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How can women physicians find balance in – and out of – the workplace?

December 14, 2023

Women physicians contend with a variety of challenges in finding work-life balance – gender and maternal discrimination, lack of schedule flexibility that affect caregiving responsibilities, and inequitable pay and time off related to parental leave, are just a few oft-cited examples. Over time, these challenges increase the risk that women physicians will suffer from burnout.

According to new data from the American Medical Association (AMA), a gender gap in physician burnout does exist. More than 13,000 physicians from 30 states responded to the AMA Organizational Biopsy, a benchmarking report that reflects trends in six key performance indicators: job satisfaction, job stress, burnout, intent to leave an organization, feeling valued by an organization, and total hours spent per week on work-related activities. In total, 57% of female respondents reported at least one symptom of burnout, compared to 47% of men respondents. Work overload was the most frequently cited reason for high burnout rates among women physicians. (Berg, 2023)

Many factors contribute to work overload, but electronic health record (EHR) burden has specifically been cited as a culprit of physician burnout, particularly in women. According to a cross-sectional study published in JAMA Netw Open, women spend on average almost an hour more per day than men working in EHRs. Some of this time is spent outside of work, during so-called “pajama time.” (Rotenstein, 2023)

Jill Jin, M.D., explains that physician burnout does not result from a lack of personal resilience. In a recent AMA webinar, “Women Physician Leaders and Balance,” she and other presenters argue that the problem is systemic, and as such, systemic changes are required to reduce burnout and improve wellbeing. But in the meantime, there are things that individuals can do. (AMA, 2023)

Monitor EHR use

Jin and her colleagues stress the importance of identifying and eliminating unnecessary EHR work. She suggests downloading a log of EHR work (or requesting one from your IT department) and analyzing where you’re spending the bulk of your time. For example, you may find that you’re spending an inordinate amount of time traveling between links. By reducing “note bloat,” or the links embedded in visit note documentation templates that automatically pull in data from other parts of the EHR and that often provide little clinical value, you might cut down on reviews, freeing up valuable time.

It's also important to avoid logging into the system when you aren’t scheduled to work. “Advocate for your own work-life integration,” said Jin. “Because at the end of the day, nobody else will.” (AMA, 2023)

Think outside of the box

In their book, The Game Plan: A Woman’s Guide to Becoming a Doctor and Living a Life in Medicine, Drs. Angela Walker, Diane Boykin, Jessica Osborn, Leah Matthews, and Sylvia Morris emphasize the importance of taking inventory of your job satisfaction and not being afraid of seeking out new opportunities.

Morris and Walker were recently interviewed on The Podcast by KevinMD, and during the conversation, Morris described being burnt out in clinical practice and recognizing that she needed to do something else. She has since found a nontraditional, dual career that mixes clinical practice and consulting work and credits that for the harmony she’s found in her life. While the variety is helpful for her, she feels it also benefits her patients. “[W]hen I’m in the room with them now, I’m really honed into what’s important.”

For Walker, she discovered that cutting back on her OB/GYN responsibilities was the wisest choice for herself and her family. “I was overwhelmed. When I got home at night, I was taking it out on my family…and I just realized that I cannot keep up with this pace and do myself and my family service.” Naturally, her decrease in hours led to a corresponding decrease in salary, but she found that it was worth the cut. “My quality of life improved, and what I could give to my family improved,” said Walker. (KevinMD, 2023)

Speak up and seek out mentorship

Jin encourages women physicians to speak up but prepared to offer solutions rather than simply complain. And don’t be surprised if you are shot down the first – and second, and third – time you bring up an idea. “Sometimes the timing makes all the difference. Ask a different person, ask a different way. But always communicate and advocate for what you need,” said Jin. (AMA, 2023)

This is especially important if you are a woman in a leadership role, say Walker and Morris.

Advocate for the women around you to ensure that their needs are being met and seek out opportunities to mentor others – or ask others to mentor you.

Walker credits two female MDs in her residency program for making a difference in her career. “They were living the life of being leaders in medicine, but they were also human and kind and accessible enough to share their experiences as caregivers and mothers and seeing them succeed in both roles was really important to me,” said Walker. (KevinMD, 2023)

Turn to your peers

Angela Chaudhari, MD, underscored the importance of peer support in the AMA webinar. “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.” (AMA, 2023)

Walker, Morris, and their coauthors have leaned on one another for more than 20 years and make a point of traveling together once a year. “It has been so important during our journey to treasure and protect our friendship. We can sometimes lose sight of that in medical school and then residency and practice because we’re so focused on our mission that we leave the most important people by the wayside,” said Walker.

Ultimately, the notion of a superwoman needs to be dismantled. “Give yourself grace, learn from the areas that are no longer serving you and have the courage to make those pivotal changes. The idea that it’s possible to be a superwoman is not good for your wellbeing,” said Walker. “The bottom line is that we can have it all, but maybe just not all at the same time. Realize that sometimes you may be doing your best at work and not necessarily the best at home and vice versa, and that it is okay.” (KevinMD, 2023)

Sources:

(2023, September 28). Women Physician Leaders and Balance. [Webinar]. American Medical Association. https://players.brightcove.net/6265598906001/default_default/index.html?videoId=6338796641112

(2023, November 20). Understanding the lives of women in medicine. [Podcast]. In The Podcast by KevinMD. https://www.kevinmd.com/2023/11/understanding-the-lives-of-women-in-medicine-podcast.html

Berg, S. (2023, September 12). American Medical Association. New data sheds light on the gender gap in physician burnout. https://www.ama-assn.org/practice-management/physician-health/new-data-sheds-light-gender-gap-physician-burnout

Rotenstein LS, Fong AS, Jeffery MM, et al. Gender Differences in Time Spent on Documentation and the Electronic Health Record in a Large Ambulatory Network. JAMA Netw Open. 2022;5(3):e223935. doi:10.1001/jamanetworkopen.2022.3935. https://pubmed.ncbi.nlm.nih.gov/35323954/