100 Best Spine Surgeons in America...What gives?!

This is cross-posted with my other blog.  Cheers!

The internal page for "my" college is boasting the inclusion of one of our faculty members on the recently released list of the "100 Best Spine Surgeons in America" by Becker's Orthopaedic and Spine Review. I was interested in which instiutions hosted the other 99 best spine surgeons, so I checked out the list myself. After getting about halfway down the page, scrolled back up, then began counting to confirm a feared conclusion: of the 100 "best" spine surgeons in this country, just 2 of them are female. I was dumbfounded--particularly as medical school classes are reporting higher and higher numbers of female entrants and applicants. And while I may have subconsciously expected a male-majority on the aforementioned list, the 98% figure was astonishing.

 

It's unclear where such a gender bias originates. I'd be willing to bet that of all the spine specialists in the united states, far more than 2% of them are women--which would rule out a representitive proportionality on the list. The site for the list reports:

"Physicians included in this list have been selected based on surveys, research and nominations. All physicians who are placed on the list undergo a substantial review with other peers and through our own research."

To me, this seems like odd selection criteria for surgeons. I suppose what really must be addressed first is the question: what makes a great spine surgeon? I would imagine it would depend on who you ask. Patients might value bedside manner and intrapersonal interactions. Other physicians and hospital administrators might value a colleague who is easy to work with and yields good patient outcomes, or a surgeon who takes on challenging cases. An insurance company might value surgeons with the most cost-effective outcomes, and those who report minimal "relapses." So the notion of an objective survey truely assessing the BEST spinal surgeons in the country is questionable, at best. Research and nominations also seem to depend on who is doing the nominating. It's also important to realize that the subtitle for Becker's Review is "Business and Legal Issues for Orthopaedic and Spine Practices."

Ultimately, I cannot answer whether the list is biased or not, only raise question with the striking minority of female surgeons.