Are women urologists caring for predominantly women patient populations? Exploring the role of patient-physician gender concordance in robotic and laparoscopic urological surgery.

Abstract

Objective: To evaluate gender proportions in women versus men urologists' patient populations as well as within subspecialties to further understand women urologists' practice patterns and workforce impact in the field of Urology.

Methods: This retrospective study analyzed American Board of Urology (ABU) case logs of Robotic and Laparoscopic Surgeries (RLS) from 2012-2022. Cases were grouped by women and men urologists, and further sub-analyzed by physician subspecialty. Comparison of patient gender was performed using Fisher's Exact test and Chi-squared test.

Results: Women urologists performed 7.2% of RLS cases, with the highest proportion of cases by women surgeons in Female Urology (36.9%) and Pediatric Urology (23.8%). Other subspecialties had 5% or less of the cases performed by women. Women urologist's patient population was 54.3% women patients, as compared to 23.5% of that of men providers (p<0.001).

Conclusions: The higher percentage of women in the patient population of women urologists likely has a multifactorial explanation (e.g. patient preference, referral practice patterns, physician preference, gender bias). These practice patterns may limit opportunity for women urologists to exercise the full scope of their surgical training while also limiting the ability of male urologists to provide full-service care to women patients. Further research is needed to explore barriers to entry for women within urologic subspecialties that may affect types of patients seen to ensure equity for women urologists within the field and to optimize patient outcomes.