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Smoking cessation counseling by primary care women physicians: Women Physicians' Health Study.

OBJECTIVES: The Women Physicians' Health Study (WPHS) offers a unique opportunity to examine the counseling and screening practices of women physicians. The objectives of this study were to: describe the prevalence of self-reported smoking cessation counseling among primary care women physicians and determine the association between physician demographic, professional, and personal characteristics and smoking cessation counseling. METHODS: Conducted in 1993-1994, WPHS is a nationally representative cross-sectional mailed survey of U.S. women physicians and included 4,501 respondents representing all major specialties. Primary care physicians included 5 specialty areas and were grouped into 3 categories: (1) general primary care; (2) obstetrics/gynecology (ob/gyn); and (3) pediatrics. Frequent counseling was defined as having counseled patients who were known smokers at every visit or at least once a year. RESULTS: Women physicians in general primary care (84%) and ob/gyn (83%) were more likely to frequently counsel their patients about cessation than were pediatricians (41%). Perceived relevance of counseling to a physician's practice was significantly associated with frequent counseling. Personal characteristics (current smoking status, personal or family history of a smoking-related disease, or living with a smoker as an adult or child) were not significantly correlated with counseling. CONCLUSION: The majority (71%) of physicians reported frequently counseling their patients. However, there was significant variation by physician specialty. In addition, perceived relevance of counseling was strongly associated with counseling behavior. Physician counseling on cessation can reduce tobacco-related morbidity and mortality. Increasing perceived relevance, implementing system changes, and creating accountability can facilitate cessation counseling by physicians.

Adult↗

Basic demographic and professional characteristics of US women physicians.

Women physicians are a rapidly growing percentage of the physician population in the United States; yet, their fundamental characteristics and largely unknown. The Women Physicians' Health Study is the first large, national study of US women physicians, comprising a random sample (n = 4,501 respondents) of women physicians aged 30 to 70. Data from the Women Physicians' Health Study showed that African-American and Latina or Hispanic physicians were underrepresented, and Asian-American and foreign-born physicians were overrepresented in proportion to their prevalence in the US female population. Women physicians were more likely to be married and less likely to have never married and less likely to have never married or to be divorced or widowed than other US women. Younger physicians were more likely to be residency trained and board-certified and to work more hours per week than older physicians. Younger physicians were also less likely to be in solo practice, government work, or inactive; they tended to be concentrated in group or hospital-based practices. We found that although US women physicians have some common characteristics that differentiate them from other US women, their practice and other characteristics vary substantially by age and specialty in ways that have not previously been reported.

Adult↗

Characteristics of pregnant vs. non-pregnant women physicians: findings from the women physicians' health study.

OBJECTIVE: Many young physicians are women, and many are in their childbearing years. Knowing pregnant physicians' status is useful for epidemiological and workforce reasons, yet no studies have compared pregnant with same-age, non-pregnant physicians, an especially appropriate comparison group. STUDY DESIGN: Data from the Women Physicians' Health Study, a national questionnaire-based survey. We compare 87 pregnant with 1148 non-pregnant women physicians, ages 30-40. RESULTS: Pregnant physicians ate more fat, fruits and vegetables, and cheese, but not more dairy than non-pregnant women physicians. While nearly half consumed alcohol, they reported drinking an average of only 0.4 drinks/week, and none smoked. Nearly all took vitamin supplements. Pregnant physicians exercised as much as non-pregnant physicians, and pregnant physicians' self-reported health status was better. Work amount, desire to work less, perceived work control, career satisfaction, and work stress did not significantly differ by pregnancy status. CONCLUSION: The prenatal period may be a time of especially healthy habits and considerable productivity for female physicians.

Adult↗

Academic versus non-academic women physicians: data from the Women Physicians' Health Study.

PURPOSE: To help encourage women physicians to enter academe, the authors gathered information about how academic and non-academic women physicians (AWPs and NAWPs) differed demographically, personally, and professionally. METHOD: The authors examined data from the Women Physicians' Health Study, a nationally representative questionnaire-based study conducted in 1993-1994. RESULTS: The 453 AWPs were more likely to be U.S.-born, white, and self-defined as liberal than were the 3,986 NAWPs. The AWPs were more likely to be board-certified and to work in urban areas, reported fewer clinical and more non-clinical hours, earned less, and performed more continuing medical education. The AWPs reported less work control and were more likely to report working too much, but were also less likely, if they could relive their lives, to want to change specialty. AWPs and NAWPs had similar career satisfaction, work stress, and personal health habits. CONCLUSION: AWPs who come from a somewhat narrow demographic group, may not provide the variety of role models necessary for encouraging ethnic diversity in medical schools. Despite somewhat greater reported work hardships, AWPs are a very professionally satisfied and motivated group.

Academic Medical Centers↗

Career satisfaction of US women physicians: results from the Women Physicians' Health Study. Society of General Internal Medicine Career Satisfaction Study Group.

BACKGROUND: Despite major changes in health care, the prevalence and predictors of career satisfaction have not recently been comprehensively studied in either women or men physicians. METHODS: The Women Physicians' Health Study surveyed a nationally representative random sample (n = 4501 respondents; response rate, 59%) of US women physicians. Using univariate and logistic regression analyses, we examined personal and professional characteristics that were correlated with 3 major outcomes: career satisfaction, desire to become a physician again, and desire to change one's specialty. RESULTS: Women physicians were generally satisfied with their careers (84% usually, almost always, or always satisfied). However, 31% would maybe, probably, or definitely not choose to be a physician again, and 38% would maybe, probably, or definitely prefer to change their specialty. Physician's age, control of the work environment, work stress, and a history of harassment were independent predictors of all 3 outcomes, with younger physicians and those having least work control, most work stress, or having experienced severe harassment reporting the most dissatisfaction. The strongest association (odds ratio, 11.3; 95% confidence interval, 7.3-17.5; P<.001) was between work control and career satisfaction. Other significant predictors (P<.01) of outcomes included birthplace, ethnicity, sexual orientation, having children, stress at home, religious fervor, mental health, specialty, practice type, and workload. CONCLUSIONS: Women physicians generally report career satisfaction, but many, if given the choice, would not become a physician again or would choose a different specialty. Correctable factors such as work stress, harassment, and poor control over work environment should be addressed to improve the recruitment and retention of women physicians.

Adult↗

Health-related behaviors of women physicians vs other women in the United States.

OBJECTIVE: To examine the health-related behaviors of women physicians compared with those of other women of high and not high socioeconomic status and with national goals. METHODS: We examined the results of a questionnaire-based survey of a stratified random sample, the Women Physicians' Health Study, and a US telephone survey (Behavioral Risk Factor Surveillance System of the Centers for Disease Control and Prevention, Atlanta, Ga). We analyzed 3 samples of women aged 30 to 70 years: (1) respondents from the Women Physicians' Health Study (n = 4501); (2) respondents from the Behavioral Risk Factor Surveillance System (n = 1316) of the highest socioeconomic status; and (3) all other respondents from the Behavioral Risk Factor Surveillance System (n = 35,361). RESULTS: Women physicians were more likely than other women of high socioeconomic status and even more likely than other women not to smoke. The few physicians (3.7%) who smoked reported consuming fewer cigarettes per day, and physicians who had stopped smoking reported quitting at a younger age than women in the general population. Women physicians were less likely to report abstaining from alcohol, but those who drank reported consuming less alcohol per episode than other women and were less likely to report binging on alcohol than women in the general population. Unlike women in the general population and even other women of high socioeconomic status, women physicians' reported behaviors exceeded national goals for the year 2000 in all examined behaviors and screening habits. CONCLUSIONS: Women physicians report having generally good health habits even when compared with other socioeconomically advantaged women and report exceeding all examined national goals for personal screening practices and other personal health behaviors. Women physicians' behaviors may provide useful standards for other women in the United States.

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What impact have women physicians had on women's health?

The proportion of women in medicine in the United States is approaching that of men, but women physicians are still the minority in positions of power. Research has shown that women physicians order more preventive tests for women patients, are more attuned to patients' psychosocial needs, and have developed more patient-oriented communication styles than men physicians. Recent organized efforts of women physicians have brought attention to many gender gaps in medical research and practice. If more women move into policy-making positions, especially in education and research, their gender-sensitive perspective could permanently influence the profession as a whole.

Delivery of Health Care↗

Family responsibilities and domestic activities of US women physicians.

BACKGROUND: Women physicians may have a multiplicity of domestic roles (eg, cook, housekeeper, child care provider) that are of inherent interest and that may affect their professional lives, but are largely unstudied. DESIGN, SETTING, PARTICIPANTS, AND MAIN OUTCOME MEASURES: We report data from respondents (N = 4501) to the Women Physicians' Health Study, a cross-sectional, questionnaire-based study of a stratified random sample of US women MDs. RESULTS: Women physicians with children aged 0 to 17 years spent a median of 24.4 hours per week on child care. Women physicians typically spent half an hour per day cooking, and another half-hour per day on other housework. Little time was spent on gardening: a median of 0.05 hours (3 minutes) per week. Those performing more domestic tasks are likely to work fewer hours outside the home and to be on call less often. Women physicians who are married or widowed, have more children, have lower personal incomes, and have more highly educated and higher-earning spouses perform more domestic activities. We found no significant adverse relationship between time spent on any domestic activity and career satisfaction or mental or physical health. CONCLUSIONS: Women physicians spend little time on domestic activities that can be done for them by others, including cooking, housework, and especially gardening. Women physicians spend somewhat less time on child care and substantially less time on housework than do other US women. Despite abundant editorializing about role conflicts of women physicians, our measures of career satisfaction and mental health were not adversely affected by time spent on domestic obligations.

Adult↗

Non-primary care physicians and smoking cessation counseling: Women Physicians' Health Study.

OBJECTIVES: The Women Physicians' Health Study (WPHS) offers a unique opportunity to examine the counseling and screening practices of women physicians in various specialties. In this study we describe the prevalence of self-reported counseling on smoking cessation among non-primary care women physicians and examine the association between their demographic, professional, and personal characteristics and such counseling on smoking cessation. METHODS: Conducted in 1993-1994, WPHS is a nationally representative cross-sectional mailed survey of U.S. women physicians with 4,501 respondents representing all major specialties. Physicians in 9 specialty areas were grouped in 6 categories: (1) anesthesiology; (2) general surgery and surgical subspecialties; (3) emergency medicine; (4) medical subspecialties; (5) psychiatry; and (6) other. Frequent counseling was defined as having counseled patients who were known smokers at every visit or at least once a year. RESULTS: Overall, 45% of the physicians frequently counseled smokers to quit. Medical subspecialists (80%) were most likely and psychiatrists (29%) least likely to counsel frequently. Specialty, perceived relevance of counseling to the physician's practice, and self-confidence in counseling about smoking cessation were associated with frequent counseling. CONCLUSION: Cessation counseling by non-primary care physicians can reduce tobacco-related morbidity and mortality. Increasing perceived relevance and self-confidence among this group of physicians, combined with implementation of system changes and the creation of physician accountability can facilitate the provision of such counseling.

Adult↗

The challenge for women physician executives.

After half a century of constituting 5 percent of the physician population, women will soon make up more than one-third of U.S. physicians. Women now practice in virtually every specialty. This enormous change has created both opportunities and tensions. Within the broader context of the changing role of women in U.S. society, women physicians are exploring new career paths--paths that are both similar to and different from those of their male colleagues. A future challenge for women physicians will be achieving significant representation in the medical management ranks.

Career Mobility↗

Women physicians and stress.

Most women physicians enjoy better than average physical health and lead satisfying and productive lives. However, higher than average rates of depression, anxiety, marital problems, and substance abuse have been reported by some, but not all, authors. This quantitative survey of 196 women physicians and qualitative focus groups with 48 other women physicians was conducted to determine perceptions of their health, stress, satisfaction, knowledge, and abuse rates in medical practice. Eight specialties plus family practice physicians participated. The average age was 44.1 years (SD 8.8, range 23-77). Seventy-four percent of women physicians were married, with children. Specialists and family physicians were similar in all demographic characteristics except that family physicians were more significantly likely to be divorced, separated, or widowed (p < or = 0.01). Specialists perceived their personal physical health to be better than that of family doctors (p < or = 0.05), and family physicians rated their medical knowledge better than that of specialists (p < or = 0.0001). Women physicians over age 50 or with children over age 19 reported the best mental health (p < or = 0.0001 and 0.003, respectively). Overall, 49% of women physicians reported usually having high levels of stress, 44% felt mentally tired, and 17% took antidepressant drugs. Seventy-three percent reported verbal abuse at work (71% in the last year), and 33% reported physical assault at work (11% in the last year). Focus groups identified three major sources of stress: high expectations, multiple roles, and work environment. These results are discussed and compared with the literature. Both personal and systemic strategies are required to solve the problems identified. Women physicians can facilitate the adoption of some of these strategies by sharing information about successes, challenges, and solutions.

Adult↗