Focus On: Physician Burnout

Focus On: Physician Burnout

Disclosures: Tawfik reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
June 09, 2021
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Survey: Women physicians have harder time achieving work-life integration

Disclosures: Tawfik reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Women physicians “consistently” reported worse work-life integration than men across a range of demographic and professional factors, survey data in JAMA Network Open showed.

More so than the general workforce, health care workers often struggle with balancing work and home responsibilities, or work-life integration (WLI), according to Daniel S. Tawfik, MD, MS, instructor of pediatrics and critical care at Lucille Packard Children’s Hospital in Palo Alto, California, and colleagues.

Mean work-life integration scores among 4,370 physicians: Women, 52 points and men, 57 points
Reference: Tawfik DS, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.11575.

WLI “is strongly associated with burnout, intention to reduce work hours, and intention to leave practice,” they wrote. “Physicians also more commonly report that their careers negatively impact relationships with their children relative to the general working population, an effect most pronounced for women physicians.”

Although previous research has shown that women physicians experience more problems than men with WLI, the researchers noted that “the interaction of gender with other demographic and practice setting characteristics is poorly understood, particularly in association with poor WLI.”

Tawfik and colleagues administered a survey to 4,370 physicians (men, 2,719; white, 3,491; married, 82.4%; mean age, 52.3 years) from October 2017 to March 2018. Nearly half the responses came from internists, psychiatrists, family medicine practitioners, general surgery subspecialists and ED physicians.

Respondents reported the frequency in which they experienced each of the following in the past week: missing a meal; consuming a “poorly balanced meal;” working a shift without a break; getting home late; having trouble sleeping; sleeping fewer than 5 hours in a night; modifying personal/family plans because of work; and feeling bothered by technology. Physicians could answer each question with “rarely or none of the time;” “some or a little of the time;” “occasionally or a moderate amount of time” or “all of the time.” The maximum score was 100 points. The higher a physician’s score, the more likely he or she was achieving successful WLI.

According to the researchers, the mean WLI score was 55, and women’s overall mean WLI score was lower than men’s (52 points vs. 57 points; mean difference –5, P < .001).

In addition, multivariable regression models showed that lower WLI was independently associated with being a woman (linear regression coefficient [LRC] = –6 points; standard error [SE] = 0.7; P < .001); aged 35 to 44 years (LRC = –7 points; SE = 1.4; P < .001); single (LRC = –3 points; SE = 1.1; P = .003); working 50 to 59 hours weekly compared with fewer than 40 hours weekly (LRC = –9 points; SE = 1; P < .001); and working on-call nights (LRC = –1 point for each night; SE = 0.2; P < .001). Lower mean WLI scores were also associated with working in emergency medicine (LRC = –18 points; SE = 1.6; P < .001), urology (LRC = –11 points; SE = 4; P = .009), general surgery (LRC = –4 points; SE = 2; P = .04), anesthesiology (LRC = –4 points; SE = 1.7; P = .03) or family medicine (LRC = –3; SE = 1.4; P = .04).

Also, interaction models showed that a physician’s age, his or her youngest child’s age and hours worked weekly influenced the link between gender and WLI. The largest disparities among women vs. men were identified in physicians aged 45 to 54 years (49 points vs. 57 points), had adult children aged older than 23 years (51 points vs. 60 points) and worked fewer than 40 hours weekly (61 points vs. 70 points).

The findings led the researchers to “suggest several potential mechanisms that organizations may use in an attempt to accelerate change and reduce gender disparities among those who are most affected,” such as ensuring physicians have more control in scheduling patient care hours and improving practice efficiency.

“Any such interventions likely will be most effective if they are designed to also decrease the well-documented gender disparities related to compensation, retention and promotion, as these disparities can encourage women to take on excess work and to perceive their work as less valuable than their male colleagues,” Tawfik and colleagues wrote.

The researchers added that offering “gender-specific mentorship, coaching and networking” as well as “on-site or other readily accessible high-quality backup childcare may also be helpful.