Collateral Damage: How COVID-19 Is Adversely Impacting Women Physicians

Jones, Yemisi; Durand, Vanessa N.; Morton, Kayce; Ottolini, Mary; Shaughnessy, Erin E.; Spector, Nancy D.; O’Toole, Jennifer K.

doi:10.12788/jhm.3470

Cited by 49 publications

(70 citation statements)

References 14 publications

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“…It is unclear why female clinicians were less likely to conduct video visits despite similar clinical and teaching workloads; however, given female clinicians were younger and thus more junior, they may have opted for fewer video and more telephone sessions. Further, prior to COVID-19, female physicians spent significantly more time on household activities and childcare than their male counterparts, which was likely exacerbated by the closing of schools, day cares, etc during the pandemic [ 26 - 28 ]. There is also evidence that female physicians are more likely to be in frontline clinical positions, less represented in high-level decision making roles [ 26 ] and that, overall, female physicians suffered from reduced publishing productivity during COVID-19 compared to male physicians [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Further, prior to COVID-19, female physicians spent significantly more time on household activities and childcare than their male counterparts, which was likely exacerbated by the closing of schools, day cares, etc during the pandemic [ 26 - 28 ]. There is also evidence that female physicians are more likely to be in frontline clinical positions, less represented in high-level decision making roles [ 26 ] and that, overall, female physicians suffered from reduced publishing productivity during COVID-19 compared to male physicians [ 29 ]. The cognitive load of new virtual workflows along with these other pandemic-related stressors [ 30 ] may provide an explanation for the differences we found in our study between males and females.…”

Section: Discussionmentioning

confidence: 99%

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Clinician Perspectives on Telemedicine: Observational Cross-sectional Study

Alkureishi¹,

Choo²,

Lenti³

et al. 2021

JMIR Hum Factors

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Background Since the COVID-19 pandemic onset, telemedicine has increased exponentially across numerous outpatient departments and specialties. Qualitative studies examining clinician telemedicine perspectives during the pandemic identified challenges with physical examination, workflow concerns, burnout, and reduced personal connection with patients. However, these studies only included a relatively small number of physicians or were limited to a single specialty, and few assessed perspectives on integrating trainees into workflows, an important area to address to support the clinical learning environment. As telemedicine use continues, it is necessary to understand a range of clinician perspectives. Objective This study aims to survey pediatric and adult medicine clinicians at the University of Chicago Medical Center to understand their telemedicine benefits and barriers, workflow impacts, and training and support needs. Methods In July 2020, we conducted an observational cross-sectional study of University of Chicago Medical Center faculty and advanced practice providers in the Department of Medicine (DOM) and Department of Pediatrics (DOP). Results The overall response rate was 39% (200/517; DOM: 135/325, 42%; DOP: 65/192, 34%); most respondents were physicians (DOM: 100/135, 74%; DOP: 51/65, 79%). One-third took longer to prepare for (65/200, 33%) and conduct (62/200, 32%) video visits compared to in-person visits. Male clinicians reported conducting a higher percentage of telemedicine visits by video than their female counterparts (P=.02), with no differences in the number of half-days per week providing direct outpatient care or supervising trainees. Further, clinicians who conducted a higher percentage of their telemedicine by video were less likely to feel overwhelmed (P=.02), with no difference in reported burnout. Female clinicians were “more overwhelmed” with video visits compared to males (41/130, 32% vs 12/64, 19%; P=.05). Clinicians 50 years or older were “less overwhelmed” than those younger than 50 years (30/85, 35% vs 23/113, 20%; P=.02). Those who received more video visit training modalities (eg, a document and webinar on technical issues) were less likely to feel overwhelmed by the conversion to video visits (P=.007) or burnt out (P=.009). In addition, those reporting a higher ability to technically navigate a video visit were also less likely to feel overwhelmed by video visits (P=.02) or burnt out (P=.001). The top telemedicine barriers were patient-related: lack of technology access, lack of skill, and reluctance. Training needs to be focused on integrating learners into workflows. Open-ended responses highlighted a need for increased support staff. Overall, more than half “enjoyed conducting video visits” (119/200, 60%) and wanted to continue using video visits in the future (150/200, 75%). Conclusions Despite positive telemedicine experiences, more support to facilitate video visits for patients and clinicians is needed. Further, clinicians need additional training on trainee education and integration into workflows. Further work is needed to better understand why gender and age differences exist. In conclusion, interventions to address clinician and patient barriers, and enhance clinician training are needed to support telemedicine’s durability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinician Perspectives on Telemedicine: Observational Cross-sectional Study

Alkureishi¹,

Choo²,

Lenti³

et al. 2021

JMIR Hum Factors

View full text Add to dashboard Cite

show abstract

“…Early reports from the summer of 2020 illustrated the magnified effect that the pandemic has had on mothers compared with fathers in dual-income households. 33 When the workplace rewards those who do not have familial responsibilities and society places domestic responsibilities more heavily on women, it is not surprising that many heteronormative couples have decided to sacrifice the woman partner's career in the face of an economic downturn and the challenges of a global pandemic. Women physicians are particularly vulnerable to the barriers magnified by these gender roles because they face structural gender discrimination while carrying high medical school debt and feeling accountable for the same work expectations as men.…”

Section: The Coronavirus Disease 2019 Variablementioning

confidence: 99%

Innovative Wellness Models to Support Advancement and Retention Among Women Physicians

et al. 2021

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Despite improvements in representation of women in academic medicine, the rate of promotion and career advancement remains unequal. Compared with their male colleagues, women report lower rates of personal-organizational value alignment and higher rates of burnout. Particular challenges further exist for Black women, Indigenous women, women of color, and third gender or gender nonbinary faculty. Promoting the well-being of women physicians requires innovative approaches beyond the traditional scope of physician well-being efforts and careful attention to the unique barriers women face. Three wellness-oriented models are presented to promote the professional fulfillment and well-being of women physicians: (1) redefine productivity and create innovative work models, (2) promote equity through workplace redesign and burnout reduction, and (3) promote, measure, and improve diversity, equity, and inclusion. By engaging in innovative models for equitable advancement and retention, it is anticipated that diverse groups of women faculty will be better represented at higher levels of leadership and thus contribute to the creation of more equitable work climates, fostering well-being for women physicians.

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“…17 It is no secret that medicine, like other professions, is riddled with inequities and bias based on factors such as race, gender, and socioeconomic status. [21][22][23] The COVID-19 pandemic is likely exacerbating these inequities, such as the adverse impacts that are specifically affecting women physicians, who take on a disproportionate share of the child care at home. 23 These biases impact not only the members of our professional community but also our patients, contributing to disparities in care and outcomes.…”

Section: Creating and Maintaining A Welcoming Community: An Opportunitymentioning

confidence: 99%