Surgeons\u2019 skills may improve with age, and male and female surgeons perform equally well, a recent U.S. study finds.\r\nMedicare patients\u2019 risk of dying in the month after an operation steadily fell as their surgeon\u2019s age increased, Dr. Yusuke Tsugawa of the David Geffen School of Medicine at UCLA in Los Angeles and colleagues report in The BMJ.\r\nThere was little difference between mortality among patients of male or female doctors, with one exception. \u201cPatients treated by female surgeons in their 50s had the lowest mortality across all groups,\u201d Tsugawa told Reuters Health in a telephone interview.\r\nLittle is known about how age and gender influence the quality of a surgeon\u2019s work, Tsugawa and his colleagues write. Skills could improve over time through experience, or the surgeon could lose dexterity with aging or have a hard time keeping up with changing technology.\r\nTo investigate, the researchers looked at mortality 30 days after surgery for Medicare beneficiaries who had one of 20 major operations in 2011-2014. The operations were all emergencies.\r\n\u00a0\r\nAmong the roughly 892,200 patients treated by nearly 46,000 surgeons, the overall risk of dying within 30 days of a surgery was 6.4 percent. After adjusting for other factors, mortality rates were 6.6 percent with surgeons under age 40; 6.5 percent with surgeons in their 40s; 6.4 percent with surgeons in their 50s and 6.3 percent for those 60 and older.\r\nMortality risk was 6.3 percent overall with female surgeons versus 6.5 percent with male surgeons, which was not a statistically meaningful difference.\r\nThis doesn\u2019t mean people should seek out older surgeons, or female surgeons in their 50s, Tsugawa said. \u201cIn the real world,\u201d he noted, people choose a surgeon based on advice from physicians or family members, reputation and the surgeon\u2019s communication skills.\r\n\u00a0\r\nStudying the quality of care that physicians provide is extremely complex, the researcher added. \u201cWe think there are huge variations in terms of their quality and the cost of care they provide. At the end of the day what matters is whether there is an intervention that . . . can improve the quality of care.\u201d\r\nFor example, Tsugawa said, the current study suggests that increasing training, education and supervision of young surgeons could be one approach to reducing operative mortality in this group.\r\nMany factors could explain age-related differences in operative mortality, said Dr. Natalie Coburn of Sunnybrook Health Sciences Center in Toronto, who co-authored an editorial on the study. \u201cThere does tend to be a trend for better results for patients who are operated on by an older surgeon,\u201d she said in a telephone interview. \u201cThis is probably a result of experience and judgment and who they would (operate on versus)who they would select for conservative management.\u201d\r\nPinning down the quality of care a surgeon provides is \u201cincredibly difficult,\u201d Coburn noted. \u201cIt\u2019s very difficult to estimate how well you are doing if you only have a handful of different types of cases. If you only do hip replacements, for example, it\u2019s easier to benchmark yourself than if you\u2019re a general surgeon or a plastic surgeon and you do 30 different procedures throughout the year.\u201d\r\n\u201cIt is also fraught with difficulty because of the inability to fully know how complex the patient was, and sometimes (the) surgeons who appear to have the worst outcomes are actually the best surgeons, they\u2019re just taking on the hardest cases,\u201d she added.