For women physicians—who often wear many other hats in addition to doctor—finding work-life balance can be difficult. This is because there are many challenges that women in medicine face compared with men. There is gender and maternal discrimination, lack of schedule flexibility that affects child care responsibilities, inequitable pay and time off related to parental leave, and more patient portal messages resulting in more time spent in the EHR.
And with so many challenges, women physicians continue to face an increased risk for burnout. But by aligning their career goals with personal responsibility, women physicians can find balance and improve their well-being.
“Women have increased EHR time both at work and at home. This is the time spent on notes and documentation during the workday as well as outside of work or the so-called ‘pajama time’ compared to men,” Jill Jin, MD, an internist and senior physician adviser for the AMA, said during a webinar. She is also an associate editor for JAMA®.
In fact, “a recent article from JAMA Network Open last year showed that women … spend on average 41 minutes per eight hours of patient scheduled time than men in the EHR. … That’s almost an hour more per day, and that is a problem,” Dr. Jin said. Additionally, “there is less mentorship for women physicians. This results in burnout, reduction in work effort—percent FTE—and exit from practice, all of which disproportionately affect women.”
“The AMA Organizational Biopsy®, which surveys physicians from around the country, in 2022 showed that 57% of female respondents reported at least one symptom of burnout, compared to 47% of men. That is a significant difference,” she said. But physician “burnout is not a problem with personal resilience. Physicians, we know, are more resilient than the average person. In other words, system-level changes are needed to reduce burnout and improve well-being.”
Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.
Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.
While system level change can be a slow process, there are some things individual women physicians can do.
It is so important for women physicians to “speak up. I know this is hard. We, as women physicians, have so much of a sense of learned helplessness that we need to work on fixing,” Dr. Jin said. To overcome this, “build relationships. It’s all about the relationships at the end of the day—with your practice manager, with your medical director, with your site leads, with your wellness committee, with the senior leaders.”
“Building relationships is what creates change,” she said. Additionally, “propose solutions along with problems so you’re not just ranting, but also proposing a solution. If you get a no, ask why, and don’t take any cop out answers.”
“And by that, I mean, ‘That’s the policy.’ Well, show me the policy. Why is that the policy? Who came up with that and when was that made? And why can’t it be changed?” Dr. Jin added. “And if you still get a no, ask again later. Sometimes it’s all just a matter of timing and if someone’s having a good day versus a bad day.”
“This has happened to me on multiple occasions in my own practice. Sometimes if you just ask again in a different way to a different person or at a different time, you can turn that no into a yes,” she said.
“As you consider your professional role, you need to evaluate what you need to do the job and then actually communicate those needs to be successful,” said Angela Chaudhari, MD, an ob-gyn and director of the peer support network at Northwestern University Feinberg School of Medicine in Chicago. “Oftentimes I find as women physicians, we aren’t as good at asking for what we need.”
That is why “it’s so important for women in leadership—whatever that leadership role is—to be advocating for those women around you to get the things that they need,” she said.
Women physicians should also monitor their “own EHR use and note-writing time,” Dr. Jin said. “So, decrease note bloat, stop writing lengthy messages to patients and ask for your own EHR audit log data to review.”
“If you use Epic, it’s called Epic signal data. You can ask your IT person to pull that for you. I did that a few weeks ago, and they gave you this little packet,” she said. “It can be helpful to see how much time you’re spending on various tasks in the EHR as a way to help decrease your total time spent in the EHR.”
Additionally, when it comes to “decreasing your own EHR time … don’t log on during weekends or evenings. And if you’re not working full-time, don’t log in on the days that you’re not supposed to be working,” Dr. Jin suggested. “Advocate for your own work-life integration because at the end of the day, nobody else will.”
“Peer support really encompasses so much of what we do and what we need every day as women physicians,” Dr. Chaudhari said. “And when we think about the colleagues who really help us get through our day, those are the people you need to seek out and find.”
“So often when I see colleagues struggling, it’s because they haven’t found their people—whether it’s at home or at work—who can support them with the everyday stressors of our jobs,” she said. “When we talk about work-life balance, what I really mean is that there are ways for you to set goals, with the help of trusted colleagues around you, to begin to turn your long-term dreams into very achievable everyday goals.”