Female physicians spend significantly more time on EHRs than male physicians
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Female physicians spent a median of 33.4 additional minutes daily — or more than three additional 40-hour work weeks annually — working on electronic health records than their male counterparts, researchers reported.
The findings conflict with previous study results, which “suggested that female physicians spend less time on paid work than male physicians,” they wrote. “However, these data suggest that measuring time spent on paid work without accounting for time outside of scheduled hours may underestimate female physician work effort.”
Sarah D. Tait, BA, a medical student at Duke University School of Medicine, and colleagues analyzed outpatient EHR use data among 997 physicians — 389 of whom were women — from a single academic medical center. Clinicians with less than 1 month of EHR data or who did not regularly provide outpatient care were not included in the analysis. The researchers also collected patient satisfaction scores from physicians who had 10 or more reviews on file.
Their results, published in JAMA Internal Medicine, indicate female physicians spent more time on EHRs than male physicians across all metrics in the study — including time spent on EHRs each day (median of 102.2 vs. 68.8 minutes; P < .001); outside of 7 a.m. to 7 p.m. (median of 24.4 vs. 15.2 minutes; P < .001); outside of scheduled hours (median of 34.6 vs. 23.8 minutes; P < .001); and during unscheduled days (median of 40.6 vs. 27.2 minutes; P < .001). According to the researchers, these differences remained significant after stratification by surgical or medical specialty. There were also no sex-specific differences in patient satisfaction scores or in measures of efficiency, “including the percentage of orders with team contributions and percentage of health records closed on the day of visit,” the researchers wrote.
“These estimates did not account for time spent on mobile devices or inactive time, thus likely underestimating actual use,” Tait and colleagues wrote. They encouraged future studies to examine links between EHR time investment and quality of care, the effect on physician burnout and causative factors behind sex-based discrepancies in EHR use.
In a related editorial, Jennifer Claytor, MD, MS, and Richard W. Grant, MD, MPH, who both serve on the JAMA Internal Medicine editorial board, called for systematic changes that would teach new clinicians “optimal time management to empower them to balance manifold time constraints with minimal necessary documentation.” They said that these efforts could “reduce sex-based disparities in medicine while also reducing a significant contributor to overall burnout for all physicians.”
References:
Claytor J, Grant RW. JAMA Intern Med. 2020;doi:10.1001/jamainternmed.2020.5008.
Tait S, et al. JAMA Intern Med. 2020;doi:10.1001/jamainternmed.2020.5036.
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