• Shannon M Ruzycki, Oluwatomilyo Daodu, Selphee Tang, Maede Ejaredar, Kirstie Lithgow, Tyrone G Harrison, and Erin A Brennand.
• Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary AB Canada.
• Ann. Surg. 2024 Jul 24.

ObjectiveThe objective of this work was to estimate the association between surgeon sex with surgical postponements or cancellations.Summary Background DataFemale surgeons receive lower hourly, per patient, and total compensation than their male colleagues. Bias in the decision to postpone or cancel surgical cases may contribute to compensation inequality, since this results in unpaid surgeon time.MethodsThis retrospective cohort study used administrative health data to identify surgeries performed at four hospitals in Calgary, Alberta, Canada that were cancelled or postponed due to surgeon/operating room overbooking or to accommodate an emergency case between April 1, 2015, and March 31, 2020. Surgeries performed in dedicated operating or procedure rooms (e.g., bronchoscopy, cardiac surgery, etc.) were excluded. The exposure of interest was surgeon sex, identified by matching their name to the provincial regulatory body record of self-identified sex, which allowed for selection between female and male only during the time of this study.ResultsThere were 214,832 eligible surgical cases, of which 1,481 and 2,473 were postponed or cancelled due to overbooking and to accommodate an emergency, respectively. After adjusting for surgical specialty, whether the procedure was a day case, and for patient sex, female surgeons were more likely to be cancelled or postponed to accommodate an emergency case compared to male surgeons (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.05-1.38).ConclusionThere may be sex-bias in the decision about which surgical cases to postpone or cancel to accommodate emergency surgeries in our setting. This bias may contribute to compensation inequality in a fee-for-service setting.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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