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    Why do women physicians experience burnout more than men?

    Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Rebekah Bernard, MD, a family physician at Gulf Coast Direct Primary Care in Fort Myers, Florida. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

     

    Dr. BernardThe statistics are clear:  Physicians are burned out, miserable and trying to get out of the clinical practice of medicine, and women physicians are leading the pack at twice the level of burnout as their male colleagues.[i]

    Even more frightening, women physicians have high rates of depression and commit suicide at a level 2.4 to 4 times higher than the general population.[ii]

     

    Hot topic: Should medical residents' work hours be increased?

     

    But why are women doctors so burned out?  And more importantly, what can we do to help?

    Here’s what we know about women doctors: First, the good stuff. Women make terrific doctors and may even get better outcomes for their patients, with a recent study making headlines when it showed that patients treated by female doctors had lower mortality and readmission rates compared to their male colleagues in the same hospital.[iii]

    Women doctors spend more time with patients on office visits, emphasizing preventive care, education and counseling, and focusing on the psychosocial aspects of patient care.[iv]  

    However, this difference in communication style creates a cycle in which women physicians tend to attract more female patients, who are more likely to have depression and other psychosocial issues in addition to the usual medical conditions. Additionally, studies show that both male and female patients tend to talk more during office visits and are often more demanding to women doctors than they are to male physicians.[v]

    Here comes the dilemma: While helping patients deal with psychosocial issues is one of the keys to improving many of society’s ills, this type of care requires time and is emotionally draining. Our current healthcare model, based on seven-minute office visits that incentivize procedures and technology, fails to reward physicians for spending the time that patients need. This may explain part of the physician gender pay gap, with female physicians earning about $20,000 less per year than male physicians.[vi]

     

    Further reading: Top 10 challenges facing physicians in 2017

     

    In addition, our current model places additional demands on doctors to become data-entry clerks and electronic health record (EHR) technicians, which is especially troublesome for doctors who are trying to manage patients with psychosocial distress. Back in the days of paper charts, most physicians found it relatively easy to provide eye contact and show empathy while documenting or reviewing the medical record. It’s relatively easy to discretely handwrite notes or flip through a paper chart while still demonstrating to the patient by body language and eye contact that you are listening.   It is completely another matter to try to show empathy to a patient while awkwardly clicking and scrolling through computer screens. 

    Once an electronic health record is introduced into the exam room, documentation during a complex psychosocial visit becomes downright impossible; a physician simply cannot meaningfully engage with a patient in distress while hammering away on a keyboard. 

    Next: Something has to give, but what can be done?

    Rebekah Bernard MD
    Dr Bernard was a National Health Care Scholar and served at a Federally Qualified Health Center in Immokalee, Florida for six years ...

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