May 1, 1998 CHAPEL HILL - Women physicians in the United States usually work at least as hard as their male counterparts, but face more on-the-job pressure from patients, according to a new study.
The study, conducted by researchers at the universities of Wisconsin at Madison and North Carolina at Chapel Hill, involved questioning 6,100 doctors in various specialties through focus groups and a national survey.
Both sexes reported feeling strong time pressure, but women doctors said they were allotted about five minutes less per new patient than men doctors reported. Lack of enough time for new patients compromised care somewhat, they felt, and boosted stress.
Female general internists said that 36 percent of their patients had such time-consuming psychosocial problems as depression, anxiety and eating disorders, compared to 27 percent of patients who saw male internists.
"When I worked for a hospital-organized group, I always felt pressured to see more patients in less time," one woman interviewee said. "Many of my fellow female MDs also told me that they felt caught between the expectations of their patients and productivity demands of their parent organization."
"In independent practice now, I feel comfortable with my patient load but concerned that eventually outside pressure will force our clinic to affiliate with a large group, financially support its administration and conform to its productivity guidelines."
Researchers presented findings from the 1997 Physician Worklife Study Saturday (April 25) at the Society of General Internal Medicine's annual meeting in Chicago.
Report authors included Drs. Mark Linzer and Julia McMurray of the UW Medical School and Drs. Thomas R. Konrad and Donald Pathman of UNC-CH's Cecil G. Sheps Center for Health Services Research and School of Medicine.
"Our most important finding is the extent to which not having enough time corresponds with physician frustration in their jobs," Konrad said. "Women physicians especially are under a lot of pressure because they tend to attract patients with more complex psychosocial problems who need a sympathetic ear and also because they often are mothers of young children themselves."
"Increasingly, we are asking physicians to do preventive health care, but these services take time the doctors often don't feel they have."
The study also found:
- Time pressure was the single most important predictor of doctor satisfaction.
- Women reported less control over such workplace issues as office schedules, referring physician contacts and hospitalizing patients.
- Women physicians had 1.5 times the odds of reporting burnout, compared with male physicians.
- Satisfaction with health maintenance organization (HMO) practice was lower overall than with many other practice types.
- Women doctors reported feeling less healthy than their male colleagues.
"This study shows that both men and women physicians have pressures, and all of these pressures are significant, but the pressure on women is just more," Linzer said. "The bottom line is that quality of care may suffer when doctors don't have enough time to treat patients. HMOs or physician practices could use these measures and survey the doctors to see how they're doing. When scores start to drop, it's an indicator that something's wrong with the practice, and it should be investigated."
The Robert Wood Johnson Foundation funded the research to improve patient care. Specific goals were to determine made physicians feel committed and satisfied and how to avoid burnout.
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