According to a recent study, female surgeons write progress notes that are, on average, 40% longer than those written by male surgeons.

The study, published in JAMA Network Open, investigated gender differences in electronic health record (EHR) usage among surgeons at a single academic hospital. This cross-sectional study analyzed data from 224 attending surgeons, including 68 females (30%) and 156 males (70%), using the Epic Signal EHR system from January to December 2022.

The study measured outcomes such as progress note length, documentation length, time spent in medical records, and time documenting patient encounters. Statistical analysis included the Kruskal-Wallis test for continuous variables and the χ2 test for categorical variables. Multivariate linear regression was utilized, with primary EHR usage metrics as the dependent variables and surgeon characteristics as the independent variables.

EHR data was used to collect variables defining surgeon characteristics (gender, specialty, academic position, time in practice since residency), EHR variables (time in system, appointments, documentation characteristics, level of service, turnaround time, messaging/calls, orders), and patient characteristics (age, items on problem list). Time spent outside of scheduled clinic hours was defined as time logged into the EHR system 30 minutes before the first and after the last appointment on clinic days.

The study found that male surgeons had more median appointments per month (78.3 vs. 57.8; P = .005) and completed more medical records per month (43.0 vs. 29.1; P = .006) compared with female surgeons. Although the total monthly EHR time did not differ significantly (664.1 vs. 635.0 minutes; P = .89), female surgeons spent more time logged into the system outside of 7 am to 7 pm (36.4 vs. 14.1 minutes per month; P = .05) and outside scheduled clinic hours (134.8 vs. 105.2 minutes per month; P = .05). Female surgeons also spent more time per note (4.8 vs. 2.5 minutes; P < .001) and wrote longer progress notes (6025.1 vs. 4307.7 characters; P = .001) and outpatient documents (6321.1 vs. 4445.3 characters; P < .001).

Multivariate linear regression revealed that male gender was associated with reduced documentation length (−1106.9 characters; P = .01) and progress note length (−1119.0 characters; P = .01). Male surgeons completed more total hospital medical records (47.3 records per month; P < .001).

“The reasons behind the differences in patient volume and medical record writing between male and female surgeons warrant further exploration,” stated researchers.

Variations in career choices and preferences may contribute to these disparities, as female surgeons often opt for lighter schedules to balance personal and professional responsibilities, resulting in a lower patient load, they noted. It was also mentioned that the administrative burden of EHR usage affects patient volume, as female surgeons spend more time on documentation, reducing time for patient care.

The researchers emphasized the need for policy interventions to address these disparities and promote equity in compensation and physician well-being.

The full list of disclosures can be found in the original study.