Working conditions for female family physicians leave ‘room for improvement’
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A recent survey revealed that women who practice family medicine generally felt “satisfied with their careers,” researchers wrote.
However, the researchers also reported that variation in working conditions “leaves room for improvement” in the field of family medicine.
There may be a deficit of up to 139,000 family physicians in the United States by 2033, making "their recruitment and retention a key planning issue in medicine,” Jinan Usta, an associate professor of family medicine at the American University in Beirut, and colleagues wrote in Family Practice.
Female family medicine physicians frequently earn less money, experience more obstacles to career advancement and report more gender-based harassment than their male counterparts, the researchers continued. They added that addressing these issues may increase the number of female family physicians.
Cross-country studies evaluating job satisfaction among family physicians could help identify successful strategies, Usta and colleagues noted.
“At present, an international comparison of women family physicians’ career satisfaction is missing from the global family medicine literature,” they wrote.
Usta and colleagues administered a cross-sectional survey in 2019 to 315 female family medicine physicians from 49 countries. Most of the responses were from the United States and Ecuador. The mean age of all respondents was 45.9 years and 65.9% were caring for dependents. The respondents had been practicing medicine for an average of 18 years at the time of the survey. Each week, they worked an average of 43.9 hours in the office and 9.5 hours at home.
Among the survey respondents, 74.6% felt satisfied and 91.2% felt extremely satisfied with their “current work conditions and career.” However, 57.5% reported that it was “difficult or very difficult to advance in their career.”
The survey further showed that 38.6% of female family medicine physicians felt that their working conditions were similar to those of their male counterparts, and 37.1% felt the same about their career satisfaction. In addition, only 29.8% said that their male counterparts would have “similar possibilities to advance their careers.”
The survey respondents had an average score of 8.2 points on the Physician Work-Life survey, which indicated “high satisfaction with their work,” according to the researchers. However, the respondents’ average scores regarding pay, personal time and administrative tasks were lower (5.3 points, 3.5 points, 3.2 points, respectively).
“Only relationships with colleagues and staff, resources, community involvement and other aspects of work satisfaction differed among the continents with statistical significance,” Usta and colleagues wrote. “Only relationships with staff and pay differed significantly between high- and middle-income countries.”
“Alarmingly, 74% reported experiencing general sexist remarks and behaviors in their training or work, 45.1% reported inappropriate sexual advances and 21.6% reported coercive advances,” the researchers continued.
Study co-author Jumana Antoun, MD, a PhD candidate in the department of family medicine at the American University in Beirut, acknowledged in a press release that some respondents may have pursued a career in family medicine for patient connections rather than “money and status.”
“Nevertheless, this does not mean that employers should not work on improving their work environment and make it safer and equitable with men doctors,” Antoun added.
Perspective
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I appreciate the authors exploring whether there are career satisfaction aspects being experienced differently by family physicians who identify as women. The results did not surprise me. Overall, family physicians are happy with their career and specialty choice. Family medicine is a wonderfully rich and rewarding specialty to practice. That satisfaction does not preclude some pain points we would like to see addressed.
Both pay and administrative burden rank highly on nearly every family medicine satisfaction survey. Gains for the overall specialty do not necessarily equate to leveling gains for women. Even as salaries rise in primary care overall, women persistently see a slower rate of rise and remain underpaid compared to male colleagues. This becomes even more apparent when you add the racial wage disparity. White male physicians make on average $63.41 an hour compared to $46.59 for Black female physicians in the exact same jobs.
Lack of personal time shines a light on the hidden burdens women generally face in the workforce. When not at work, women spend a disproportionate amount of time tending to household chores, childcare and other home supportive duties, leaving them precious little time for hobbies or self-care. During the COVID-19 pandemic, as childcare options became limited, female physicians were forced out of the workforce at rates higher than men, and some still have not returned.
Addressing these situations really takes system-level change which we can advocate for, such as normalizing closing the gender and racial wage gaps, improving access to childcare and flexible work options, confronting the need for women to have “done more” than their male counterparts in order to be considered for promotions/pay increases, pressing for administrative burden reduction (this can be done with your support through your specialty societies like the American Academy of Family Physicians or AMA) and taking advantage of time-saving options when available (like grocery delivery, cleaning services, etc.) to free up personal time.
Adjunct associate professor of family and community medicine
Adjunct associate professor of urban bioethics and population health
Lewis Katz School of Medicine at Temple University
Healio Primary Care Peer Perspective Board member
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