Female physicians face bigger EHR burdens, study finds

A new study from the University of Michigan Medical School sheds light on a growing concern in primary care — though men and women receive similar numbers of patient portal messages, female physicians are the ones spending more time, and paying the higher price.

The study, published Thursday in the Journal of General Internal Medicine, tracked one year’s worth of electronic health record (EHR) activity and survey responses from 406 primary care/general medicine physicians at a major academic center in the Midwest. The findings point to a notable gender gap in how the work of digital communication gets done and the effect it has on doctors.

Same messages, different workloads

On paper, the message load looks even. But when it comes to what happens after those messages arrive in the physician’s inbox, the differences are clear. On average, female physicians spent nearly six more minutes per day entering orders and 17 more minutes writing notes — tasks often triggered by patient portal communications but categorized separately in the EHR.

That added time translates to longer workdays and, in many cases, increased burden. While men and women spent a similar amount of time in the in-basket — the EHR inbox for patient messages — women were significantly more likely to say those messages required deeper clinical assessments and contributed to burnout.

“While some institutions report a higher message volume for female providers, our institution observed that women tend to spend more time managing these messages,” said the study’s lead author, Greta Branford, M.D., of the University of Michigan Medical Center’s Division of General Medicine. “Compared to their male counterparts, women find the EHR system easier to learn and more beneficial in clinical practice. However, they are more likely to cite the in-basket workload as a source of burnout.”

The toll of patient messages

Beyond time and workload, the study also found that female physicians were 60% more likely to report receiving demeaning or negative messages from patients, adding another emotional layer to the burden.

That aligns with past research showing that female physicians are more likely to encounter inappropriate behavior or discrimination in clinical settings. And it’s part of a broader story: despite finding the EHR easier to learn and more useful for patient education, women in the study were 76% more likely to say that portal messages were fueling their burnout.

A system out of sync

At the University of Michigan’s general and internal medicine-pediatrics clinics, women already make up 57% of the physician workforce — higher than the national average. As more women enter the field, unequal demands on their time and emotional bandwidth could have lasting consequences for the profession.

Overall, women accounted for roughly two-thirds of the time spent on major EHR tasks — including messaging, note writing, clinical review and order entry — even though their turnaround times were just as fast as their male peers. That is, they were managing more work just as efficiently, but with more time and effort.

“Recognizing these gender differences can help us develop tailored solutions to address these challenges,” Branford said.

The authors call for health care organizations to consider real changes — adjusting panel sizes, easing productivity demands, embracing value-based care models and streamlining EHR workflows. Better teamwork, mentorship and administrative support may also help ease the burden.

Survey responses also pointed to the role of organizational culture. Women were more likely to cite a lack of effective teamwork as a driver of burnout, while men were more likely to point to a lack of personal control. Both reasons matter, but they suggest different approaches to solving the same problem.

With burnout costing the U.S. health system an estimated $4.6 billion annually in lost productivity and turnover, the stakes are high. For practices already stretched thin, fixing these disparities is about more than fairness — it’s about survival.

“These findings highlight the need for targeted interventions to optimize workflows and promote equitable work distribution,” the authors concluded. “Future research should examine the underlying causes and impacts of these gender differences to inform effective solutions.”