542 - Burden of Household "Invisible Work" on Louisiana Pediatricians: Cognitive Labor Variation by Gender

Household cognitive labor (CL), unlike physical tasks, entails anticipating needs, identifying options for filling them, making decisions, and monitoring progress. Feeling disproportionately responsible for household management is associated with decreased life satisfaction. Studies demonstrate that women pediatricians bear more responsibility for physical tasks at home, but pediatricians’ household CL is not well-described.

Objective:

We examined gender discrepancy in household CL among physicians in pediatric specialties in Louisiana. This study aimed (1) to examine the extent to which physicians’ proportional responsibility for household CL varies by gender, as well as (2) to evaluate for association between greater responsibility for household CL and negative professional outcomes such as burnout, career dissatisfaction and sense of family-to-work conflict.

Design/Methods:

We performed a cross-sectional survey of physicians in pediatric specialties at five Louisiana centers associated with training programs. We analyzed data from subjects with 3-35 years of practice, working at least 20 hours per week. We dichotomized CL as high (primary responsibility in 6-11 domains) and low (0-5 domains).

We ran categorical analysis to determine associations between variables, using a Chi-square test. We assessed for association between gender and reported responsibility for household CL in 11 domains. Similarly, we assessed for association between “high” CL and professional outcomes related to well-being.

Results:

Response rate was 39%. We analyzed 208 surveys. Respondents were 66% women; mean time in practice 16 years (IQR 9-22 years); mean work hours 48 per week.

Women more often than men reported primary responsibility for CL in 9 of 11 domains of household/family work, including scheduling (e.g. coordinating family calendar), shopping (e.g. researching and choosing items), various cognitive aspects of childcare (e.g. managing activity enrollment, setting sleep schedule, awareness of school deadlines), and other domains (all p< 0.01). See table.

Women more often than men reported monthly symptoms of burnout (69% vs 50%) and increased callousness (45% vs 25%), as well as frequent distraction at work from home responsibilities (30% vs 13%); these same outcomes were also higher for those with high vs low CL (71% vs 57%; 51% vs 31%; 35% vs 17% respectively) (all p< 0.05).

Conclusion(s):

Gender disparity in household cognitive labor may contribute to gender disparity in professional well-being. This is relevant as discussions of healthcare improvement offer increasing consideration to equity and provider well-being.