Subpecialty, not MD gender, influences hysterectomy procedure

Physician gender is not linked to hysterectomy rates, but subspecialty physicians employ laparoscopic hysterectomies more frequently than general obstetricians and gynecologists, according to a report in the October issue of the American Journal of Obstetrics & Gynecology.

Herbert Gretz, MD, of Mount Sinai Medical Center in New York City, and colleagues examined the Empire Blue Cross/Blue Shield claims database from 2001-2005 to determine the relationship of physician gender and specialty on utilization of hysterectomy and alternatives to hysterectomy.

Overall, 1,972 hysterectomies and 5,077 hysterectomy alternatives were performed representing 2.4% of all coded physician encounters, the researchers report. No gender differences in the utilization of hysterectomy and hysterectomy alternatives were noted. Physicians practicing gynecology-only or gynecologic oncology utilize laparoscopically assisted vaginal hysterectomy more commonly than physicians practicing obstetrics and gynecology.

“Patient choices and physician recommendations of surgical and non-surgical management of hysterectomy-associated diagnoses may be more influenced by physician training and local norms,” the authors comment. “It does not appear from these results that the changing demographics of gynecologists in the coming years will influence the utilization of hysterectomy and hysterectomy alternatives.”Gretz H, Bradley WH, Zakashansky K, et al. Effect of physician gender and specialty on utilization of hysterectomy in New York, 2001–2005. Am J Obstet Gynecol. 2008;199:347.e1-347.e6.