CANCÚN, MEXICO — Female family physicians tend to engage more emotionally with patients than their male colleagues, and they also report more job-related stress, a survey has found.
Such gender differences are particularly relevant now that many more women are entering medical school. “Women are coming to medical school in huge numbers, even overtaking the number of males,” Dr. Brenda Lovell said.
The preponderance of literature shows that patients really benefit from having a trusting relationship with their physicians, she continued. “I think it's especially important for family physicians to build a strong doctor-patient relationship because, unlike specialists who may only see someone once or twice, family doctors see their patients over and over, sometimes for many years.”
This deeper relationship, however, seems to carry a burden of greater stress for women physicians, who reported more headaches, sleep difficulties, gastrointestinal problems, and family stresses than their male colleagues.
Dr. Lovell of the University of Manitoba, Winnipeg, and her colleagues surveyed 110 family physicians in Canada about the way they interact with patients, how they cope with stress and burnout, and how stress affects them physically. Respondents used a one-to-five scale to describe how frequently they experience these issues.
The study cohort consisted of 70 men and 40 women. Men had been in practice significantly longer than women (mean 22 years vs. 15 years). Although men saw almost an equal percentage of male and female patients (55% and 45%, respectively), women saw a preponderance of female patients (67% vs. 33% men). Women also reported spending significantly more time with each patient (17.8 minutes vs. 13.3 minutes).
Women engaged emotionally with their patients significantly more often than men, taking the time to “listen carefully, show respect, provide simple explanations of diagnosis and treatment, and allow time for questions.” Women also were significantly more likely to use relationship-building techniques, including sharing emotions, expressing a wide variety of emotions, and using positive emotions like smiling and reassurance.
Women experienced physical signs of stress significantly more often. They were also more likely than men to rely on social support from friends and family and to seek professional help to deal with these issues. The women more often actively tried relaxing to relieve tension.
A second portion of the survey allowed physicians to freely express thoughts on their daily practice. When discussing practice constraints, women tended to list issues like “the politics of health care” and interpersonal factors, such as unpleasant office interactions and lack of collegial support.
Men focused more on administrative issues, such as staffing difficulties, lack of resources, and business competition.
Women said that they felt pressure to see more patients in less time and complained about administrative decisions from superiors that added to job stress. Men said they felt a loss of control because of numerous protocols that must be followed and expressed frustration at not being adequately recognized for their skills.
Decreased bureaucracy and better working conditions would go a long way toward improving the life of the family physician, “even more than higher pay,” she said.