The Gender Gap in EHR Workload: A Comparative Analysis of Primary Care Physician In Basket Usage

Gender disparities in emotional exhaustion and burnout are well-recognized, but few studies have assessed gender differences in EHR patient portal workload and implications for clinician well-being.

To investigate gender differences in EHR in basket activity, workload, and burnout among physicians.

Observational analysis of EHR usage data and survey responses.

406 physicians (43.1% men, 56.9% women) at a large academic medical center.

Time spent on EHR activities, including in basket tasks, orders, and notes. Survey responses were collected on factors contributing to burnout, experiences with patient portal messages, and perceptions of EHR usability.

Women physicians spent significantly more time on orders (34.00 vs 28.39 min/day, p = 0.004) and notes (70.38 vs 53.17 min/day, p = 0.004) than men physicians. Women physicians were more likely to report that patient portal messages required more clinical assessment (OR = 1.60, 95% CI: 1.05-2.45, p = 0.0297) and contributed to burnout (OR = 1.76, 95% CI: 1.12-2.79, p = 0.0152). They were also more likely to receive negative messages from patients (OR = 1.61, 95% CI: 1.08-2.42, p = 0.0204). Interestingly, women physicians found EHR systems easier to learn (OR = 2.03, 95% CI: 1.37-3.02, p < .0001) and were less likely to feel EHRs inhibited quality care (OR = 0.57, 95% CI: 0.43-0.74, p < .0001) compared to men physicians.

Gender disparities exist in EHR usage and patient communication, and these disparities are associated with increased burnout risk among women physicians. Effective leadership engagement is essential for optimizing EHR workflows, promoting equitable work practices, and implementing flexible work provisions that ensure safe and sustainable care delivery.