Burnout in physician and scientist faculty threatens professional satisfaction, mental health, and work quality while impacting women more than men. Women experience gender mistreatment more often than men, which may impact burnout.
Objective
To determine the differences in burnout, discrimination and harassment by gender, and whether these variables were associated with burnout in physician and scientist faculty.
Methods
An anonymous cross-sectional survey from November 2018 through February 2019 was conducted in physician and scientist faculty at a large urban hospital. Survey instruments included MaslachBurnout Inventory-2, gender-based discrimination and harassment questions, and demographic and professional characteristics.
Results
Of 4156 faculty, 1497 (36%) provided gender identification and were included in analyses. Women experienced burnout at higher rates than men (30.9% vs. 23.3%, p = 0.002). Women also experienced gender discrimination and gender harassment at 11 (25.0% vs 2.3%, p < 0.001) and 5.7 (13.0% vs 2.3%, p < 0.001) times the rate of men, respectively. In a multivariable analysis, gender-based discrimination and harassment was associated with burnout among women (OR 1.65, p = 0.035) and overall (OR 1.65, p = 0.017), but not among men. In men, those aged 40–60 experienced increased burnout compared to those aged >60 (OR 2.67, p = 0.017). For all participants, burnout was associated with depression symptoms, poor work life integration, and lower leadership scores.
Conclusion
Burnout is prevalent in both men and women physicians and scientists, but correlates vary by gender. Findings suggest that interventions to reduce burnout should account for gender differences, target leadership behaviors and address gender bias and mistreatment.
McPeek-HinzEBoazakMSextonJB, et al.Clinician burnout associated with sex, clinician type, work culture, and use of electronic health records. JAMA Netw Open2021; 4: e215686.
2.
PrasadKMcLoughlinCStillmanM, et al.Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. eClinicalMedicine2021; 35. DOI: https://doi.org/10.1016/j.eclinm.2021.100879.
3.
HoffTLeeDR. Burnout and physician gender: what do we know?Med Care2021; 59: 711–720.
McMurrayJELinzerMKonradTR, et al.The work lives of women physicians. J Gen Intern Med2000; 15: 372–380.
6.
RittenbergELiebmanJBRexrodeKM. Primary care physician gender and electronic health record workload. J Gen Intern Med.2022; 37: 3295–3301.
7.
LinzerMHarwoodE. Gendered expectations: do they contribute to high burnout among female physicians?J Gen Intern Med2018; 33: 963–965.
8.
HoffTLeeDR. The gender pay gap in medicine: a systematic review. Health Care Management Review2021; 46: 37.
9.
MeteMDickmanJRoweS, et al.Beyond burnout: understanding the well-being gender gap in general surgery by examining professional fulfillment and control over schedule. Am J Surg2022; 223: 609–614.
10.
TawfikDSShanafeltTDDyrbyeLN, et al.Personal and professional factors associated with work-life integration among US physicians. JAMA Netw Open2021; 4: e2111575.
11.
FlynnBStilesKFritzelA, et al.Survey of workplace perceptions of female anesthesiologists. Anesth Essays Res2020; 14: 177–182.
12.
AhmadSRAhmadTRBalasubramanianV, et al.Are you really the doctor? Physician experiences with gendered microaggressions from patients. J Womens Health (Larchmt)2022; 31: 521–532.
13.
DyrbyeLNWestCPHerrinJ, et al.A longitudinal study exploring learning environment culture and subsequent risk of burnout among resident physicians overall and by gender. Mayo Clinic Proceedings2021; 96: 2168–2183.
14.
DyrbyeLNWestCPSinskyCA, et al.Physicians’ experiences with mistreatment and discrimination by patients, families, and visitors and association with burnout. JAMA Netw Open2022; 5: e2213080.
15.
RichterKPBefortCASimariRD. Women physicians and promotion in academic medicine. N Engl J Med2021; 384: 680–681.
16.
SpataroBMTilstraSARubioDM,et al.The toxicity of self-blame: sex differences in burnout and coping in internal medicine trainees. J Womens Health (Larchmt)2016; 25: 1147–1152.
17.
LinosELasky-FinkJHalleyM, et al.Impact of sexual harassment and social support on burnout in physician mothers. J Womens Health (Larchmt)2022; 31: 932–940.
18.
PeccoraloLAKaplanCAPietrzakRH, et al.The impact of time spent on the electronic health record after work and of clerical work on burnout among clinical faculty. J Am Med Inform Assoc2021; 28: 938–947.
19.
SpitzerRLWilliamsJBKroenkeK, et al.Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA1994; 272: 1749–1756.
20.
KroenkeKSpitzerRLWilliamsJBW. The patient health questionnaire-2: validity of a two-item depression screener. Med Care2003; 41: 1284–1292.
21.
WhooleyMAAvinsALMirandaJ,et al.Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med1997; 12: 439–445.
22.
KuiperHvan LeeuwenCCMStolwijk-SwüsteJM,et al.Measuring resilience with the Connor-Davidson resilience scale (CD-RISC): which version to choose?Spinal Cord2019; 57: 360–366.
DyrbyeLNWestCPRichardsML, et al.A randomized, controlled study of an online intervention to promote job satisfaction and well-being among physicians. Burnout Research2016; 3: 69–75.
25.
DyrbyeLNSateleDShanafeltT. Ability of a 9-item well-being Index to identify distress and stratify quality of life in US workers. Journal of Occupational & Environmental Medicine2016; 58: 810–817.
26.
WestCPDyrbyeLNSloanJA,et al.Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med2009; 24: 1318–1321.
27.
ShanafeltTDWestCPSinskyC, et al.Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2020. Mayo Clin Proc2022; 97: 491–506.
28.
ShanafeltTDWestCPDyrbyeLN, et al.Changes in burnout and satisfaction with work-life integration in physicians during the first 2 years of the COVID-19 pandemic. Mayo Clinic Proceedings2022; 97: 2248–2258.
HarryEMCarlasareLESinskyCA, et al.Childcare stress, burnout, and intent to reduce hours or leave the job during the COVID-19 pandemic among US health care workers. JAMA Network Open2022; 5: e2221776.
31.
MarshallALDyrbyeLNShanafeltTD, et al.Disparities in burnout and satisfaction with work-life integration in U.S. Physicians by gender and practice setting. Acad Med2020; 95: 1435–1443.
32.
RotensteinLHarryEWicknerP, et al.Contributors to gender differences in burnout and professional fulfillment: a survey of physician faculty. Jt Comm J Qual Patient Saf2021; 47: 723–730.
33.
LuDWLallMDMitzmanJ, et al.#Metoo in EM: a multicenter survey of academic emergency medicine faculty on their experiences with gender discrimination and sexual harassment. West J Emerg Med2020; 21: 252–260.
34.
WestCPDyrbyeLNSinskyC, et al.Resilience and burnout among physicians and the general US working population. JAMA Netw Open2020; 3: e209385.
35.
JollySGriffithKADeCastroR, et al.Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers. Annals of Internal Medicine2014; 160: 344–353.
36.
PietrzakRHFeingoldJHFederA, et al.Psychological resilience in frontline health care workers during the acute phase of the COVID-19 pandemic in New York city. J Clin Psychiatry2020; 82: 20l13749.
37.
PeccoraloLAPietrzakRHTongM, et al.A longitudinal cohort study of factors impacting healthcare worker burnout in New York city during the COVID-19 pandemic. Journal of Occupational and Environmental Medicine2023; 65: 362–369.
38.
ShanafeltTDGorringeGMenakerR, et al.Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc2015; 90: 432–440.
39.
StollerJK. Developing physician-leaders: a call to action. J Gen Intern Med2009; 24: 876–878.
40.
ShanafeltTTrockelMRodriguezA,et al.Wellness-centered leadership: equipping health care leaders to cultivate physician well-being and professional fulfillment. Acad Med2021; 96: 641–651.
41.
PeccoraloLTongMKaplanS, et al.Strategies for enriching the resident, fellow, and faculty physician experience: a system-based approach to physician well-being. J Hosp Manag Health Policy2022; 6: 35.
42.
WestCPDyrbyeLNErwinPJ,et al.Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet2016; 388: 2272–2281.
43.
KangCSarkarN. Interventions to reduce electronic health record-related burnout: a systematic review. Applied Clinical Informatics2024; 15: 10–25.
44.
OngNYTeoFJEeJZ, et al.Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis. General Psychiatry2024; 37(3).
45.
DyrbyeLNShanafeltTDGillPR, et al.Effect of a professional coaching intervention on the well-being and distress of physicians: a pilot randomized clinical trial. JAMA internal medicine2019; 179(10): 1406–1414.
46.
SmithSGoldhaberNMaysentK, et al.Impact of a virtual coaching program for women physicians on burnout, fulfillment, and self-valuation. BMC Psychology2024; 12: 31.
47.
CarnesMDevinePGManwellLB, et al.Effect of an intervention to break the gender bias habit for faculty at one institution: a cluster randomized, controlled trial. Acad Med2015; 90: 221–230.
48.
McKinleySKWangLJGartlandRM, et al.‘Yes, I’m the Doctor’: one Department’s approach to assessing and addressing gender-based discrimination in the modern medical training era. Acad Med2019; 94: 1691–1698.
49.
MorganAUChaiyachatiKHWeissmanGE,et al.Eliminating gender-based bias in academic medicine: more than naming the ‘elephant in the room’. Journal of General Internal Medicine2018; 33: 966–968.
