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Variation by Gender in Staff Support for Documentation Among Primary Care Physicians: A Nationwide, Cross-Sectional Analysis

Lisa S. Rotenstein, MD, MBA; Nate Apathy, PhD; David W. Bates, MD, MSc; Bruce Landon, MD, MBA

Corresponding Author: Lisa S. Rotenstein, MD, MBA; Brigham and Women’s Hospital.

Contact Email: LRotenstein@partners.org

Section: Brief Report

Final Publication: | HTML |     | PDF |

BACKGROUND: There are known gender differences in both time spent on the electronic health record (EHR) and burnout. Previous studies have described potential benefits of staff support for documentation for physician experience and EHR time. It is not known, however, to what extent availability of staff support for documentation differs by gender in the context of primary care.

METHODS: This was a cross-sectional study of PCPs using data from the 2018 and 2019 National Electronic Health Records Survey administrations. After descriptively analyzing the prevalence of staff support for documentation, we used multivariable logistic regression to identify the adjusted relationship of staff support for documentation with gender.

RESULTS: Among the 813 physicians who endorsed having an EHR (92.5% of sample, representing 296,854 physicians), female PCPs were significantly less likely than male PCPs (25.1% vs. 37.3%; p=0.04) to report having staff support for documentation. This difference was most pronounced in practices with a single physician and practices with more than 50% of patients insured by Medicaid. Gender differences persisted in analyses adjusted for practice ownership and percent of patients insured by Medicaid.

CONCLUSIONS: Given positive effects of documentation support and known gender differences in burnout and EHR use times, the differences identified have important implications for the physician workforce. Future research should focus on identifying underlying reasons and potential solutions for the gender differences described.

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