Negative Experiences Due to Gender and/or Race: a Component of Burnout in Women Providers Within a Safety-Net Hospital
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J Gen Intern Med DOI: 10.1007/s11606-020-06144-y © Society of General Internal Medicine 2020
INTRODUCTION
The Office of Professional Worklife (OPW) at Hennepin Healthcare System (HHS) has been measuring burnout and overseeing its prevention across approximately 700 providers (doctors and advanced practice providers, including nurse practitioners and physician assistants) for over 5 years. Current attention to disparities and discrimination in medicine motivated OPW to consider negative experiences due to gender and race as potential contributors to burnout.1, 2 The study objective was to use a new survey item to assess frequency of negative experiences and determine associations with burnout, teamwork, and values alignment.
survey via email and 461 (68%) responded. Reminder emails were sent out weekly for three weeks and providers were encouraged to participate by colleagues and department leaders. Participants answered demographic questions, including gender and race, along with the ten Mini-Z questions. Since very few participants identified “other” as their gender versus “man” or “woman,” we only included those identifying as men or women. Survey data was aggregated, stratified by gender, and analyzed to determine the frequency of negative experiences due to gender and/or race. Logistic regression models assessed relationships between negative experiences, kept on a five-point scale, and binary outcomes of burnout, teamwork, and values alignment. Count and percentages of results for select demographic and relevant Mini-Z questions can be seen in Table 1.
RESULTS METHODS
The validated ten-item Mini-Z quantifies satisfaction, burnout, and their workplace contributors including work control, chaotic workplaces, electronic medical record stress, teamwork, and values alignment.3, 4 The new, 5-point Likert scale item requests frequency of negative experiences due to gender and/or race, reading, “How often do you encounter negative experiences at work due to your gender and/or race? (e.g., being denied work opportunities, being isolated or treated as if you were not competent, experiencing repeated, small slights at work, or other forms of discrimination).” It was based on Pew Research’s comprehensive national 2017 STEM Survey on workplace experiences in science, technology, engineering, and math (STEM).5 The item is unable to differentiate between negative experiences due to gender versus race. In October 2018, we surveyed providers who were at or over 0.5FTE and had been working at HHS for 6 months or more. All 679 eligible providers received the
Over one in ten women (13%) reported negative experiences due to gender and/or race “fairly often” or “frequently” (the two highest choices for frequency), compared with 3.2% of men. Only 35% of women reported never encountering negative experiences due to gender nor race, compared with 70% of men (Cochran–Armitage test, p < 0.001) (Fig. 1). In regression analyses adjusted for gender, negative experiences due to gender and/or race were significantly associated with bur
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