Wednesday, May 12, 2010

Who's the hottest doc?

Thanks to our friend Francesc Calafell, an evolutionary geneticist at the University of Pampeu Fabra in Barcelona for alerting us to the important research reported in the British Medical Journal (here) by some of his countrymen. We are embarrassed not to have noticed this before, as it was published in 2006!

The burning question is whether physicians are shorter and less handsome than surgeons in one chosen study area, a hospital in Barcelona (though, surely generalizable to all of Catalonia and beyond), and if so, why. For the moment, this research was restricted to men around age 50, although the authors intend to expand their study within 10 years, when the number of female surgeons and physicians in the appropriate age range at their hospital is large enough to warrant such a project. At which time of course the burning question will be re-phrased to "who's hotter?"

Even despite this limitation, this study touches on a number of the themes we consistently write about here. When reporting their findings, the authors suggest some correlations, but don't assume they necessarily explain causation -- we applaud this cautiousness. It turns out that not only are surgeons taller (though that finding is confounded by their tendency to wear clog-like shoes that artificially increase their height, an attention to possible confounding variables that we can only heartily support) and handsomer (this may have to do with their habitual wearing of protective masks over their faces, and their spending so much time in oxygen-rich operating rooms), but they are also less frequently bald (which may be due to the head coverings they wear while operating). Note the welcome caution. And, "Male surgeons are taller and better looking than physicians, but whether these differences are genetic or environmental is unclear." There may be a hint of excessive genetic determinism there, but at least they are open to alternate explanations.

Though they are too cautious to say so (again, for which we applaud them), the obvious Darwinian explanation is that the genes 'for' surgery (HeartSurgery1, BrainSurgery 1 and 2, and Appendectomy331) which make them taller so they can wield scalpels (well, originally, it was hunting knives) better. The short physician genes (SPG1, SPG2, and SPG3 so far have been discovered) gave their Galenic and pre-Galenic ancestors an advantage in stooping over delicately to monitor modest female patients' heartbeats with their short, demure, stiff wooden stethoscopes. Or to more deftly reach into their leech box. It will be interesting to see what the results for female MD's show in future, or what they evolved those traits for (let your imagination run wild!).

Another difference between surgeons and physicians commented on but left unexplained in the paper is that "Surgeons are the only doctors who practise what has been called "confidence based medicine," which is based on boldness." Cut first, ask questions later. By contrast, presumably physicians practise "by guess and By Golly!" medicine.*

Francesc brought this paper to our attention, and we know he did so with the appropriate level of disinterested scientific quest for knowledge -- he's not a physician or surgeon, so he has no vested interest in the truth of the HandsomeQuotient therein reported -- handsome as he is!

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*A table listing alternatives to 'evidence-based medicine' (from a BMJ paper, Seven alternatives to evidence-based medicine, David Isaacs and Dominic Fitzgerald, BMJ 1999;319:1618-1618 (18 December )).

10 comments:

Holly Dunsworth said...

Doesn't it take more training, more hoop-jumping, and higher marks/grades, etc to be a surgeon? What I'm saying is -not that I think surgeons need be more intelligent than physicians -but there's a lot of research linking (or attempting to link) health and attractiveness to intelligence (which could be interpreted as performance).

A student pointed this type of work out to me, done by Satoshi Kanazawa from the London School of Economics.

If this correlation does exist then it starts a chicken egg thing: Are healthy looking/attractive people actually more intelligent or are they given more opportunities to cultivate their intelligence?

Ken Weiss said...

Well, Holly, it's surprising to see this comment from you.

Most people--well, most women, at least--argue that the size compromise in men is between their brains and another organ, rather than stature! And most would argue that,, judging the quality of men's behavior, brains are the losers most of the time.

It isn't clear that what amounts to fancy butchery is more challenging than figuring out what's going on inside a person that you can order many expensive tests for.

Although, I guess, the physicians doing the tests don't have to worry that they'll leave any gear inside the patients, the way surgeons do. So maybe it's the worrying that makes the difference.

Anne Buchanan said...

The table at the end of this post is tongue-in-cheek but as usual with wit, there's some truth in it. That is to say, what makes someone a surgeon rather than a GP must be a complex mix of ability, personality and motivation. And luck.

Anne Buchanan said...

And that "luck" could well include the kinds of social expectations you are talking about, Holly.

EllenQ said...

The boldness issue rings true to me. My father used to oversee the psychology rotations for med students at the med school where he worked and on the first day of the course he would administer personality tests (which the students found weird because mostly he would lecture on brain injuries). However, from these tests he could guess the specialization of almost all of the students.

It is an unfair generalization to say that all surgeons are narcissists or that all pediatricians are nurturing earth-mother types, but peoples' personalities certainly influence their career choices. Attractive individuals may have developed more of the confidence (or as Holly pointed out, been given extra opportunities) needed to be a surgeon.

Geoffrey Vasile said...

Sure surgeons maybe more attractive, but what's the cost? Would you rather an attentive physician gently thump and probe your abdomen while askiing you indepth questions about your daily habbits, hobbies, and activities - or some brash gigolo surgeon knock you out, get "all up in you", and then leave before you're even awake?

Holly Dunsworth said...

Hahahaha! This is so great. I need to figure out a way to use this in a class. Here's hoping future students will be as funny/illuminating as you guys.

Anne Buchanan said...

That's a tough call, Geoff....

Ken Weiss said...

Well, Geoff, love 'em and leave 'em would be nothing new for man-kind. But whether surgeons knocking out (or up) or physicians 'thumping' abdomens (was that a euphemism?) is better, who can say?

This day's exchanges show clearly why serious, high-powered science studies such as the one we reviewed today demand our most intense thought--not just laughter.

Francesc said...

I'm blushing...