Physicians and nurses walking in the hallway of the hospital
The burnout rate among U.S. physicians is at an all-time high, according to a survey of over 9,000 physicians from almost 30 specialties, recently released by Medscape Psychiatry.
Women physicians are especially likely to report the mix of mental exhaustion and cynicism toward work that combine to create a sense of burnout: 63% of women and 46% of men physicians reported being burnt out in 2022 (compared to 48% of women and 38% of men in 2018). This also mirrors accounts of a widening workforce gender gap in burnout.
This should frighten us all: Patients of burnt-out doctors are more likely to receive a wrong diagnosis, be prescribed a flawed treatment, and experience adverse drug reactions, studies on the topic show.
And doctors suffer, too: Emotional exhaustion is linked to a host of adverse health consequences, like anxiety, depression, and substance abuse, according to a review published by the Annual Review of Organizational Psychology and Organizational Behavior.
Physicians say the top three burnout culprits are too many bureaucratic tasks, lack of respect from coworkers and too many work hours, according to the report.
However, one logical and appealing solution to reduce burnout – providing professionals in high-stress jobs with more support staff – could widen the gender burnout gap even further, if not carefully implemented.
Women Physicians Receive Less Support And More Pushback From Nurses
Women physicians – like other women who make it into male-dominated jobs – have had to overcome a host of obstacles along the way. Now, new research suggests that once they make it into those roles, women physicians may not be able to count on their professional authority to gain cooperation from support staff, making their jobs even harder.
Nurses often push back on women physicians’ requests, questioning their authority and withholding basic assistance, things that men physicians don’t experience. This is according to a study published by researchers at University of Illinois at Urbana-Champaign, Washington University in St Louis, and Stanford University School of Medicine.
First, nurses rarely tolerate from women surgeons the authoritative behaviors that they accept from men (and that critical medical situations often require).
Nurses also show women less deference and respect than they give men, according to the doctors who were interviewed. Even male surgeons noticed that their female colleagues were getting more pushback and eye-rolling from the nurses. Another concern doctors had, according to the study, is that nurses could undermine female surgeons and talk badly about them to patients and other doctors.
The findings emerged from the researchers’ qualitative analyses of interview transcripts. The researchers interviewed 45 surgeons (29 women and 16 men) from various surgical sub-specialties, revealing several consistent themes from their observations of physician-nurse interactions. The hour-long interviews were conducted over the phone over a period of two years, using a common set of questions that the researchers refined over time.
To Gain Support From Their Staff, Women Pay A Tax
Women reported feeling pressure to erase the status difference between them and their staff. So, they helped with nursing tasks, spent extra time making themselves accessible, and put in extra effort to come across as warm and friendly. By leveling the status differences, female surgeons reported success in enlisting cooperation from women at lower levels in the organization, who are crucial to their performance.
But clearly, this status-leveling work feeds burnout: Making overt and demonstrated efforts to appear friendly and secure respect is extra emotional labor. Making oneself more accessible and helping with the support staff’s tasks extends women’s work hours.
The researchers studied doctor-nurse interactions, but they expect similar dynamics between lawyers and paralegals, executives and administrative staff, or between any high-status women who work in men-dominated occupations and rely on the support of staff from women-dominated occupations.
These dynamics are also unique to the interactions between higher-status and lower-status women: Men doctors don’t experience this resistance from women nurses, and neither men nor women doctors get it from male nurses.
Reduce Burnout Gender Gap By Equalizing Support Staff Cooperation
Addressing staff shortages would undoubtedly lessen physician burnout. It could also dramatically reduce burnout among nurses and other health workers who are themselves overworked. And it could produce measurable improvements in patient outcomes.
But if women continue to receive less support from staff – and must put in extra work to benefit from it – the gender burnout gap is here to stay.
Some steps may help put organizations on the path to better equalize the support women receive when they occupy jobs that are traditionally associated with men:
- Assess the support culture of the work unit, by asking how well men and women feel supported by their staff. Health care leaders need to understand the full scope of the work climate for women physicians and account for it in evaluation and rewarding performance, the researchers say.
- Evaluate whether a different culture altogether - one where workers of all statuses can effectively work together - benefits the organization and its stakeholders. Different organizations have different cultures. Surveys can provide a benchmark against which work units can be compared, progress can be measured.
- Reward units and their administrators for closing the gender gap in the extent and quality of support women and men receive from support staff. Linking rewards with diversity goals is one of the more effective ways of making progress on inclusion.
- Advocate for a more equitable representation in elite jobs: Staff seem to push back less against women and provide them with more equal support in organizations with more women in high status jobs.
Physicians – all healthcare workers, really - could use a lot more support and care, especially given the sacrifices they made to keep us safe during the pandemic.
More broadly, giving women and men an equal share of support could help narrow the burnout gender gap in all of our workplaces and make our organizations more effective.
