Acknowledging gender bias to improve physician health

November 12, 2022

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Pétursson MM. Addressing gender and well-being in healthcare. Presented at: ACAAI Annual Scientific Meeting; Nov. 10-14, 2022; Louisville, Ky.

Petersen does not report any relevant financial information. She acknowledges that the views in her presentation are her own and do not reflect the views of the Ministry of Defence.

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LOUISVILLE, Ky. — Although there is a gender gap that affects health care, there has been an indication of improvement and reason to be optimistic about changes in the future, according to a speaker here.

Maureen M. Petersen, MD, FACAAI, The U.S. Army colonel and director of medical education at Walter Reed National Military Medical Center told attendees at the American College of Allergy, Asthma & Immunology Annual Scientific Fund that her “why” for becoming passionate about wellness stems from the loss of a colleague, Dr. internal medicine doctor, whom she described as a compassionate and amazing teacher, to commit suicide in August 2020.

With a 43% burnout rate among allergists/immunologists—including 50% among women and 39% among men—burnout can also lead to an increase in patient safety errors, poorer patient satisfaction ratings, and the financial impact of high turnover. Source: Adobe Stock.

“It rocked our organization and … was a slap in the face,” Petersen said. “I was very involved in wellness and watched our organization recover from the death of this doctor.

Burnout, gender inequality

Gender inequality affects the medical profession and, in turn, affects patients, Petersen said.

“If we don’t do our part to address our own personal wellness and influence our organization’s culture of wellness, we will continue to see an increase in burnout rates.” [among physicians],” she said. “This in turn has costs for us as physicians, costs for our patients and costs for our institutions.

Petersen added that the burnout epidemic has led to high physician suicide rates, with female physicians having a 130% higher suicide rate than women in the general population.

With a 43% burnout rate among allergists/immunologists — including 50% among women and 39% among men — burnout can also lead to an increase in patient safety errors, poorer patient satisfaction ratings and the financial impact of high turnover, Petersen said.

System processes, such as electronic medical records and preauthorizations, contribute to burnout along with “increased pressure to be perfect, with a spotlight on patient safety, so doctors feel like they can’t make mistakes,” Petersen said.

Sexism also affects well-being, Petersen said, citing data showing that 30% of women and 4% of men in academic medicine have experienced sexual harassment.

Gender differences among doctors also lead to different patient outcomes, she added.

“We need to have women at the research table to remind us of the importance of examining gender differences, especially in areas such as cardiovascular disease, where women and men have equivalent survival rates given the same upfront treatment, but since 1984, the death rate from heart attacks in women is much higher,” Petersen said.

In addition to having lower starting salaries and disparities in compensation, which affects the well-being of female doctors, there is also a lack of women at the top of the medical hierarchy, Petersen said. For example, in the United States, women make up only 15% of medical deans, 3% of CEOs, 6% of department heads, 9% of department heads, and 3% of chief medical officers.

The gender imbalance in publications, which can be caused by different funding, also makes it more difficult for women to obtain leadership positions.

“However, it is optimistic to realize that the representation of women among our fellows in training is shifting in favor of women,” said Petersen, specifically referring to data in the field of allergy/immunology.

Moving the needle

Gender bias must be acknowledged to improve physician health, Petersen said.

“Improving wellness and eliminating gender bias in health care first starts with recognizing and understanding the problem,” she said. “Providing opportunities in research and education will continue to move the needle.” We need to make sure we are aware of gender bias and make a conscious decision to participate. We need to provide opportunities for equality, not equality, and also do research that affects women so we do better for our patients.”

Well-being—when defined as fulfillment—comprises three areas: personal resilience, a culture of well-being, and practice effectiveness, according to Petersen.

Personal resilience includes several aspects, such as emotional, environmental, financial, intellectual, occupational, physical, social and spiritual. Strategies to strengthen this aspect of wellness may include developing a life coaching program, providing physicians with access to financial advisors, creating volunteer and mentoring programs, and providing physicians with time and resources to practice.

To improve a culture of wellness, Petersen referred to the National Wellness Institute’s competency model, which describes five critical areas, including commitment, education, participation, communication and compliance.

Regarding diversity, equity and diversity, or DEI, it’s important to understand that equity is different from equity, Petersen said, adding that “equality is giving people what they need to achieve a goal, and inclusion is considering someone in that that you are doing and actually serving them. Membership is more than having them sit at the table.”

Exercise effectiveness can be addressed by using tools like Vanderbilt’s long-term curriculum to improve leadership and teamwork, which will then improve well-being, Petersen said.

Petersen also pointed to Dr. The Lorna Breen Health Care Protection Act of 2022, which was signed into law in March, requires HHS to provide grants to improve mental health and resilience among healthcare workers, and to develop policies to reverse the burnout epidemic and promote resilience.

“I’ve had a career in military medicine … for 29 years, and in that time I’ve witnessed and experienced gender disparities that affect health care,” Petersen said. “However, I stand here today optimistic because I, too, have witnessed and experienced progress in the gender gap, and I know that the opportunity to give this speech today is just one of the things that will continue to lead to change for women in medicine in the future.”

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