Female clinicians spend more time with patients and earn less because of it, study shows

Female clinicians spend more time filling out patients' electronic health records and thus treat fewer patients, according to a new study that highlights the economic effects of a volume-over-value payment model on women in the workforce.

The EHR vendor Athenahealth analyzed how 14,520 clinicians used its record systems over a five-month period last year and discovered that female clinicians see fewer people per week than their male counterparts because they devote more time to documenting patient encounters. Female and male clinicians spend the same amount of time filling out patient records per week, but female clinicians see approximately 18% fewer patients, the study found.

The discrepancy persists across medical specialties and is wider within some. For example, female primary care providers spend 19% more time on EHRs per encounter. In cardiology and neurology, the differences were 61% and 40%, respectively.

Female clinicians reported to Athenahealth that they feel pressure to include comprehensive notes about patients within their medical records, said Jessica Sweeney-Platt, the company's vice president of research and editorial strategy. Female clinicians also spend more face-to-face time with each patient, Athenahealth found.

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"We see this kind of rippling out across the way that we see practice patterns emerging, so when you spend more time with each patient, you're probably collecting more information. Therefore, it's going to take you longer to document that information," Sweeney-Platt said.

The findings help explain why the average female physician earns an estimated $2 million less than a male physician over a 40-year career. The report also suggests employers should ease administrative burdens on clinicians while retaining high-quality medical records.

Transitioning to value-based payment models also could mitigate the pay gap by financially rewarding clinicians for quality outcomes rather than for treating high volumes of patients, Sweeney-Platt said.

"You take the pressure away to see more and more and more patients when you eliminate the penalty for seeing fewer patients," Sweeney-Platt said. "You could speculate that it would minimize the gap between the earnings potential of female physicians and male physicians."

Spending more time on clinical documentation doesn't necessarily translate to better health outcomes, but it does put pressure on EHR vendors to make it easier for clinicians to create comprehensive patient records.

"This type of research uncovers that there are big, structural issues that affect all clinicians, not just women," Sweeney-Platt said.