Burnout is often associated with work-related stressors, but those too can vary in their impact on individual physicians, according to a National Academy of Medicine discussion paper. And while many causes affect both men and women, there are factors at play that more prominently affect female burnout in medicine.
Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face. By focusing on factors causing burnout at the system-level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction.
Authors of the discussion paper published on the National Academy of Medicine website, “Gender-Based Differences in Burnout: Issues Faced by Women Physicians,” examined the prevalence of burnout, as well as the contributing factors to burnout that are more predominant among women physicians.
Responsibilities at work and home are directly related. For example, if the experiences at home make it easier to perform at work, then the work-home interaction can be positive. However, if roles conflict, there can be adverse consequences for women physicians. While both men and women report challenges with work-life balance, there are differing definitions.
The authors cited research showing that women who are employed full time spend 8.5 additional hours per week on child care and other domestic activities. Women who are employed and whose partners also work perform an additional two hours of work at home each day. This is three times more than that reported by men whose partners work—their domestic work only increased by about 40 minutes.
Gender bias and discrimination
More than 70% of women physicians have reported some form of gender discrimination, which includes disparaging or disrespectful treatment or comments, lack of career promotion, and disparities in resources, rewards and reimbursement. There is additional discrimination at all levels of their careers for women in racial or ethnic minority groups. This affects their sense of well-being and perception of work stress.
Gender-related bias is also more prevalent among women physicians who are mothers with one-third saying they experienced discrimination related to their role as a mom. And among those who experienced discrimination, almost 90% reported it was related to pregnancy or maternity leave.
Autonomy and workload
Two other significant contributors to female physician burnout are a lack of autonomy and big workloads. In a large survey of primary care physicians, it was revealed that “women are less likely to believe that they have sufficient time to see patients during office visits,” the National Academy of Medicine paper notes. Research also has found that women had less control over their workload and schedules than do their male counterparts.
Institutional pressures to perform administrative tasks and support patients’ emotional needs have also been shown to disproportionately affect women. This might be because “women are more frequently identified culturally as caretakers and nurturers,” which leads to female physicians spending, on average, two minutes more on each patient visit than men, the authors wrote. Gender expectations from patients can also play a role.
Whether a female physician is a victim of, or works in an environment where women have experienced sexual harassment, this all-too-common situation can create a sense of alienation from the workplace. It can also highlight the discrepancies between the values of the women physicians and those doctors or administrators with or for whom they work.
The paper cited research showing that women physicians are much more likely than men physicians to be victims of workplace sexual harassment, ranging from sexist comments to sexual coercion and assault. Workplace sexual harassment and bullying leads to mental health issues and may contribute to the development of burnout among victims of both direct and indirect harassment.