Gender Differences in Time Spent on Parenting and Domestic Responsibilities by High-Achieving Young Physician-Researchers

By S. Jolly, Kent Griffith, R. Decastro, A. Stewart, P. Ubel, Reshma Jagsi. Annals of Internal Medicine, 2014

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The traditional family unit, headed by a breadwinning husband and stay-at-home wife, now characterizes a minority of American households (1). Women have entered the workforce in large numbers over the past few decades, and family structures are considerably more varied than in the past. In families headed by a married couple, responsibility for parenting and domestic activities has been more evenly divided (2). Nevertheless, women in the general population still spend more time on parenting and housework than men (3). Scholars have noted that this may reflect rational economic calculations in the face of a market that still pays men more than women (4), or it may be driven by deeper sociocultural barriers to changes in traditional gender roles (5). In elite professions, such as medicine, where earning potential and professional demands are high and members have self-selected for career commitment by pursuing lengthy training, one may expect to observe less, if any, gender difference in time spent on domestic responsibilities. A recent study of surgeons suggested that although burnout rates were similar among men and women, women were more likely to experience workhome conflicts (6). However, little research to date has considered how highly career-driven contemporary male and female physician-researchers allocate time to professional and domestic responsibilities. Examining gender differences in the nonprofessional responsibilities of physicians is particularly important because of growing evidence that female academic physicians are still not achieving career success at the same rate as their male colleagues (710). Understanding gender differences in nonprofessional responsibilities may help to explain this gap. We investigated these issues in a survey study. To minimize variability in commitment to career and nature of work, we focused on physician-researchers who had received career development awards from the National Institutes of Health (NIH). We selected both K08 and K23 awards, which are highly selective grants made to early-career researchers who hold clinical doctorate degrees to support their career development. We focused on persons who recently received these awards to capture the experiences of Generation X because most recent K award recipients would have been raised when it was common for mothers to work outside the home. Their attitudes have been documented to be relatively egalitarian, both in general (11, 12) and specifically within the medical profession (1316). In so doing, we investigated whether gender differences exist in time allocation within a population in which differences may not be expected and, if present, would lend insights about the causes of gender differences in domestic labor more generally and relevant information for policy development specifically within the medical profession. Methods Data Collection We identified 1719 recipients of new K08 and K23 awards from 2006 to 2009 using the NIH RePORTER (Research Portfolio Online Reporting Tools Expenditures and Results) database. After approval from the institutional review board, we conducted Internet searches and telephone calls that identified valid U.S. mailing addresses for 1708 persons, to whom we mailed a questionnaire and $50 incentive. Nonrespondents received follow-up mailings (17). We merged survey responses to data previously collected from RePORTER. Measures We designed the questionnaires after review of the relevant literature; consideration of other instruments used to determine time allocation, responsibilities, and the outcomes of academic careers (18, 19); and cognitive pretesting (20). The final questionnaire included 173 items that assessed demographics, education, time allocation, mentoring experiences, family responsibilities, career satisfaction, and work environment (Appendix Tables 1, 2, 3, and 4). Appendix Table 1. Multivariable Linear Regression Model to Explain Time Spent on Research Appendix Table 2. Multivariable Logistic Regression Model to Explain Time Spent on Teaching Greater Than the Median for Married or Partnered Respondents With Children Appendix Table 3. Frequency and Percentage of Respondents Reporting Teaching Time Greater Than 1 Hour per Week Appendix Table 4. Multivariable Linear Regression Model to Explain Time Spent on Clinical Duties for Married or Partnered Respondents With Children Time Allocation To evaluate time spent on domestic labor, we asked how many hours were spent on parenting and domestic tasks on a typical workday (including the evening) and on a typical weekend (including both days). Definitions were provided: Parenting includes meeting physical needs (such as feeding or bathing), as well as meeting psychosocial needs (such as talking or playing with children, driving them to activities and attending their recitals or sporting events). Domestic Tasks include cooking, cleaning, laundry, home maintenance, yard work, shopping for necessities, errands, finances and other such activities. A continuous variable reflecting weekly total time spent on parenting or domestic tasks was created. We also asked respondents to describe the percentage of all time spent on parenting or domestic tasks by the respondent, their spouse or domestic partner, employed help, relatives, and others. To evaluate time spent on paid labor, we asked respondents to think about their most frequent weekly working pattern and to estimate the total number of hours worked. We then asked how many of those hours were spent on patient care (including time spent rounding with trainees when a primary purpose is patient care), research, and teaching (defined as formal didactic teaching unrelated to patient care or research). Family Responsibilities We inquired whether respondents had children and, if so, asked for their children's ages. We asked, Do your children require adult supervision or care? and gathered information on who provided that care during work hours (school, day care, family member, nanny or babysitter, spouse or domestic partner, or other). Satisfaction with child care arrangements was ascertained using a 5-point response scale. We also asked: When your children are ill, when school or institutional care is closed (such as during holidays or vacations), or when other disruptions in your usual child care arrangements occur, who usually stays with your children? Respondents selected 1 option: I usually do, My spouse or partner usually does, My spouse or partner and I usually alternate, A friend or neighbor usually does, I usually bring my children to work, A family member usually does, or Other. Additional items, using 5-point response scales, inquired, When you have after hours work (e.g., manuscript writing or grant writing, dinner meetings) to attend to, how easy is it for you to get such work done? (for which responses were dichotomized as difficult vs. so-so or easy) and, How often does child rearing and/or family responsibility currently interfere with your ability to get work-related things done? (for which responses were dichotomized as always, frequently, or sometimes vs. infrequently or never). Individual Characteristics We determined the respondent's age (continuous), gender, specialty (grouped by nature into 5 categories as detailed elsewhere [9, 21]: medical [internal medicine and related subspecialties]; surgical [general surgery and surgical subspecialties]; hospital-based [for example, radiology, pathology, and anesthesiology fields]; relating to care of women, children, and families [family medicine, obstetrics and gynecology, pediatrics, and related subspecialties]; or basic sciences), PhD degree (yes or no), and spousal employment (full-time, part-time, or not employed) through self-report. Statistical Analysis We conducted statistical analyses using SAS, version 9.2 (SAS Institute, Cary, North Carolina). We compared respondents with the remainder of the initial target population for gender, K award type and year, and institution (ranked by total NIH funding) using chi-square or Fisher exact tests for categorical data and 2-sample t tests or the Wilcoxon rank-sum test for continuous data. The analytic sample was limited to persons who held MD degrees and were still affiliated with U.S. academic institutions. We described the characteristics of this sample by gender and constructed a multivariate linear regression model to explain the time spent on domestic labor. Time spent on domestic labor was assessed graphically and using other diagnostics and was found to be normally distributed. The model was restricted to the married or partnered population with children using the following theoretically selected respondent characteristics: gender, age, age of the youngest child, number of children, weekly work hours, race, spousal employment, K award type, specialty nature, and MD or MD/PhD status. Most characteristics were categorical and modeled as indicator variables with a reference category. Continuous variables were centered at their medians. We also constructed linear regression models to test for the independent associations of gender with time spent on clinical and research activities. For time spent on teaching, we constructed a logistic regression model for the odds of spending more than the median time of 1 hour on teaching, given the lack of a sufficiently normal distribution for a linear model. We constructed CIs for proportions from categorical data using the exact binomial distribution or the multinomial distribution (22). For statistical inference, we conducted 2-tailed tests and considered P values of 0.05 or less to be significant. Role of the Funding Source This work was supported by the NIH. The funding source had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript. Results Of the 1719 K awardees identified, 1708 were surveyed, with 1435 of those surve

Subfields: Gender Studies, General Health Professions, Sociology and Political Science

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