Whether they’re physicians or working in other fields, women face a higher risk of occupational burnout than their male colleagues, according to a study published in JAMA Network Open.
The study researchers analyzed data from national surveys of physicians and U.S. workers over 12 years, and found that female physicians had about 33% lower odds of satisfaction with work-life integration compared to their male counterparts. This disparity was greater among physicians than other U.S. workers.
Contributing to these findings, according to the research letter, may be that women in medicine are more likely to face mistreatment and take on a larger burden of home and family responsibilities than men. Patient and staff expectations and professional norms are also different for women physicians, which could lead to occupational burnout.
While women physicians had 33% lower odds of being satisfied with work-life integration than their male physician counterparts, female workers had 16% lower odds of satisfaction with work-life integration than male workers outside medicine.
“Even in nonphysicians, female workers have a harder time with work-life integration. But it's even harder for female physicians,” said Michael Tutty, PhD, a coauthor of the study and the AMA’s group vice president of professional satisfaction and practice sustainability, in an interview.
Investigators of the JAMA Network Open letter analyzed data from multiple national surveys over a 12-year timespan to compare disparities in burnout and satisfaction with work-life integration by sex among physicians and workers in other professions. The analysis included 25,248 physicians and 20,283 U.S. workers who completed surveys in 2011, 2014, 2017, 2020, and 2023.
Doctors overall work longer hours
Among all survey respondents, physicians had 63% higher odds of burnout after adjusting for age, relationship status, hours worked per week and survey year. This isn’t surprising, considering that physicians on average work 10 more hours per week than people in other professions, said Tutty, citing another recent study he conducted with the same group of colleagues.
The extra hours reflect the frequency in which physicians log in to their computers at home to do documentation in the EHR, he said. Coupled with the intensity of the work environment, the complexity of providing high quality patient care, the documentation burden, and regulatory burdens such as dealing with prior authorization, physicians are outpacing other U.S. workers on burnout and lower satisfaction with work-life integration.
Disparities in occupational burnout among physicians were not statistically different than other professions. But even after adjusting for work hours, sex disparity in work-life integration was more prominent among physicians.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine®.
Women doctors take on more admin burdens
Meanwhile, women physicians had 36% lower odds of satisfaction with work-life integration compared to other workers, whereas male physicians had 20% lower odds of satisfaction. Among U.S. workers outside of medicine, women also had higher odds of burnout.
Looking specifically at medicine, women physicians had higher odds of burnout than male physicians at four of the five survey time points. Women physicians also had lower odds of satisfaction with work-life integration compared to male physicians at all five survey time points.
Women physicians are facing higher work burdens on several fronts, said Tutty.
In fact, research has shown that women physicians spend more time with their patients than male doctors. They also spend more time doing documentation. Women physicians are also more likely to experience sexist remarks and suffer harassment by patients.
There's a direct correlation between physician burnout, depersonalization, emotional exhaustion, and the degree of harassment you're receiving from patients, said Tutty.
“In addition, studies also show in general women are still more likely to do more home care and family activities than their male counterparts,” he added.
What health systems can do to support physicians
Higher education is usually associated with lower rates of burnout. But in the case of physicians, higher education has not been a protective factor, noted Tutty. “It goes to show you how unique the profession and the type of work physicians do.”
Health systems can support physicians by getting rid of administrative burdens and providing documentation support to address the nonclinical burdens physicians face. It’s also important that people take vacation time and that they get coverage while they’re away.
If no one is covering for you, it means you’ll still have to log in to the EHR and follow up on patient requests and prescription renewals, which can lead to more burnout, said Tutty.
Gender disparities in burnout and work-life integration satisfaction will likely get worse as more women enter the field of medicine.
“We now have nearly two women in college for every man. In medical school, there are more female medical students than male,” Tutty summarized.
Employers in health care systems should be offering support that women physicians can take advantage of, such as in-house child care, he advised. It’s also critical to establish policies that discourage mistreatment of physicians. Some hospitals, for example, distribute statements to patients, warning of their dismissal if they mistreat staff.
This is about creating a respectful environment and letting patients know that there are consequences for verbally abusing physicians and nurses and other staff, Tutty emphasized.
Partner or spousal support can aid in improving satisfaction with work-life integration. The JAMA Network Open authors suggested that organizationally sponsored couples’ health promotion programs such as couples therapy could assist physicians in their personal relationships.
Here are examples from organizations that are part of the AMA Health System Member Program—which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine—that show commitment to improving the work environment for women physicians.
Baptist Health ensures physicians come back to an empty inbox
- As part of its efforts to reduce the burden on physicians to manage their inboxes while they’re on paid time off, Baptist Health Medical Group has created a pilot program to tackle EHR use on vacation. As part of the program, a team—which consists of a physician, nurse practitioner or nonphysician provider—helps to offload some of the messages received by physicians who are out of the office.
Confluence Health boosts physician leadership, one piece at a time
- Great physician leaders need to be adept on multiple fronts, said Galen Sorom, MD, an internist and physician leader at Confluence Health in Wenatchee, Washington. Some leaders, for example, already are strong on the use of quality metrics. Others excel as communicators while other physician leaders understand their organizations inside and out. To help, Confluence Health takes a multitiered approach to help physician leaders create a thriving team.
Hattiesburg Clinic helps physicians feel supported
- At Hattiesburg Clinic in Mississippi, as part of exploring the link between feeling valued and reducing burnout, leaders are looking for system-wide strategies to show physicians how vital they are to the group’s success. A key part of helping physicians feel supported is allowing them the ability to unwind and unplug with clinical coverage—particularly EHR inbox coverage—while they are out of the office without burdening their colleagues.
HCA Healthcare takes a systemic approach to improving efficiency
- When it comes to physician well-being, leaders at the nation’s largest health system say they’ve learned that efforts need to focus on the larger picture, shifting away from simply supporting individuals and toward changing the organization itself for the better. HCA Healthcare undertakes a systematic approach to finding and then addressing hindrance job demands—the "pebbles in the shoe" that contribute to physician frustration and burnout. Examples of “hindrance” demands might include broken equipment or EHR inefficiencies.
Northwest Permanente works on building relationships
- As a leader, Stella Dantas, MD, ob-gyn at Northwest Permanente, is committed to creating psychological safety. This serves as the foundation on which to build a strong culture. Naturally, establishing psychological safety starts at the top with strong, diverse leadership. To do this, Dr. Dantas suggests that effective leaders often have to be all things to all people. That means it’s a constant balancing act—they need to be driven yet flexible, analytical yet open-minded, tough yet amiable.
Ochsner Health develops leaders with the right training
- Before the pandemic, AMA member Nigel Girgrah, MD, PhD, chief wellness officer at Ochsner Health in New Orleans, and other members of his team learned about a leadership program in North Carolina that led to a rise in engagement scores—a measure of interaction and interest in an organization—from the 50th percentile to the 95th at that health system.
Privia Health helps physicians in private practice reclaim autonomy
- People are driven to choose a career in medicine not only because of their passion for the art and science of healing, but their deep capacity for care. However, the bureaucracy, systematic redundancies and chronic inefficiencies that are commonplace in some practices can interfere with that calling, leading to frustration and burnout, as it did for Nalini Casey, MD, a pediatrician at Privia Health.
Sanford Health empowers doctors to make a change
- At Sanford Health, they take the saying “culture eats strategy for breakfast” seriously. Leaders at the integrated rural health system knew that bringing a strategic plan to life would be an uphill battle if they didn’t invest in a people-focused culture to drive it. That’s why culture comes first at Sanford Health, and helps physicians feel valued.
Sutter Health celebrates successes and offers recognition
- Based on comments about the need to feel valued and for leaders to show more gratitude, Sutter Health shared with leaders its best practices. Those best practices included several ways of celebrating successes and recognizing employees via a smartphone app, handwritten notes, callouts at huddles and meetings, and intown halls.
Washington Permanente Medical Group is incorporating AI to help
- For women physicians within Washington Permanente Medical Group, two of the biggest factors that contributed to burnout were documentation and work outside the office. That is another reason why Mary Pan, MD, is optimistic about incorporating augmented intelligence (AI)—often called artificial intelligence—into the workflow.
Tutty recommended that future studies tackle the “why” behind these sex disparities in burnout and work-life integration, and what the solutions should be.
“That would be an interesting mixed methods study—to ask physicians why we're seeing these differences and what kind of supports they would like to have. And doing more evidence-based research on the types of supports that seem to have a bigger impact on improving work-life integration than those that don’t,” said Tutty.
AMA STEPS Forward® resources offer innovative, physician-developed strategies that allow doctors and their organizations to thrive in the new health care environment. These resources can help you prevent burnout, create an organizational foundation for joy in medicine and improve practice efficiency.
