Women in medicine face more work and family conflict, which can impact resilience

September 26, 2022

5 minute read


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Key points to remember

  • Among clinicians on the front lines of the COVID-19 pandemic, women were more likely to experience family-work and work-family conflict.
  • Three study authors spoke with Healio about the results and how systemic influences negatively affect resilience.

CHICAGO — The COVID-19 pandemic has exacerbated gender inequalities among frontline healthcare workers, according to research presented at the Women in Medicine Summit.

The cross-sectional survey, which was administered by email from April 2021 to June 2021, included 150 clinicians from the University of Minnesota and M Health Systems. Of these, 56.6% reported having been a worker on the front line during the pandemic. Among them, 64.8% were women.

Researchers used validated measures to better understand how gender and the pandemic have impacted academic clinicians. These measures included the Work-Family/Family-Work Conflict Scale, Work Autonomy Scale, Brief Resilience Coping, Brief Resilience Scale, and Patient Health Questionnaire-4.

Overall, there was no significant difference between front-line and non-front-line clinicians, the researchers said. They found that male frontline clinicians had higher resilience scores than female frontline clinicians, but female frontline clinicians experienced higher family-work and work-family conflict. . This may be due to structural, systemic, and societal influences “that can negatively impact resilience, such as implicit gender bias and micro-aggression in the workplace,” the researchers wrote.

To learn more about the results, Healio spoke with Sima Patel, MD, FAES, assistant professor of neurology at the University of Minnesota, member of the Center for Women in Medicine and Science – Salary, Resource, Leadership Equity Action Group, and member of the Gender Equity Task Force for the American Women Medicine Association; Jerica Bergé, PhD, MPH, LMFT, Professor and Vice President for Research, and Director of the Center for Women in Medicine and Science and the Women’s Health Research Program/Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) at the University of Minnesota Medical School; and Kait Macheledt, MPH, administrative assistant at the Center for Women in Medicine and coordinator of the BIRCWH program.

Healio: Your study revealed that women can experience family-work conflicts and work-family conflicts compared with men because of gender roles. Can you expand on that, and gender roles in the workplace?

patel: Women across the United States discussed the unprecedented demands of the COVID pandemic and how it has exacerbated existing gender disparities for many women. Recent studies have highlighted the disproportionate burden placed on women to provide domestic care and childcare. Additionally, we know that healthcare professionals as a whole experience family-professional role conflict at higher rates than other professions. Healthcare facilities have the opportunity to better understand/recognize the domestic workload that many healthcare workers experience. For many working mothers, coming home and caring for their families is a second full-time job. During the pandemic, child care and domestic support have been cut for many professional women, and most health care facilities have not identified strategies for providing support in these areas to these care workers. healthcare, especially frontline clinical teachers. If we want frontline clinicians to be more engaged, thrive at work, stay in academic medicine, and participate in innovation and leadership, we need to understand the barriers and remove them.

Macheledt: We used a bi-directional validated scale that measures family-work conflict and work-family conflict and found that among clinical faculty, front-line workers had [family-work conflict] (P= .004) and more [work-family conflicts] (P= .021).

Healio: What role, if any, do you think implicit biases play in this?

patel: Although we have not studied this, it is possible that an implicit bias may play a role within a partnership when it comes to domestic workload and childcare. Many professional women negotiate gender role expectations, family responsibilities, childcare, the mental load of running the home, and career ambitions. It is important to be aware of our own biases and our partners, and then to have healthy and fair conversations and a division of labor to raise a healthy family.

Healio: Do ​​you think an analysis of other demographics such as race and socioeconomic status might yield different results?

patel: In our study, we captured racial demographics; however, the majority of frontline workers surveyed were not underrepresented in medicine, so we are unable to draw conclusions on this. It is likely that in a larger sample these differences could be captured. Data on socio-economic status can also be useful; however, we did not request this data and cannot draw any conclusions.

Healio: How can these problems be solved? What do you think needs to be done to fix it?

Bergé: that’s a great question. Women in academic medicine are ambitious and make significant contributions to improving innovative research, medical education, leadership and advocacy. So, we need to create environments that help women stay in academic medicine, because we know from previous research that many are leaving and the pandemic has accentuated that exit. Conflicts between work and family are one of the main reasons why female professors leave academic medicine. The results of our study regarding work and family conflict have implications for institutions wishing to retain female faculty, especially post-pandemic. For example, it is important that institutions provide support to women, especially with regard to childcare and domestic responsibilities.

Macheledt: Additionally, it is helpful to understand what a faculty member may be going through with their household responsibilities during a pandemic and these circumstances should not be used against that individual. For example, the COVID-19 pandemic has delayed the promotion of many women and reduced academic productivity. It will be useful to assess promotion and tenure policies and modify these policies so that women do not feel the added burden of gender disparities in academic careers and “being held back” in the event of a pandemic. The Work-Family and Family-Work Conflict scale assesses conflict at several levels, including demands, time, and strain. Organizations need to determine which workplace policies, practices and cultures promote the well-being of their workforce and which promote opportunities for conflict.

Healio: Can you explain why this is an important issue that deserves more attention?

patel: If we are to care for a diverse patient population and provide education for the next generation of scientists and physicians, we must have this diverse representation in our leadership and faculty. Women leave academic medicine for many reasons, and their contribution to the field is paramount. More than 50% of medical school graduates are women; however, the workforce has a lower percentage of female faculty because women are leaving medicine. We need to understand the barriers and break them down to enable diverse representation in leadership, research and education.

Healio: Is there anything else you would like to add?

Bergé: This study is a sub-analysis of a larger project assessing the lived experiences of academic medical teachers during COVID-19. More upcoming findings from our Center for Women in Medicine and Science group, including projects focusing on intersectionality frameworks, telemedicine, experiences of leaders, caregivers and more. We all have a responsibility to be an ally for those who are underrepresented in medicine/science if we are to create an inclusive and diverse community.

Reference:

  • Patel S, et al. Well-being and resilience of frontline academic clinicians during the COVID-19 pandemic: Were there gender differences? Presented at: Women in Medicine Summit; September 16-17, 2022; Chicago (hybrid meeting).

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