Female emergency physicians leave EM workforce >12 years b/f male EPs
Also: Two-thirds of 55 y/o+ EPs have been sued, TeamHealth’s debt, ED psych boarding is unconstitutional, & residents on strike.
Top of the Week
Dr. Cameron Gettel, winner of this year’s ACEP Policy Pioneer Award, caused a jaw-drop moment at SAEM23 when he presented the slide, “2013 and 2019 violin plots of attrition median age by gender”:
Prior to the pandemic (2013-19), female emergency physicians left the clinical workforce an average of 12.4 years earlier than their male counterparts. 12.4-year difference. Before the pandemic!
The full abstract from SAEM’s Academic Emergency Medicine is below. (Source link; DOI: 10.1111/acem.14718)
Emergency Medicine Workforce Attrition Differences by Age and Gender
Cameron Gettel, D (1) Mark Courtney (2), Pooja Agrawal (1), Tracy E. Madsen (3), Arjun K. Venkatesh4 (4) - 1. Yale University School of Medicine, 2. UT Southwestern, 3. Brown University, 4. Yale University
Background and Objectives: Analyses to date have not assessed the age at which male and female emergency medicine (EM) physicians exhibit attrition from the workforce. We sought to identify trends in: (1) the median age at the year of attrition, and (2) variables associated with EM workforce attrition.
Methods: We performed a repeated cross-sectional analysis of EM physicians receiving reimbursement for at least 50 Evaluation & Management (E/M) services [99281–99285] from Medicare Part B linked to demographic data from the American Board of Emergency Medicine (ABEM). Stratified by gender, we calculated the median age at the year of attrition for EM physicians including both temporary and permanent attrition, respectively defined as physicians not meeting the reimbursement threshold for E/M services in the immediate subsequent year or all subsequent study years. Finally, we estimated logistic regression models to quantify the association of age and gender with attrition from the workforce.
Results: From 2013 to 2020, 38,909 unique EM physicians met study inclusion criteria, including 27,208 males and 11,701 females. Across all years, 5914 male EM physicians permanently left the workforce and had a median (IQR) age at attrition of 56.4 (44.5–65.4) while 2464 female EM physicians permanently left the workforce and had a median age at attrition of 44.0 (38.0–53.8). In 2013, the median (IQR) age at permanent attrition for male EM physicians was 59.2 (46.9–64.8), which decreased to 55.3 (44.3–65.8) in 2018. Female EM physicians exhibited a similar trend, but at younger ages, with the median (IQR) age at permanent attrition being 45.6 (38.1–56.6) in 2013 compared to 43.4 (38.1–52.9) in 2018. Regression analyses identified male gender (OR 0.69, 95% CI 0.66–0.73) and age (OR 1.06, 95% CI 1.06–1.06) as variables associated with attrition.
Conclusion: Female EM physicians permanently exited clinical practice over 12 years prior to their male EM physician counterparts, with the age at time of permanent attrition being considerably younger in later study years for both genders. This work provides important foundational data regarding age- and gender-based differences in EM workforce attrition.
Why are female emergency physicians dropping out of the clinical EM workforce more than a decade earlier than their male counterparts? I asked ChatGPT. ChatGPT’s answer:
“The issue of female emergency physicians dropping out of the clinical Emergency Medicine (EM) workforce earlier than their male counterparts can be attributed to various factors. While it's important to note that individual experiences may vary, several common reasons have been identified:
Work-Life Balance: Women often face greater challenges in balancing their personal and professional lives, particularly when it comes to raising children or caring for elderly parents. The demanding nature of emergency medicine, with irregular schedules, long hours, and high levels of stress, can make it difficult for female physicians to maintain a satisfactory work-life balance.
Burnout and Stress: Emergency medicine is known for its high-stress environment, which can contribute to burnout. Female physicians may experience additional pressures due to societal expectations, gender biases, and disparities in promotions and pay. These factors can increase the risk of burnout and decrease job satisfaction, leading some women to leave the clinical workforce.
Lack of Support: The presence of a supportive work environment is crucial for retaining physicians. Female emergency physicians may face challenges related to gender bias, discrimination, and a lack of mentorship opportunities. Without adequate support and opportunities for career advancement, women may feel marginalized and choose to leave the clinical workforce.
Family Responsibilities: Women often bear a larger burden of domestic and family responsibilities. The demanding nature of emergency medicine may make it challenging for female physicians to fulfill their caregiving roles, leading to higher rates of attrition from the clinical workforce.
Career Interruptions: Women may experience career interruptions due to maternity leave, childcare responsibilities, or family obligations. These interruptions can impact career progression and lead to decreased opportunities for professional advancement, ultimately influencing the decision to leave clinical practice.
Addressing these issues requires a multifaceted approach. Creating more flexible work schedules, providing mentorship and support programs, promoting diversity and inclusion, and implementing policies that address gender disparities and promote work-life balance can help retain female emergency physicians in the clinical workforce. Additionally, promoting cultural change within the field and addressing systemic biases are essential to ensure equal opportunities for all physicians, regardless of gender.”
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