Mounting evidence finds that women working in health care are experiencing disproportionately more feelings of burnout during the pandemic, as they're more likely to carry primary responsibility of family care such as meal preparation, shopping and family activities -- on top of caring for their patients.
A recent study in The Lancet found nearly half of female U.S. health care workers -- 49.4% -- experienced burnout, compared to 41.5% of men. Also more common among women was self-reported prevalence of some mental health issues, with 39.3% of women reporting experiencing anxiety and depression, compared with 26.4% of men. On the flip side, more men -- 55.5% -- said they felt valued by their organizations, compared with 45.9% of women.
"Before the pandemic, I had some work-home balance and was beginning to experience some burnout, but this was magnified during the pandemic," said Dr. Maritza Brown, a board certified nephrologist and associate program director of inpatient medicine at Elmhurst Hospital in Queens, New York. She was a physician on the front lines at Elmhurst, one of the hardest hit hospitals during the onset of the pandemic.
During the initial rise of the novel coronavirus, Brown found herself in a difficult situation of caring for many sick patients on the front lines, then coming home after a demanding hospital shift to carry out her responsibilities as a mother. Luckily Brown's family stepped up for her, including her sons, who helped take care of the housework before she got home from her shifts.
"My family did more of the caring than I did," she said. "They took over all the house chores and insisted that I rest while I was home."
Burnout in health care was already a major problem prior to the pandemic. Doctors and other health care staff are often expected to be available 24/7, leading to an unhealthy work-life balance.
Burnout is more likely among female physicians due to gaps in career advancement, unequal pay and expectations about family and child care, relative to men.
"When individuals are burned out, they're fatigued, they have no energy, they feel completely depleted. The demands that are placed upon them outweigh their resources," said Dr. Janet Taylor, a board-certified psychiatrist in Sarasota, Florida. "They really feel like they are just completely stuck."
All of these problems compounded when the pandemic hit. Many women in health care feel the system has failed them.
"An approach to personal resilience will fail miserably when trainees meet dysfunctional systems that perpetuate clinician burnout," said Dr. Vineet Arora, the dean of medical education at University of Chicago.
"We can't teach a canary to be more resilient in the same coal mine. We have to change the environment to foster a culture of well-being. We need to shift our focus to building a more resilient coal mine," added Dr. Heather Farley, chief wellness officer at ChristianaCare.
Burnout in health care affects everyone -- from doctors to patients to family members. That's because when health care professionals are burned out, they make mistakes. Many quit.
"When the health care teams are burned out, there are more medical errors, lower patient satisfaction, poorer communication and worse patient outcomes," said Dr. Susan Hingle, an internal medicine physician at the Southern Illinois University School of Medicine and the associate dean for human and organizational potential, with a focus on wellness in health care staff.
Fixing burnout among female health care workers won't be easy, experts say. The first step is talking about it openly so women feel less shamed and more encouraged to seek help. Next is addressing systemic issues like wage inequality. For instance, a 2013 study published in JAMA Internal Medicine found an annual pay gap of $51,315 between male and female physicians at U.S. public medical schools.
"I emphasize to all of my students that if they are feeling burned out, it is not a failure on their part, but due to a system that many of us are working on trying to change," said Dr. Shikha Jain, a board-certified hematology and oncology physician and assistant professor of medicine at the University of Illinois Cancer Center in Chicago. "Hospitals and institutions must start valuing their health care workers as more than just cogs in a wheel."
Some large medical organizations are encouraging health care professionals to seek help themselves and watch out for one another.
"Talk to a psychologist or psychiatrist or coach if you find that you are approaching a state of burnout, to ask for help," Taylor said. "So often as women, and in particular, professional women, we feel like we have to be super women and don't ask for the help that we need."
Alexis E. Carrington, M.D. is an ABC News Medical Unit associate producer and a rising dermatology resident at George Washington University. Dr. Jay Bhatt is an internist, instructor at UIC School of Public Health and an ABC News contributor.