Mitigating the gender gap: How "DOCTOR" badges affect physician identity.

Jenny Chang,Michael P Jones,Joshua Silverberg,John Arbo,Jill Corbo

doi:10.1016/j.ajem.2021.04.037

Jenny Chang, Michael P Jones + Show 3 more

Open Access

https://doi.org/10.1016/j.ajem.2021.04.037

Copy DOI

Abstract

Patients and their families frequently misclassify female physicians in the Emergency Department (ED) as non-physicians. Physician misidentification impacts the environment of care on multiple levels; including patient satisfaction and physician well-being. Implementing "DOCTOR" badges may be a low-cost tool to rectify these problems. The study was conducted in a large urban academic medical center. Badges with the title "DOCTOR" was distributed to 83 Emergency Medicine (EM) residents and 28 EM Attendings in the department. After 3 months, the residents and Attendings were surveyed to assess the efficacy of the intervention. Descriptive data, univariable, and multivariable analyses were conducted. There were 98 respondents to the pre-intervention survey and 87 respondents to the post-intervention survey. 91% of EM physicians reported that they were misidentified by the patients and their families. Compared to male EM physicians, female EM physicians were disproportionately more likely to be misidentified as a non-physician 43% vs 97%, respectfully, 95% CI: [37,66], p < 0.0001. After wearing the "DOCTOR" badges, a postintervention survey showed decrease in misidentification of female EM physicians by patients and their families to 81.6%, a 15.4% decrease, p = 0.03. Being more valued was reported by 73.7% female physicians vs. 44.9% male physicians, 95% CI [7.9,46], p = 0.007. Similarly, 64.3% EM physicians felt less frustration with misclassification, 81.6% female physicians vs. 51% male physicians, 95% CI [10.5,47], p = 0.0033. Female EM physicians are disproportionately misidentified by patients and their families and are more likely to feel undervalued when clarifying their roles. In only a span of 3 months, we found that the use of "DOCTOR" badges decreased misidentification and improved outcomes that may enhance physician wellness. Having EM physicians wear a "DOCTOR" badge may be a simple and effective long-term solution to this issue.

Highlights

EM residents were already known to be high-risk for depression and burnout; in all likelihood the Covid-19 pandemic has added to this risk
Our study aims to evaluate whether the incorporation of “DOCTOR” badges can improve identification and the overall wellness of EM physicians
There was a decrease in misidentification of female EM physicians to 81.6%, p=0.03 and 73.7% of female physicians reported feeling more valued vs 44.9% male physician 95% CI [7.9,46], p=0.007

Summary

Introduction

EM residents were already known to be high-risk for depression and burnout; in all likelihood the Covid-19 pandemic has added to this risk. In addition to the understandable work stressors, social isolation caused by the lockdowns likely has affected their support structure negatively. Multiple studies have shown that only a small fraction of patients are able to identify their physician. Physician misidentification impacts patient care, patient satisfaction, and physician wellbeing. EM residents face emotional challenges every day: conflicts with patients and providers, witnessing trauma, uncertain decision making, and a chaotic work environment. Residency education lacks training for emotional processing and empathetic skill building. A form of humanities education, may foster empathy and reduce emotional exhaustion; its value has been studied in undergraduate and graduate medical settings, but not within an EM residency program

Objectives

Methods

Results

Conclusion