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Physicians for a Healthy California (PHC), formerly known as the CMA Foundation, started in 1963 as a charitable arm of the California Medical Association (CMA), disbursing over $1 million dollars in grants and loans to medical students to support future physicians. It is dedicated to improving community health, growing a diverse physician workforce and promoting health equity.

A recent study, “A Prescription for Change,” by the nonprofit reveals a growing number of minority female doctors are feeling burned out and leaving their field of work.

Prior research has demonstrated that women physicians are more likely than their male counterparts to report feelings of “burnout.” Our prior research funded by The Physicians Foundation found that “burnout” among women physicians of color was uniquely associated with workplace harassment and low perceived value at work. Burnout and disengagement were also higher in women physicians whose competency was questioned by peers.

This follow-up study was undertaken to determine if there were changes in the rates of burnout among different races or the factors that contribute to career dissatisfaction since the beginning of the COVID-19 pandemic, and to collect data to inform health care organizations on effective strategies to improve the recruitment and retention of women physicians of color.

Reported burnout of respondents increased by 4.8 percentage points with 45.8% reporting high levels of overall burnout in the current study. Women physicians of color, whether represented or underrepresented in medicine, reported slightly lower overall burnout. When probed in focus groups, women physicians of color reported several protective factors that interviewees credited with their resilience.

Physician retention has been a growing problem for decades, exacerbated partly due to the COVID- 19 pandemic. California already suffers from severe physician shortages, creating vast underserved areas and under-resourced populations. Women physicians of color are more likely to serve these more vulnerable communities; therefore, to promote access to care and advance health equity, it is critical for health care organizations to implement effective strategies focused on the retention of this important group of clinicians.

Both the qualitative and quantitative research undertaken in this current study have led PHC researcher to develop eight recommendations for health care organizations to help address the retention of women physicians of color.

Summary of Recommendation to Improve Retention.

– – Commit to understanding, acknowledging and addressing the ways in which health care organizations influence attrition among women physicians of color.
– – Consider and accommodate for the effects of health care system changes on physicians, especially women physicians. Identify high-yield metrics to help determine success with diversity, equity and inclusion (DEI) programs and retention efforts.
– – Develop trusted mechanisms for employees to provide anonymous feedback to leadership.
– – Establish transparency into DEI measures and employee feedback, and develop an accountability framework that tracks plans to address inequities and outcomes.
– – Evaluate compensation, benefits, opportunities, and resources to ensure equity among genders and races.
– – Compensate for the diversity tax.
– – Revitalize employees’ sense of meaning and community at work.

This qualitative research also aligns with growing body of research that moral injury, rather than personal characteristics, is an important driver of physicians’ decisions to leave the workforce. In addition to the COVID-19 pandemic, interviewees reported several systemic issues leading them to feel stress and burnout including institutional racism, individual acts of discrimination committed by patients and colleagues, increased focus on revenue generation, decreased boundaries between work and personal life due to technology, and pressures to take on uncompensated diversity and equity work.