How Do Disparities in the Physician Workforce Affect Patients?

Burnout as Catalyst for Leaving Medicine

The authors of the study describe burnout as a “public health crisis” and a major reason why physicians choose to leave medical practice. In addition to affecting morale and self-esteem, burnout also diminishes physicians’ ability to provide patient care and collaborate effectively with staff and colleagues. It can lead to higher hospital staff turnover, increased risk to patient safety, patient dissatisfaction with care, and decreased clinical hours — all of which could result in a physician leaving the field of medicine, which may, in turn “exacerbate workforce shortages that ultimately impact patient care.”

It is important to note that female physicians experience burnout at a rate nearly twice that of their male counterparts.⁵ Burnout also appears to affect men and women differently, with men reporting more symptoms of depersonalization and women reporting more symptoms of emotional exhaustion.

Factors contributing to burnout among female, URM, LGBTQ+ physicians and physicians with disabilities are listed in Table 3.

Table 3. Factors Contributing to Burnout in Specific Physician Groups

Physician Group	Contributors to Burnout
Women	· Extra time spent in communication with patients necessitating longer hours or seeing fewer patients, negatively impacting compensation · Higher levels of work-family/home conflicts · Inequities in work-life balance · Effort-reward imbalances · Lower income, compared to men in primary care and in specialties · Lack of equitable promotions (eg, professorships, speaking engagements, publishing, and leadership opportunities) · Gender-based workplace discrimination · Sexual harassment in the workplace · Gender bias
URM	· Racial discrimination, prejudice, feelings of isolation, and different cultural expectations among medical school students · Greater proportion of patients with medical/psychosocial complexity and more environmental/structural challenges · More challenging work environment · Less physician autonomy · Underrepresentation in leadership positions · Wage gaps · Higher educational debt
LGBTQ+	· Harassment by heterosexual colleagues · Denial of referrals, ostracism · Witnessing discriminatory behavior toward other LGBTQ+ individuals (patients, partners, coworkers) · Greater risk of depression, anxiety, low perceived self-health, harassment, isolation
Disabilities and intersectional identities	No available data

From Silver JK, et al. Health Equity. 2019;3(1):360-377.

This article originally appeared on Medical Bag