{
  "abstract": "Introduction Over the past two decades, the proportion of women in medicine has markedly increased, yet gender disparities persist in leadership, compensation, and academic advancement. While structural inequality is well-documented, less attention has been paid to how gender correlates with differences in clinical performance, communication styles, stress response, and team leadership—factors that are particularly relevant in high-acuity settings such as anesthesiology and perioperative care. Key findings related to gender and performance in medicine, with implications for the field of regional anesthesia and pain medicine are presented.Quality of Care and Guideline Adherence Several large-scale observational studies have demonstrated that female physicians are more likely to deliver guideline-concordant care. In a registry study of over 51,000 patients with type 2 diabetes, patients treated by female physicians achieved better control of their diabetes and prevention of complications. 1 A similar trend was observed in patients with chronic heart failure, where those under the care of female physicians were more likely to receive recommended pharmacotherapy at guideline-based dosages.2 Notably, male physicians were less likely to prescribe optimal treatments to female patients, suggesting a potential interaction between physician and patient gender.Physician-Patient Communication Meta-analytic evidence indicates that female physicians engage in longer consultations and exhibit more patient-centered communication behaviors. 3 These include increased use of empathy, psychosocial discussion, and participatory decision-making. In specialties where communication is a cornerstone of patient safety—such as preoperative assessment or acute pain management—these traits may enhance patient understanding, trust, and satisfaction. Although such communication requires more time and emotional labor, it may contribute to improved perioperative outcomes.Gender and Leadership in Medicine Despite growing representation in the clinical workforce, women remain markedly underrepresented in leadership. In emergency medicine, fewer than 12% of department chairs are women, a figure stagnant for two decades. 4 Qualitative analyses show that male chairs often describe leadership as a natural progression, supported by mentorship. Female leaders, by contrast, report heightened risk aversion, internalized scrutiny, and reliance on self-advancement.4 The result is a persistent gender gap in access to institutional power, particularly in surgical and anesthesiology departments.Burnout and Workload Disparities Physician burnout is a well-recognized phenomenon, but data consistently show that female physicians experience higher rates and more severe manifestations. In 2021, 56% of U.S. women physicians reported burnout symptoms compared to 41% of men. 5 Contributing factors include; more time per patient and greater use of electronic health records, increased patient messaging and administrative burden, less autonomy and schedule flexibility, fewer leadership roles and less recognition, greater responsibilities at home (e.g., childcare, eldercare) Women also experience higher emotional exhaustion, while men more frequently report depersonalization.6 In anesthesiology, where unpredictable hours and clinical acuity are common, these gendered stressors may be amplified.Personality Traits and Narcissism Personality may influence both individual performance and team functioning. A recent large-scale study using the Narcissistic Admiration and Rivalry Questionnaire (NARQ) found that male surgeons score significantly higher on narcissistic rivalry—a construct associated with competitiveness, devaluation of others, and dominance. 7 Female surgeons, by contrast, displayed lower narcissism levels and higher interpersonal sensitivity. In team-dependent specialties like anesthesiology, such traits may influence collaboration, communication, and conflict resolution.Discussion This review highlights that gender is not a neutral factor in medical performance. Female physicians, despite facing systemic barriers, often exhibit behaviors aligned with safer, more collaborative, and patient-centered care models. However, these strengths are counterbalanced by increased burnout and underrepresentation in leadership. In anesthesiology, where both cognitive and interpersonal performance are critical, ignoring gender dynamics risks undermining workforce well-being and patient safety.Conclusions Gender differences in medicine extend beyond representation. Female physicians tend to provide more guideline-based care, engage more deeply with patients, and foster collaborative environments—skills especially valuable in anesthesiology. Addressing the structural and cultural barriers that undermine these contributions is essential for both professional equity and optimal care delivery.References Berthold HK, Gouni-Berthold I, Bestehorn KP, et al. Physician gender is associated with the quality of type 2 diabetes care. J Intern Med. 2008;264(4):340–350.Baumhäkel M, Müller U, Böhm M. Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure. Eur J Heart Fail. 2009;11(3):299–303.Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. JAMA. 2002;288(6):756–764.Hobgood C, Draucker C. Gender differences in experiences of leadership emergence among emergency medicine department chairs. JAMA Netw Open. 2022;5(3):e221860.Lyubarova R, Salman L, Rittenberg E. Gender differences in physician burnout: driving factors and potential solutions. Permanente J. 2023;27:23.023.Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population. Mayo Clin Proc. 2015;90(12):1600–1613.Moellmann HL, Rana M, Daseking M, et al. Exploring grandiose narcissism among surgeons: a comparative analysis. Sci Rep. 2024;14:11665.",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology, Radbouduniversity Medical Centre, Nijmegen, The Netherlands"
      ],
      "name": "Geert-Jan Van Geffen"
    }
  ],
  "title": "FT47 Gender differences in work performance in medicine and anesthesia",
  "uid": "2c7c4354-5d52-5986-88d6-fe2007019a6a"
}