Gender bias in TKA: A roundtable discussion Moderated by Laura L. Tosi, MD

Four surgeons discuss unconscious bias—and what can be done about it

Men and women are not always treated equally, especially in the doctor’s office. Although some treatment differences may be appropriate, others may be the result of unrecognized bias. For instance, a man with moderate knee arthritis and a woman with the same degree of disease may not receive a comparable course of treatment, as documented in a recent study appearing in the Canadian Medical Association Journal.

The study, spearheaded by James G. Wright, MD, MPH, of Toronto’s Hospital for Sick Children, found that orthopaedic surgeons are 22 times more likely to recommend total knee arthroplasty (TKA) to a male patient with moderate osteoarthritis (OA) than to a female patient with similar symptoms. Family physicians were found to recommend TKA to males twice as often as they did to females. (If the patient had severe knee OA, however, the recommendation for TKA was the same for both males and females.) A survey of the same physicians prior to the study showed that they were unaware of any gender bias affecting their recommendations for knee replacement.

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