Women found more likely to burn out from practice stress

Study data reveal that female primary care physicians treat more complex patients.

The practices of female primary care physicians are different from those of their male counterparts, according to data collected by Dr. Horner-Ibler, director of the Center for Population Research at the National Institute of Child Health and Human Development at the National Institutes of Health.

Typically, women doctors find that their patient panels are highly complex and predominantly female -- often because these patients seek out female physicians. Like Dr. Horner-Ibler, physicians may find it difficult to stay on schedule as they deal with these time-intensive patients. They are also twice as likely to report high levels of stress and feeling burned out as their male counterparts.

As women inch closer to being half of the physician work force, their impact on the medical profession will grow. This makes it paramount that women become involved at the highest levels in their organizations to make practicing medicine a better fit for women, say Dr. Horner-Ibler and fellow researchers.

Dr. Horner-Ibler, who is also an assistant professor at the University of Wisconsin Medical School in Madison, presented her most recent research results at an Assn. of American Medical Colleges conference last month. Her work is part of a larger project called "Minimizing Error, Maximizing Outcomes" or MEMO, a three-year study on whether physician satisfaction means higher quality care with fewer errors.

The study surveys 420 primary care physicians in Illinois, New York and Wisconsin and their office administrators as well as 2,500 of their patients. The MEMO study is intended to build on the "Physician Work Life Study" published in the June 2000 Journal of General Internal Medicine.

What this research has found is that female physicians tend to have more Medicare, Medicaid and uninsured patients than male physicians. They wish they had more time per patient and feel more at odds with the values of the organizations in which they work than men.

"As a woman physician, I know I spend much more time with patients than my male colleagues," Dr. Horner-Ibler said. "I spend probably double the amount of time in phone calls to patients that my male colleagues spend in a week. What surprised me [in this research] was the fact that nothing in my experience is unique. Women everywhere in every system are experiencing these stressors. ... The data we have thus far clearly show that the essence of the job is different for women because of how patients sort themselves out."

To deal with this, practices need to devise a compensation plan that reflects the different patient panels women physicians treat, she said.

"Someone has to see these more difficult patients, and who better than women? But practices need to understand that seeing these patients requires more time and energy and that more time needs to be allotted to women physicians [to treat these patients]," Dr. Horner-Ibler said.

In the National Football League, this is called revenue sharing, which allows teams in smaller markets to survive, increasing the appeal of the entire sport.

"Revenue sharing in practices, where men are seeing more patients and women are seeing more difficult patients, should be implemented, so that all physicians and all patients find themselves more satisfied, less stressed and healthier," she said.