Citizenship Tasks and Women Physicians: Additional Woman Tax in Academic Medicine?

Abstract

Background: Our aim was to evaluate differences in reported citizenship tasks among women physicians due to personal or demographic factors and time spent performing those tasks for work. Materials and Methods: Attendees of a national women physician's leadership conference (Brave Enough Women Physicians Continuing Medical Education Conference) replied to a survey using Qualtrics ª (2019 Qualtrics, Provo, UT), in September 2019. Data collected included age, race, ethnicity, training level, medical practice, specialty, current annual total compensation, educational debt, and number of children. We asked about employment-related citizenship tasks, including time spent on those activities, and perceived obligation to volunteer for citizenship tasks. Descriptive and impact of demographic factors on those opinions were evaluated using IBM SPSS v26.0. Results: Three hundred eighty-nine women physicians replied. When compared with their younger counterparts, women physicians older than 49 years stated they feel obligated to volunteer for these tasks because of their gender (p = 0.049), and were less likely able to decide which citizenship tasks they were assigned to (p = 0.021). Furthermore, a higher proportion of women of color physicians perceived race as a factor in feeling obligated to volunteer for workrelated citizenship tasks, when compared with White women physicians (p < 0.001). Additionally, nearly 50% of women physicians reported spending more time on citizenship tasks than their male counterparts. Conclusions: Our findings suggest that gender, race, and age may play a role in the decision of women physicians to participate in work-related citizenship tasks. To our knowledge, this is the first study to report on work-related citizenship tasks as described by women physicians. Still, an in-depth assessment on the role citizenship tasks play in the culture of healthcare is warranted.

How Physician Compensation and Education Debt Affects Financial Stress and Burnout: A Survey Study of Women in Physical Medicine and Rehabilitation

“…Furthermore, a novel part of this study was to assess perceptions of work‐related citizenship tasks, and the majority of women physiatrists reported they believe they do more of these duties than their men peers. The issue of citizenship tasks at work has not been well elucidated 25 , but importantly these duties are placed in the context of other research that shows women physicians often spend more time with their patients who in turn are more medically and psychosocially complex and work in environments where sexual or gender‐related harassment is common 9,26 …”

Academic careers and the COVID-19 pandemic: Reversing the tide

“…Somewhat ironically at the expense of their other career goals, URM researchers have experienced an increase in this "tax" in the wake of the killing of George Floyd in May 2020, as many have felt compelled or been asked to take on roles related to helping direct the responses of their institutions to calls for increased diversity, equity, inclusion, and antiracism (25,26). URM women researchers are especially affected by the minority tax, because they experience an even greater obligation to fulfill service roles (27).…”

More than grit: growing and sustaining physician-scientists in obstetrics and gynecology

“…Uncompensated work-related duties that contribute to the organization but are less likely to contribute to career advancement (known as "citizenship tasks" or "invisible work") are shouldered primarily by women in academic medicine, and women of color are more likely to feel obligated to volunteer for such tasks. 50 Underrepresented faculty also carry the burden of extra responsibilities, including mentoring of underrepresented trainees and diversity efforts, which are placed on them because of their racial, ethnic or gender identity. 46 Framing the work as "voluntary" centers the problem on the person doing the work; in reality, many external and internal factors create an environment in which faculty feel they cannot say "no" because of their identity.…”