By Michael Parker, MD
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According to a 2017 Medscape survey on burnout, our specialty fell just behind emergency medicine for the highest rate of burnout. A 2018 study found 50 percent of respondents reported being burned out, depressed or both. In this category, Ob/Gyns rank third, behind Critical Care and Neurology.
The survey highlights what we already know. Excess of bureaucratic tasks, too many hours at work, inadequate compensation, increasing utilization of the electronic health record and lack of control/autonomy are the leading contributors to burnout.
Disparities among male and female physicians
Most concerning about the survey was the disparity between female and male physicians. The 2017 Medscape survey found 61 percent of female Ob/Gyns expressed some symptoms of burnout, compared to 47 percent of male counterparts. This finding was an upward trend from prior years. Female Ob/Gyns also showed lower levels of happiness at work (26 percent for females versus 43 percent for males).
Burnout affects our happiness at work and at home. Less than 50 percent of Ob/Gyns experiencing burnout said they were very or extremely happy outside of work.
The demographics of our specialty are changing. Women make up more than 80 percent of graduating residency classes each year. At Cleveland Clinic, women comprise 37 percent of all staff. The Ob/Gyn & Women’s Health Institute medical staff is 71 percent female. They are also younger than their male counterparts – almost 70 percent are under the age of 50.
Younger age and female gender are consistent risk factors for burnout. Women medical staff lag behind their male counterparts in critical areas of the engagement survey conducted by Press Ganey. Overall scores are lower for engagement, reliability, communication, trust and well-being. Female medical staff felt less satisfied overall. They were more likely to say their level of stress was unreasonable, that the enterprise provided less assistance with job stress/burnout and that there is a lack of support for balancing work and professional life.
How to address burnout?
These statistics highlight the need to address the unique needs of female Ob/Gyns. We must evaluate the differences related to gender-specific work expectations from patients, physician colleagues, administrators or nonphysician co-workers.
Restoring a sense of autonomy and work-life balance are critical components. In another older study, women who described a high degree of work control had 11 times the odds of reporting satisfaction with their job, had more specialty stability and were more likely to say they would once again become a physician, if given the opportunity. Women place more significant value to the importance of items such as “compatible physician colleagues, control of time away from work, recognition that their work is important, good relationships with practice staff, and adequate material resources for practice.”
With the changing demographics of our specialty, we must address these issues to improve engagement, trust and well-being. A discussion on the specific factors leading to lower satisfaction and higher rates of perceived stress should occur and solutions need to be proposed. Opportunities for assistance should be communicated and encouraged.
Addressing the issue: returning joy to patient care
Restoring the balance between work and home is a top priority in our specialty, and at Cleveland Clinic.
In alignment with direction from Cleveland Clinic leadership, the Ob/Gyn & Women’s Health Institute has adopted recognizing burnout and building resiliency as part of its mission. Our goal is to empower physicians to solve problems at the local level and focus on providing quality patient care, building community through empathy that drives action and learning to “think outside the box” for creative clinical enhancements that will return the joy to patient care.
We are developing productivity solutions to promote efficiency and personal fulfillment. We also are encouraging individual caregivers to develop their own program of personal wellness and professional growth.
Dr. Parker, a Regional Staff Ob/Gyn, chairs the Ob/Gyn & Women’s Health Institute’s Physician Engagement Committee.