tricco, A.C.; Bourgeault, I.L.; Moore, A.; Grunfeld, E.; Peer, N.; Straus, S.E. Advancing gender equity in medicine. CMAJ Can. Med. Assoc. J. 2021, 193, E244–E250. [Google Scholar] [CrossRef] [PubMed]
- Janssen, S.M.; Lagro-Janssen, A.L. Physician’s gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: A systematic review. Patient Educ. Couns. 2012, 89, 221–226. [Google Scholar] [CrossRef] [PubMed]
- Burgess, D.J.; Fu, S.S.; Ryn, M. Why do providers contribute to disparities and what can be done about it? J. Gen. Int. Med. 2004, 19, 1154–1159. [Google Scholar] [CrossRef] [PubMed]
- Albornoz, C.R.; Bach, P.B.; Mehrara, B.J.; Disa, J.J.; Pusic, A.L.; McCarthy, C.M.; Cordeiro, P.G.; Matros, E. A Paradigm Shift in U.S. Breast Reconstruction. Plast. Reconstr. Surg. 2013, 131, 15–23. [Google Scholar] [CrossRef]
- Berner, E.S.; Graber, M.L. Overconfidence as a Cause of Diagnostic Error in Medicine. Am. J. Med. 2008, 121, S2–S23. [Google Scholar] [CrossRef]
- Subki, A.H.; Agabawi, A.K.; Hindi, M.M.; Butt, N.S.; Alsallum, M.S.; Alghamdi, R.A.; Subki, S.H.; Alsallum, F.; Alharbi, A.A.; Lodhi, Y.I.; et al. How Relevant is Obstetrician and Gynecologist Gender to Women in Saudi Arabia? Int. J. Women’s Health 2021, 13, 919–927. [Google Scholar] [CrossRef] [PubMed]
- Vasilenko, P. Physician gender issues in obstetrics-gynecology: Patient preferences of physician characteristics. Obstet. Gynecol. 2003, 101, S22. [Google Scholar] [CrossRef]
- Tempest, H.V.; Vowler, S.; Simpson, A. Patients’ preference for gender of urologist. Int. J. Clin. Pract. 2005, 59, 526–528. [Google Scholar] [CrossRef]
- Alsafar, F.A.; Tehsin, F.; Alsaffar, K.M.; Albukhaytan, W.A. Physicians’ Gender Influence on the Patients’ Choice of Their Treating Obstetrician-Gynecologist in the Eastern Province of Saudi Arabia. Cureus 2022, 14, e23457. [Google Scholar] [CrossRef]
- Alkhaldi, L.M.; Alsulaimani, A.I.; Altalhi, W.A.; Alghamdi, G.M.; Alqurashi, N.N.; Abdelrahman, T.M. Population Preference of Surgeon’s Gender for Surgical Care and Their Attitudes toward Female Surgeons in Taif, Saudi Arabia. Cureus 2022, 14, e28017. [Google Scholar] [CrossRef] [PubMed]
- The World Bank. Saudi Arabia Demographics. 2022. Available online: https://data.worldbank.org/indicator/SP.POP.TOTL?locations=SA (accessed on 30 May 2024).
- The World Bank. Literacy Rate, Adult Total (% of People Ages 15 and Above)—Saudi Arabia. 2023. Available online: https://data.worldbank.org/indicator/SE.ADT.LITR.ZS?locations=SA (accessed on 30 May 2024).
- Ministry of Education, Saudi Arabia. Higher Education Statistics. 2021. Available online: https://departments.moe.gov.sa/Statistics/Educationstatistics/Pages/HEStats.aspx (accessed on 30 May 2024).
- Cooper-Patrick, L. Race, Gender, and Partnership in the Patient-Physician Relationship. JAMA 1999, 282, 583. [Google Scholar] [CrossRef]
- Roter, D.L.; Hall, J.A. Physician gender and patient-centered communication: A critical review of empirical research. Annu. Rev. Public Health 2004, 25, 497–519. [Google Scholar] [CrossRef]
- Hall, J.A.; Roter, D.L.; Katz, N.R. Meta-analysis of Correlates of Provider Behavior in Medical Encounters. Med. Care 1988, 26, 657–675. [Google Scholar] [CrossRef]
- Bertakis, K.D.; Helms, L.J.; Callahan, E.J.; Azari, R.; Robbins, J.A. The Influence of Gender on Physician Practice Style. Med. Care 1995, 33, 407–416. [Google Scholar] [CrossRef]
- Hekman, D.R.; Aquino, K.; Owens, B.P.; Mitchell, T.R.; Schilpzand, P.; Leavitt, K. An Examination of Whether and How Racial and Gender Biases Influence Customer Satisfaction. Acad. Manag. J. 2010, 53, 238–264. [Google Scholar] [CrossRef]
- Shapiro, J. Patterns of psychosocial performance in the doctor-patient encounter: A study of family practice residents. Soc. Sci. Med. 1990, 31, 1035–1041. [Google Scholar] [CrossRef] [PubMed]
- Hall, J.A.; Irish, J.T.; Roter, D.L.; Ehrlich, C.M.; Miller, L.H. Satisfaction, Gender, and Communication in Medical Visits. Med. Care 1994, 32, 1216–1231. [Google Scholar] [CrossRef] [PubMed]
- Schmid Mast, M.; Hall, J.A.; Roter, D.L. Disentangling physician sex and physician communication style: Their effects on patient satisfaction in a virtual medical visit. Patient Educ. Couns. 2007, 68, 16–22. [Google Scholar] [CrossRef] [PubMed]
- Van den Brink-Muinen, A.; de Bakker, D.H.; Bensing, J.M. Consultations for women’s health problems: Factors influencing women’s choice of sex of general practitioner. Br. J. Gen. Pract. 1994, 44, 205–210. [Google Scholar] [PubMed]
- Rathert, C.; Wyrwich, M.D.; Boren, S.A. Patient-Centered Care and Outcomes. Med. Care Res. Rev. 2012, 70, 351–379. [Google Scholar] [CrossRef] [PubMed]
- Tabo, L.Y.; Greenberg, D.; Haviv, Y.S.; Riesenberg, K.; Nesher, L. The impact of gender on early scientific publication and long-term career advancement in Israeli medical school graduates. BMC Med. Educ. 2021, 21, 163. [Google Scholar] [CrossRef] [PubMed]
- Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs. female physicians. Br. Dent. J. 2017, 222, 170. [CrossRef] [PubMed]
- Hamberg, K.; Risberg, G.; Johansson, E.E. Male and female physicians show different patterns of gender bias: A paper-case study of management of irritable bowel syndrome. Scand. J. Public Health 2004, 32, 144–152. [Google Scholar] [CrossRef]
- Al-Mujaini, A.; Al-Adawi, S. Gender preferences of patients in medical practice. Oman Med. J. 2018, 33, 103–108. [Google Scholar]
- Al-Yousefi, N.A. Observations of gender preference in the context of medical care in Saudi Arabia. Middle East J. Fam. Med. 2017, 15, 12–19. [Google Scholar]
- El-Shazly, M.; Grunfeld, A.F. Female patients’ preferences regarding the gender of their obstetrician and gynecologist. J. Women’s Health Issues Care 2016, 5, 1–6. [Google Scholar]
- Alahmad, G. Cultural aspects of health care in Saudi Arabia: An overview. East. Mediterr. Health J. 2018, 24, 778–784. [Google Scholar]
- Gutowski, K. What Patients Look for When Choosing a Plastic Surgeon: An Assessment of Patient Preference by Conjoint Analysis. Yearb. Plast. Aesthet. Surg. 2013, 2013, 76–77. [Google Scholar] [CrossRef]
- Martins, R.S.; Gillani, M.; Jawaid, S.; Zaidi SM, Z.; Malik, M.A. Societal Preferences for Gender of Surgeons: A Cross-Sectional Study in the General Population of Pakistan. World J. Surg. 2022, 46, 757–766. [Google Scholar] [CrossRef]
- Al-Shahri, M.Z. Culturally sensitive caring for Saudi patients. J. Transcult. Nurs. 2002, 13, 133–138. [Google Scholar] [CrossRef] [PubMed]
- Mobeireek, A.F.; al-Kassimi, F.A.; al-Majid, S.A.; al-Shimemry, A. Communication with the seriously ill: Physicians’ attitudes in Saudi Arabia. J. Med. Ethics 1996, 22, 282–285. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
N | % | ||
---|---|---|---|
Age | 18–25 | 1067 | 51.2 |
26–35 | 383 | 18.4 | |
36–45 | 348 | 16.7 | |
Above 45 | 287 | 13.8 | |
Gender | Male | 852 | 40.9 |
Female | 1233 | 59.1 | |
Marital status | Single | 1201 | 57.6 |
Married | 770 | 36.9 | |
Divorced | 40 | 1.9 | |
Widowed | 74 | 3.5 | |
Nationality | Saudi | 1986 | 95.3 |
Non-Saudi | 99 | 4.7 | |
Educational level | General education (primary, intermediate, secondary) | 504 | 24.2 |
University | 1475 | 70.7 | |
Postgraduate | 106 | 5.1 | |
Employment status | I study or work in a healthcare field | 560 | 26.9 |
I study or work in a non-healthcare field | 905 | 43.4 | |
Not working | 620 | 29.7 | |
Area of Residence | Central Region | 427 | 20.5 |
Western Region | 416 | 20.0 | |
Eastern Region | 417 | 20.0 | |
Southern Region | 410 | 19.7 | |
Northern Region | 415 | 19.9 |
N | % | ||
---|---|---|---|
Have consulted or undergone treatment by a surgeon or surgeons | 1077 | 51.7 | |
Body region that would be examined by a surgeon of the same sex | Face | 491 | 23.5 |
Mouth | 399 | 19.1 | |
Head region | 335 | 16.1 | |
Neck region | 363 | 17.4 | |
Chest region | 695 | 33.3 | |
Abdomen | 623 | 29.9 | |
Pelvic region | 591 | 28.3 | |
Genitals | 1073 | 51.5 | |
Extremity | 283 | 13.6 | |
Back | 451 | 21.6 | |
I did not have any preferences | 596 | 28.6 | |
Reasons for preferring gender of the same gender | Comfortable | 679 | 32.6 |
Modesty | 69 | 3.3 | |
I can talk openly with a surgeon of the same gender | 1093 | 52.4 | |
Do not believe that a surgeon of the same sex has a greater understanding of the symptoms | 127 | 6.1 | |
Confusion | 117 | 5.6 |
Gender | Total | p-Value | ||||
---|---|---|---|---|---|---|
Male | Female | |||||
Surgeon’s gender preferences for breast cancer surgery | No | N | 458 | 641 | 1099 | 0.001 |
% | 53.8% | 52.0% | 52.7% | |||
Yes, female surgeons are always the best | N | 186 | 351 | 537 | ||
% | 21.8% | 28.5% | 25.8% | |||
Yes, male surgeons are always the best | N | 208 | 241 | 449 | ||
% | 24.4% | 19.5% | 21.5% | |||
Surgeon’s gender preferences for hemorrhoid surgery | No | N | 396 | 589 | 985 | <0.001 |
% | 46.5% | 47.8% | 47.2% | |||
Yes, female surgeons are always the best | N | 74 | 500 | 574 | ||
% | 8.7% | 40.6% | 27.5% | |||
Yes, male surgeons are always the best | N | 382 | 144 | 526 | ||
% | 44.8% | 11.7% | 25.2% |
Reasons for Choosing a Surgeon | Surgeon’s Gender Preferences for Breast Cancer Surgery | Surgeon’s Gender Preferences for Hemorrhoid Surgery | |||||
---|---|---|---|---|---|---|---|
Yes, Female Surgeons Are Always the Best | Yes, Male Surgeons Are Always the Best | Total | Yes, Female Surgeons Are Always the Best | Yes, Male Surgeons Are Always the Best | Total | ||
Fearless | N | 52 | 36 | 88 | 73 | 39 | 112 |
% | 9.7% | 8.0% | 8.9% | 12.7% | 7.4% | 10.2% | |
Confident | N | 77 | 68 | 145 | 54 | 57 | 111 |
% | 14.3% | 15.1% | 14.7% | 9.4% | 10.8% | 10.1% | |
Higher level of patience | N | 18 | 29 | 47 | 13 | 22 | 35 |
% | 3.4% | 6.5% | 4.8% | 2.3% | 4.2% | 3.2% | |
More experienced | N | 44 | 99 | 143 | 25 | 61 | 86 |
% | 8.2% | 22.0% | 14.5% | 4.4% | 11.6% | 7.8% | |
Competent | N | 26 | 96 | 122 | 24 | 73 | 97 |
% | 4.8% | 21.4% | 12.4% | 4.2% | 13.9% | 8.8% | |
Can talk openly with a surgeon of the same gender | N | 243 | 58 | 301 | 328 | 211 | 539 |
% | 45.3% | 12.9% | 30.5% | 57.1% | 40.1% | 49.0% | |
Bad experience with surgeons of opposite gender in the past | N | 8 | 10 | 18 | 9 | 5 | 14 |
% | 1.5% | 2.2% | 1.8% | 1.6% | 1.0% | 1.3% | |
Superior professional skills | N | 20 | 36 | 56 | 16 | 36 | 52 |
% | 3.7% | 8.0% | 5.7% | 2.8% | 6.8% | 4.7% | |
Examines patients better | N | 49 | 17 | 66 | 32 | 22 | 54 |
% | 9.1% | 3.8% | 6.7% | 5.6% | 4.2% | 4.9% |
p-Value | aOR | 95% C.I. | |||
---|---|---|---|---|---|
Surgeon preferred for regular non-emergency visits to the surgery clinic | Male | <0.001 | 0.505 | 0.344 | 0.742 |
Female | <0.001 | 2.344 | 1.543 | 3.560 | |
No preference | <0.001 | ||||
Surgeon preferred for emergency surgical cases | Male | 0.837 | 0.960 | 0.653 | 1.413 |
Female | 0.190 | 0.683 | 0.386 | 1.209 | |
No preference | 0.398 | ||||
Surgeon preferred for “sensitive” surgical cases (genital, obstetric, or sexual problems) | Male | <0.001 | 0.218 | 0.151 | 0.314 |
Female | <0.001 | 7.064 | 5.044 | 9.895 | |
No preference | <0.001 | ||||
Surgeon preferred in the event that you need a minor surgical procedure (such as draining an abscess) | Male | 0.966 | 0.992 | 0.672 | 1.463 |
Female | <0.001 | 2.489 | 1.628 | 3.804 | |
No preference | <0.001 | ||||
Surgeon preferred for major surgery (surgical intervention or laparoscopic surgery) | Male | 0.164 | 1.314 | 0.895 | 1.928 |
Female | 0.572 | 1.165 | 0.685 | 1.982 | |
No preference | 0.379 |
Gender of Participant | Total | p-Value | |||
---|---|---|---|---|---|
Male | Female | ||||
Surgeon preferred for regular non-emergency visits to the surgery clinic | Male |
452 (53.1%) |
181 (14.7%) |
633 (30.4%) | <0.001 |
Female |
75 (8.8%) |
607 (49.2%) |
682 (32.7%) | ||
No preference |
325 (38.1%) |
445 (36.1%) | 770 (36.9%) | ||
Surgeon preferred for emergency surgical cases | Male | 502 (58.9%) | 415 (33.7%) | 917 (44%) | <0.001 |
Female | 40 (4.7%) | 319 (25.9%) | 359 (17.2%) | ||
No preference | 310 (36.4%) | 499 (40.9%) | 809 (38.8%) | ||
Surgeon preferred for “sensitive” surgical cases (genital, obstetric, or sexual problems) | Male | 583 (68.4%) | 104 (8.4%) | 687 (32.9%) | <0.001 |
Female | 95 (11.2%) | 976 (79.2%) | 1071 (51.4%) | ||
No preference | 174 (20.4%) | 153 (12.4%) | 327 (15.7%) | ||
Surgeon preferred in the event that you need a minor surgical procedure (such as draining an abscess) | Male | 399 (46.8%) | 191 (15.5%) | 590 (28.3%) | <0.001 |
Female | 72 (8.5%) | 557 (45.2%) | 629 (30.2%) | ||
No preference | 381 (44.7%) | 485 (39.3%) | 866 (41.5%) | ||
Surgeon preferred for major surgery (surgical intervention or laparoscopic surgery) | Male | 480 (56.3%) | 415 (33.7%) | 895 (42.9%) | <0.001 |
Female | 50 (5.9%) | 340 (27.6%) | 390 (18.7%) | ||
No preference | 322 (37.8%) | 478 (38.8%) | 800 (38.4%) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Hakami, N.A.; Al-Musawa, H.I.; Alharbi, A.I.; Marwahi, N.A.; Almutlaq, A.S.; Alghamdi, R.A.; Alshammari, S.M.; Almalki, A.A.; Mojiri, M.E.; Mahzara, N.K.; et al. Public Preferences for Surgeon Gender in Saudi Arabia: A Cross-Sectional Analysis. Healthcare 2024, 12, 1185. https://doi.org/10.3390/healthcare12121185
Hakami NA, Al-Musawa HI, Alharbi AI, Marwahi NA, Almutlaq AS, Alghamdi RA, Alshammari SM, Almalki AA, Mojiri ME, Mahzara NK, et al. Public Preferences for Surgeon Gender in Saudi Arabia: A Cross-Sectional Analysis. Healthcare. 2024; 12(12):1185. https://doi.org/10.3390/healthcare12121185
Chicago/Turabian StyleHakami, Nasser A., Hafiz I. Al-Musawa, Ali I. Alharbi, Nawaf A. Marwahi, Abdulaziz S. Almutlaq, Rayan A. Alghamdi, Sadeem M. Alshammari, Abdulaziz A. Almalki, Mohammed E. Mojiri, Naif K. Mahzara, and et al. 2024. "Public Preferences for Surgeon Gender in Saudi Arabia: A Cross-Sectional Analysis" Healthcare 12, no. 12: 1185. https://doi.org/10.3390/healthcare12121185
APA StyleHakami, N. A., Al-Musawa, H. I., Alharbi, A. I., Marwahi, N. A., Almutlaq, A. S., Alghamdi, R. A., Alshammari, S. M., Almalki, A. A., Mojiri, M. E., Mahzara, N. K., Hakami, A. A., & Nemri, A. A. (2024). Public Preferences for Surgeon Gender in Saudi Arabia: A Cross-Sectional Analysis. Healthcare, 12(12), 1185. https://doi.org/10.3390/healthcare12121185