What is the Geographic Distribution of Women Orthopaedic Surgeons Throughout the United States?

Abstract

Background Orthopaedic surgery has a shortage of women surgeons. An even geographic distribution of women orthopaedic surgeons may provide more uniform care to patients. However, little is known about the geographical distribution of women orthopaedic surgeons. Questions/purposes (1) Is there substantial geographic variation in the distribution of orthopaedic surgeons who are women? (2) How does the geographic distribution of women orthopaedic surgeons compare with that of other physicians? (3) What are the variables associated with increased region-based proportions of orthopaedic surgeons who are women? Methods To obtain a national snapshot of orthopaedic providers, two Medicare databases were used (Medicare Provider Utilization and Payment Data and Medicare’s current and archived Physician Compare Data). These databases were used to identify physicians with self-reported specialties of “Orthopedic Surgeon,” “Hand Surgeon,” or “Sports Medicine” with at least 11 Medicare claims in 1 year for a single procedure type between 2012 and 2014. These databases are the only databases known to specifically report surgeon gender on a national scale and include physician demographics and education. The Dartmouth Atlas’s hospital referral regions and United States Census Bureau divisions were used to group physicians by geographic region. The Gini coefficient, a measure of statistical dispersion, was used to quantify the regional distribution of orthopaedic surgeons. This was compared with the dispersion of non-orthopaedic physicians within the same Medicare databases. Surgeon and regional characteristics were correlated with the proportion of women orthopaedic surgeons in the region. Results There is substantial geographic variation in the distribution of orthopaedic surgeons who are women, ranging from 0% to 15%. There was a greater prevalence of women orthopaedic surgeons in New England (7.3%, 107 of 1469 surgeons) and the Pacific region (6.5%, 208 of 3196 surgeons) than in the South Atlantic (4.5%, 210 of 4618 surgeons) and East South Central regions (3.5%, 50 of 1442 surgeons). This represents a greater level of variation (Gini coefficient = 0.37) compared with other specialties (0.30 and 0.37) and compared with men orthopaedic surgeons (0.16). Variables independently associated with an increased prevalence of women orthopaedic surgeons based on hospital referral region were an increased proportion of currently practicing women physicians who graduated from medical schools in that region (beta = 0.03; p = 0.01), increased proportion of Medicaid-eligible patients (beta = 0.12; p = 0.002), increased proportion of regional population is black (beta = -0.06; p = 0.03), and increased regional supply of women physicians (beta = 0.26; p < 0.0001). Conclusions Despite the recent increase in women orthopaedic surgeons nationally, gains have not been equally distributed throughout the United States. Clinical Relevance In other medical fields, gender diversity has been proven to be beneficial for patients. If this holds true in the field of orthopaedic surgery, we should be mindful of the geographic distribution of women orthopaedic surgeons as the percentage of these surgeons increases.

Gender Representation in Orthopaedic Surgery: A Geospatial Analysis From 2015 to 2022

“…The gender diversity hotspots identified in this study align with the high female surgeon clusters found in a study by Chapman et al [ 18 , 19 ]. When the US was divided into hospital referral regions, this study found that nearly half of all female orthopaedic surgeons practiced within regions that had the highest proportions of female orthopaedic surgeons [ 18 ].…”

“…The gender diversity hotspots identified in this study align with the high female surgeon clusters found in a study by Chapman et al [ 18 , 19 ]. When the US was divided into hospital referral regions, this study found that nearly half of all female orthopaedic surgeons practiced within regions that had the highest proportions of female orthopaedic surgeons [ 18 ]. These high practice regions included New England and the Pacific Coast, with relative deficiencies identified in the South and Upper North Midwest (Michigan, Illinois, Ohio, Wisconsin, and Indiana).…”

“…Additionally, the high number of academic institutions also indicates the presence of numerous large residency programs. Since trainees often establish their practice in the region they received their training, the females who train in these areas may ultimately end up practicing there as well [ 18 , 19 ].…”

Is surgical subspecialization associated with hand grip strength and manual dexterity? A cross-sectional study

“…This study also has some potential limitations. The participants in this study were predominantly male surgeons However this is consistent with studies reporting that females are underrepresented within the surgical specialty [ 21 , 22 ]. HGS and manual dexterity might not be representative of the entire surgical population, as this study was performed within an academical setting.…”

Representation of Women in Academic Orthopaedic Leadership: Where Are We Now?

“…Thirty programs had no women in at least 1 of the 5 years of residency, and eight programs did not have a single trainee who was a woman [3]. A recent study by Chapman et al [9] found the highest prevalence of women in orthopaedic surgery was in New England and Pacific regions, and the lowest was in the South Atlantic and East South Central regions, and overall, they found a greater level of variation than other medical specialties.…”