Last week, while on vacation, my husband and I were swimming in a salt-water inlet when a rainstorm hit. (Actually, I was indulging in my favorite leisure-time pursuit: floating prone, chin resting on my forearm, on a lime green inner tube.)
Fortunately, there was no lightning, though there was a bit of hail. We decided to stick it out. Heck, we were already wet.
As we floated along with the outgoing tide, I noticed that with the downpour, each drop appeared to be popping up from below the surface rather than striking from above. I was amazed by how real the illusion appeared. But being aware of the “science” of rain, I knew the true source of the drop was the sky.
It struck me that a recent body of research also delves into an illusion.
Research has shown that women physicians spend more time in the electronic health record than their male colleagues. Just looking at the surface, you might surmise that the women are less efficient and perhaps in need of additional training or the guidance of a superuser.
But more nuanced research by Dr. Lisa Rotenstein and others reveals that the real cause is more complex. Women receive more inbox messages from patients and from staff. They also respond to messages more quickly. Added to that, as I learned in a conversation with Dr. Rotenstein, patients hold expectations about communication with their female clinicians and will rate them based on these expectations—yet don’t hold the same expectations of male clinicians.
Fascinating—and it leads to a completely different conclusion about the data on EHR use. It’s not that women clinicians are less efficient—it’s that they are doing different work and responding to different patient expectations about communication.
With research like this, we can address the true drivers of the higher burnout rates among women clinicians. What are some potential solutions? Improved team-based care and improved processes for handling patient communication. Adjusting compensation to account for work effort that is not currently captured, such as care coordination. Technology support, such as AI-generated replies for non-clinical messages in the patient portal. Being aware of the real problems we are trying to solve is the first step.
Do these data mesh with your experience as a clinician? Do you notice different patient expectations based on your gender? And how might being aware of these differences help you?
Diane W. Shannon is an internal medicine physician and physician coach and can be reached at her self-titled site, Diane W. Shannon.
