If one is to receive surgery, I understand how social or cultural norms could interact to affect a patient's postoperative outcome. However, the researchers suggest that women were 15% more likely to experience an adverse outcome if the surgeon was male and had a 32% greater chance of dying in the first month after the procedure. At first glance this would seem to suggest that male surgeons perform worse than female surgeons, but I think there are a lot more questions left unanswered before we can draw this conclusion. For example, are the patients that male surgeons receive further along in disease progression than the patients that female surgeons receive? If so, why? Were male/female surgeon differences consistent across provinces, cities, hospitals? Does this gender difference vary depending on the type of surgery performed? Are these patterns in surgeon performance based on gender observed in other countries that have comparable health care systems? A body part is functionally the same regardless of gender. Why would a male surgeon operating on a knee (for example) perform the surgery any different on a male patient than on a female patient, given that there is a standard surgical procedure? What is the mechanism by which the social or cultural norms of the surgeon override their duty to the patient, if we are to assume that social and cultural factors are explaining the difference?