Gender Differences in Stress and Burnout: Department Survey of Academic Family Physicians
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Abbreviations EHR
Electronic health record
J Gen Intern Med DOI: 10.1007/s11606-020-06287-y © Society of General Internal Medicine 2020
INTRODUCTION
Female physicians consistently report higher rates of burnout and lower satisfaction than male physicians, but the etiology is unclear.1 Studies conflict regarding the overlap between burnout and depression and to what degree work/home conflicts contribute to burnout differences. We sought to explore gender variations in burnout and health in a large academic family medicine department.
METHODS
We conducted three annual department-wide assessments (2017, 2018, 2019) to assess burnout, stress, and satisfaction using anonymous and voluntary Qualtrics surveys distributed via email. The study was deemed exempt by the University of Michigan Institutional Review Board. Surveys included years since residency, gender, selfreported minority status, the Mini-Z burnout scale;2 questions from the Physician Wellness Inventory;3 four questions about work-home balance from the Physician Worklife Survey;4 and single-item measures of mental and physical health (e.g., “In thinking about my health, I would say my health is…very good, good, fair, or poor”). As the 2017 survey showed striking differences by gender, in 2018, we added exploratory questions (5-point Likert scale from agree strongly to disagree strongly) asking, “How much do you think the following factors [9 listed] contribute to more burnout for women, compared to men?” In both 2018 and 2019, we queried the presence of a partner at home, partner work status, and children under 6. Analyses used Stata/IC 13.1 (College Station, TX) and included summary statistics plus bivariate analysis with Prior presentations A poster including some of the results was presented at the American Association of Medical Colleges “Learn, Serve, Lead” annual conference, Nov. 9, 2019. Received March 18, 2020 Accepted October 5, 2020
Fisher’s exact test for cell sizes < 5 and Chi-squared for larger cell sizes.
RESULTS
Of eligible faculty, 77 of 84 (92%) completed the survey in 2017, 91 of 96 (95%) in 2018, and 81 of 105 (77%) in 2019. Variables had up to 9% missing data in 2017, 8% in 2018, and 3% in 2019. In 2019, 51 respondents (64%) identified as women. Women were more likely to have completed residency within 10 years (n = 24 women, 47% versus n = 6 men, 21%; p = 0.019). One-fifth of faculty (n = 16, 20%) identified as an under-represented minority. Women were more likely to report burnout in 2017 (52% women versus 24% men, p = 0.022), 2018 (38% versus 15%, p = 0.043), and 2019 (34% versus 31%, p = 0.787). Female faculty (n = 38, 83%) were more likely than men (n = 9, 38%, p < 0.0005) to have a partner working full-time versus parttime or not at all and to have young children at home (n = 21 women, 41% versus n = 4 men, 14%; p = 0.013). Neither partner work status nor children were associated with burnout. In all years, men were significantly more likely to report “good” or “very good” physical and mental health (Table 1). Women had wors
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