The Work Lives of Women Physicians: Results from the Physician Work Life Study

Vast changes in the health care system have dramatically affected the day-to-day work lives of most physicians. These changes are significant for their effects not only on individual physicians, but also on the organizations and patients whom they serve. Claims of stress and burnout are well documented,1,2 as are outcomes such as physician dissatisfaction and its relation to patient disenrollment,3,4 satisfaction, compliance, and health outcomes.5–8. Women in the workforce have been understudied in general and in medicine, specifically. Their numbers continue to increase, however, in both medical training and practice,9 and their effect on the profession is likely to be felt as the older cohort of largely male physicians reaches retirement in the next decade.10 Professional socialization, a long and intensive process of learning how to become a physician by instilling knowledge, values, and a set of occupational norms, has been thought likely to lead to a convergence of values and practice styles of physicians. However, newer research suggests that differences of practice styles persist between male and female physicians.11–15 Women are more likely to practice in primary care fields and to pay more attention to preventive services, health education counseling, and the psychosocial needs of their patients.16–19 Communication styles of female physicians have been shown to improve health outcomes,13,20 lessen disenrollment in managed care plans,21 and decrease chances of malpractice litigation.22 Female patients are more likely to seek out female physicians for care23,24 and more likely than male patients to have depression and complicated psychosocial issues to be managed in addition to their medical needs.25 The effect of this patient mix on physician satisfaction has not been well studied. In addition, recent research suggests that given the phenomenon now occurring in for-profit managed care whereby physicians are assessed as to their economic profitability to plans, female physicians may fare poorly in a system in which, “it doesn't count unless you can count it.”26 Because they spend more time with patients, participate in more collaborative decision making, and pay more attention to preventive practices, female physicians may be less productive if measured by simple measurements of numbers of patients seen or resources utilized. The Physician Work life Study (PWS) collected data from a large representative national sample of practicing female and male physicians in both primary care and subspecialty fields. In this article we analyze gender differences in personal and professional characteristics, indices of psychological well-being, work and time pressures, as well as intermediate outcome measures regarding professional satisfaction and burnout.