So in the midst of the sleep-related comments (will report back on that in a few days), a kind reader forwarded me this blog post, which references this article. It ended up in the comments, but I wanted to bring it front and center because I think it’s interesting, important, tricky, and (to some extent) depressing.
The key finding:
Female PCPs receive 24% more staff messages (9.6 messages/month), and 26% more patient messages (51.5 messages/month) (p values 0.03 and 0.004, respectively). The differences in EHR time are not explained by the percentage of female patients in a PCP’s panel.Rittenberg, E., Liebman, J.B. & Rexrode, K.M. Primary Care Physician Gender and Electronic Health Record Workload. J GEN INTERN MED (2022).
One might argue this is a good thing — patients feel comfortable asking their female doctors questions!
And to some extent, it might be, for patient care (in fact – this is something the literature suggests, as referenced in this article).
But dear god, it is not easy from the perspective of the manager of one of these inboxes. And when you add this burden of work (because that’s what it is, work!) to other challenges like:
- having to be on the defensive at meetings because you are much more likely to be questioned, argued with or interrupted
- getting paid less overall
- being less likely to be offered directorships or paid for extra committee work (okay, I don’t have a study to support this, but it has been my personal observation)
- being far more likely to be doing the bulk of the home management work (ditto)
Well, you can see where I’m going with this.
I felt validated by the article. But also mad. Because I don’t see a good way out. I don’t WANT patients to be afraid to contact me, and I also don’t think it’s easy to just deflect questions because – as a female – I am so much more likely to be seen as standoffish or rude. I did recently have someone ask me for a ‘pre appointment phone conference’ (which likely would have been fairly long, and entirely for free) and told them very politely that I’d prefer to have our conversation at the (soon) upcoming appointment.
And I felt a lot of anxiety about that.
I am sure this translates quite easily to other fields. But unlike an attorney, inbox minutes are not billable minutes. AND, as it goes with email, I find that more messages lead to more messages. And more time. And more work.
Finally, this is a quantitative study. I also wonder if the tone patients feel comfortable using and the types of things they feel comfortable asking for are different. I bet male physician are less likely to receive messages that are purely administrative, for a number of reasons.
Anyway. I still like my job. And these complaints are not in any way specific to my institution. But damn, there’s a lot here to think about.
BACK TO SCHOOL
On an entirely unrelated note, back to school went well!