The work lives of women physicians
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OBJECTIVE: To describe gender differences in job satisfaction, work life issues, and burnout of U.S. physicians.
DESIGN/PARTICIPANTS: The Physician Work life Study, a nationally representative random stratified sample of 5,704 physicians in primary and specialty nonsurgical care (N=2,326 respondents; 32% female, adjusted response rate=52%). Survey contained 150 items assessing career satisfaction and multiple aspects of work life.
MEASUREMENTS AND MAIN RESULTS: Odds of being satisfied with facets of work life and odds of reporting burnout were modeled with survey-weighted logistic regression controlling for demographic variables and practice characteristics. Multiple linear regression was performed to model dependent variables of global, career, and specialty satisfaction with independent variables of income, time pressure, and items measuring control over medical and workplace issues. Compared with male physicians, female physicians were more likely to report satisfaction with their specialty and with patient and colleague relationships (P<.05), but less likely to be satisfied with autonomy, relationships with community, pay, and resources (P<.05). Female physicians reported more female patients and more patients with complex psychosocial problems, but the same numbers of complex medical patients, compared with their male colleagues. Time pressure in ambulatory settings was greater for women, who on average reported needing 36% more time than allotted to provide quality care for new patients or consultations, compared with 21% more time needed by men (P<.01). Female physicians reported significantly less work control than male physicians regarding day-to-day aspects of practice including volume of patient load, selecting physicians for referrals, and details of office scheduling (P<.01). When controlling for multiple factors, mean income for women was approximately $22,000 less than that of men. Women had 1.6 times the odds of reporting burnout compared with men (P<.05), with the odds of burnout by women increasing by 12% to 15% for each additional 5 hours worked per week over 40 hours (P<.05). Lack of workplace control predicted burnout in women but not in men. For those women with young children, odds of burnout were 40% less when support of colleagues, spouse, or significant other for balancing work and home issues was present.
CONCLUSIONS: Gender differences exist in both the experience of and satisfaction with medical practice. Addressing these gender differences will optimize the participation of female physicians within the medical workforce.
- Sutherland VJ, Cooper CL. Job stress, satisfaction and mental health among general practitioners before and after introduction of a new contract. BMJ. 1992;304:1545–8.
- Ramirez AJ, Graham J, Michels MA, Cull A, Gregory WM. Mental health of hospital consultants: the effect of stress and satisfaction at work. Lancet. 1996;347:724–8. CrossRef
- Hilzenrath DS. Disability claims rise for doctors. Washington Post. February 16, 1998:A1.
- Grumbach K, Osmond D, Vranizan K, Jaffe D, Bindman AB. Primary care physicians’ experience of financial incentives in managed care systems. N Engl J Med. 1998;339:1516–21. CrossRef
- DiMatteo MR, Sherbourne DC, Hays RD, et al. Physicians’ characteristics influence patients adherence to medical treatment: results of the Medical Outcomes Study. Health Psychol. 1993;12(2):93–102. CrossRef
- Melville A. Job satisfaction in general practice: Implication for prescribing. Soc Sci Med. 1980;14:495–9.
- Linn LS, Brook RH, Clark VA, Davies AR, Fink A, Kosecoff J. Physician and patient satisfaction as factors related to the organization of internal medicine group practices. Med Care. 1985;23(10):1171–8. CrossRef
- Gross DA, Zyzanski SJ, Borawski EA, Cebul RD, Stange KC. Patient satisfaction with time spent with their physician. J Fam Pract. 1998;46:133–7.
- American Medical Association. Women in Medicine in America: In the Mainstream. Chicago, Ill: AMA; 1995.
- Kletke PR, Mader WD, Silberger AB. The growing proportion of female physicians: implications for US physician supply. Am J Public Health. 1990; 80(3):300–4. CrossRef
- Dennis T, Harris I, Detzel R, et al. Influences of mental states and parental status on the preferred choices of physicians about to enter practice. Acad Med. 1990; 65(12):775–7. CrossRef
- Kaplan SH, Greenfield S, Gandek B, Rogers WH, Ware JH. Characteristics of physicians with participatory practice styles. Ann Intern Med. 1996;124:497–504.
- Hall JA, Irish JT, Roter DL, Erhlich CM, Miller LH. Gender in medical encounters: an analysis of physician and patient communication in a primary care setting. Health Psychol. 1994;13:384–92. CrossRef
- Irish JT, Hall JA. Interruptive patterns in medical visits: the effect of role, status and gender. Soc Sci Med. 1995;41:873–81. CrossRef
- Bertakis KD, Helms LJ, Callahan EJ, Azari R, Robbins JA. The influence of gender on physician practice style. Med Care. 1995;33:407–16. CrossRef
- Lurie N, Margolis KL, McGwen DL, Mink PJ, Slater JS. Why do patients of female physicians have higher rates of breast and cervical cancer screening? J Gen Intern Med. 1997;12:34–43. CrossRef
- Delgado A, Lorez-Fernandez JA, Luna JD. Influence of the doctor’s gender in the satisfaction of users. Med Care. 1993;31:795–800.
- Lurie N, Slater J, McGivern P, Eksbury O, Marles K. Preventive care of women: does the sex of the practitioner matter? N Engl J Med. 1993;329:478–82. CrossRef
- Kreuter MW, Streches VJ, Harris R, Robin SC. Are patients of women physicians screened more aggressively? J Gen Intern Med. 1995;10:119–25. CrossRef
- Kaplan SH, Gandek B, Greenfield S, Rogers W, Ware JE. Patient and visit characteristics related to physicians’ participatory decision-making style: results from the Medical Outcomes Study. Med Care. 1995;33(12):1176–87. CrossRef
- Weissman CS, Teitelbaum MA. The work family role system and physician productivity. J Health Soc Behav. 1987;28:247–57. CrossRef
- Taragin JI, Wliczak AP, Harris ME, Trent R, Carson JL. Physician demographics and the risk of medical malpractice. Am J Med. 1992;93:537–42. CrossRef
- Thomas S. Women showing preferences for treatment by female health physicians. CMAJ. 1994;150:1466–7.
- Kerssens JJ, Bensing JM, Andala MG. Patient preferences for the gender of health professionals. Soc Sci Med. 1997;44(10):1531–40. CrossRef
- Linzer M, Spitzer R, Kroenke K, Williams S, Brody D, deGruy F. Gender, quality of life and mental disorders in primary care: results from the PRIME-MD 1000 study. Am J Med. 1996;101:526–33. CrossRef
- Woolhandler S. Managed care and women’s health. J Am Med Womens Assoc. 1997;52:50–1.
- Konrad TR, Williams ES, Linzer M, et al. Measuring physician job satisfaction. Med Care. 1999;37:1174–82. CrossRef
- McMurray JE, Williams E, Schwartz MD, et al. Physician job satisfaction: developing a model using qualitative data. J Gen Intern Med. 1997;12:711–4. CrossRef
- Williams E, Konrad TR, Linzer M, et al. Refining the measurement of physician job satisfaction: results from the Physician Work Life Study. Med Care. 1999;37:1140–54. CrossRef
- CASRO (Committee of American Survey Research Organization). On the Definition of Response Rates: A Special Report from the CASRO Taskforce on Completion Rates. Port Jefferson, NY: CASRO; 1982.
- Lessler JT, Kalsbeek WD. Nonsampling error in surveys. New York, NY: Wiley and Sons; 1992.
- Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96. CrossRef
- Schmoldt RA, Freeborn DK, Klevit HD. Physician burnout: recommendations for HMO managers. HMO Pract. 1994;8:58–63.
- Phelan J. The paradox of the contented female worker: an assessment of alternative explanations. Soc Psychol Q. 1994;57:95–107. CrossRef
- Starfield B, Weiner J, Steinwachs D. Ambulatory care groups: a categorization of diagnoses for research and management. Health Serv Res. 1991;26(1):53–74.
- Linzer M, Gerrity M, McMurray JE, Douglas J, Williams E, Konrad TR, for the SGIM Career Satisfaction Study Group (CSSG). Case mix, time pressure and physician mental health: results from the Physician Work life Study. Presented at the AMA:CMA Conference on Physician Health, Victoria, BC, Canada, May 1998.
- Carr PL, Friedman RH, Moskowitz MA, Kazis LE. Comparing the status of women and men in academic medicine. Ann Intern Med. 1993;119:908–13.
- Baker LC. Differences in earnings between male and female physicians. N Engl J Med. 1996;334:960–4. CrossRef
- Angier N. Among doctors, pay for women still lags. New York Times. January 12, 1999;D7
- Frank E, McMurray JE, Linzer M, Elon L. Career satisfaction of US women physicians: results from the Women Physicians’ Health Study. Arch Intern Med. 1999;159:1417–26. CrossRef
- Hochschild AR. The Second Shift: Working Parents and the Revolution at Home. New York, NY: Metropolitan Books; 1989.
- Ducker, D. Research on women physicians with multiple roles: a feminist perspective. J Am Med Womens Assoc. 1994;49:78–84.
- Asch DA, Jedrziewski MK, Christakis NA. Response rate to mail surveys published in medical journals. J Clin Epidemiol. 1997;50(10):1129–36. CrossRef
- The work lives of women physicians
Journal of General Internal Medicine
Volume 15, Issue 6 , pp 372-380
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- women physicians
- job satisfaction
- case mix
- primary care
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, University of Wisconsin, 2870 University Ave., Suite 106, 53705, Madison, Wis
- 2. The Program on Primary Care and Health Professionals, Cecil Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
- 3. Department of Biostatistics and Epidemiology, University of Wisconsin, Madison, Wis
- 4. Department of Pediatrics, University of Washington, Seattle, Wash
- 5. the Department of Pediatrics, University of Alabama, Birmingham, Ala