Relative Importance of Race, Sex, and Non-demographic Characteristics in Orthopaedic Surgeon Selection: A Survey of U.S. Adults

TL;DR

This study explores how U.S. adults choose orthopaedic surgeons, finding that factors like experience and referrals are more important than surgeon demographics.

Contribution

The study provides new insights into patient preferences for surgeon selection, emphasizing non-demographic factors over race or sex.

Findings

Most respondents had no preference for surgeon sex or race.

Technical skills and years of experience were rated as the most important factors.

Referrals from doctors and internet research were highly valued in surgeon selection.

Abstract

Introduction: Orthopaedic surgery remains among the least diverse specialties in the United States (U.S.), and our understanding of how patients weigh surgeon demographics relative to other important selection factors remains unclear. This study sought to characterize public attitudes regarding various demographic and non-demographic attributes of orthopaedic surgeons.

Methods: A prospective, cross-sectional survey was administered to U.S. adults recruited via Amazon Mechanical Turk (age ≥18 years; Human Intelligence Task (HIT) rating >95%) and delivered through Qualtrics. Respondents rated surgeon attributes and referral sources using Likert scales. Analyses used t-tests and χ² tests (p < 0.05).

Results: A total of 510 responses were included for analysis. Support for initiatives to increase diversity was 80.8%. Respondents preferred surgeons with at least 11.2 ± 6.1 years of experience, and willingness to travel was 94.2 ± 247.0 minutes. Most respondents reported no preference for the sex (320, 62.7%) or race (352, 69.0%) of their surgeon. Among respondents who preferred a specific sex of their surgeon, men preferred male surgeons (102, 94.4%), whereas women preferred female surgeons (59, 72.0%) (p < 0.001). Regarding importance, technical competencies dominated: surgical skills were rated “most important” by 82.0% (418), and years in practice by 50.4% (257). Surgeon gender and race/ethnicity were reported as “does not matter” by 60.2% (307) and 65.1% (332), respectively. Referral from a doctor or physical therapist was rated “most important” by 72.2% (368) of respondents. Additionally, 74.3% (379) reported using the internet to find surgeons, and 78.6% (401) reported using it to research credentials.

Conclusion: Demographic concordance mattered only to a minority of respondents. Perceived factors of competence, years of experience, and trusted referral pathways outweighed surgeon sex or race in orthopaedic surgeon selection in this sample of U.S. adults.