Will Women Physicians Face an AI Gap?

So one of the things you talk about in the piece, I think you actually open with this, is the observation that technologies that we think will make us more efficient don't always make us more efficient, the productivity paradox.

Yes.

And there's a stat in the article that I couldn't believe about the number of notes for a patient presenting going from like five to hundreds.

So how did we get here?

In my deep dive, among the things that I learned was that over time, over the last 20, 30 years, we have seen this like astronomical growth in the administration of medicine and not this same growth in the physicians who are delivering this care.

So as we think about the administrative challenges, EHR adoption, quality metric reporting, billing, prior auths, you name it, portal messages, all of that has grown astronomically.

And the doctors who are doing it have not grown that much.

One of the stats that was this incredible paper that was called, Call Me Dr. Ishmael.

And it was about the note count.

This has sort of happened during my career.

It has, in fact, happened during my career.

So if you go now to the emergency department to see a patient, if you went in 2006 to go see a patient, the chart that you had to review had five notes.

If you go in 2022 when the study was done, that same chart had 359 notes.

How we've delivered medicine over that last 20 years or 15 years has not changed that much, but what we have to consume and how we have to consume it has changed dramatically.

The reason for the title of the paper was they actually say that 20% of charts now are longer than Moby Dick, which is just an extraordinary volume for what is needed to be consumed.

Even in the last five years from 20 to 2025, there was also a study that actually demonstrated the number of portal messages that people are receiving and that that portal message volume has gone up by two and a half fold just in the last five years.

Patients know that they can hit click and reach a physician.

And so AI actually has a lot of promise to decrease the administrative burden, to decrease what we have to take in or how we can consume it and to help with the portal messages.

But I'm guessing for the docs who are listening, that's no big surprise.

But what might be a surprise is just how disproportionately that shift seems to impact women.

And also some stats in the paper about women physicians spending more time in the EHR and on documentation and getting more portal messages.

This one was harder for me to get my mind around.

I mean, why would there be such a gender difference?

So I think you're highlighting several studies done by different people looking at different things, like how much time people are spending in the EHR.

Over 40 minutes more per women compared to men spent in the EHR.

So one of the things you talk about in the piece, I think you actually open with this, is the observation that technologies that we think will make us more efficient don't always make us more efficient, the productivity paradox.

Yes.

And there's a stat in the article that I couldn't believe about the number of notes for a patient presenting going from like five to hundreds.

So how did we get here?

In my deep dive, among the things that I learned was that over time, over the last 20, 30 years, we have seen this like astronomical growth in the administration of medicine and not this same growth in the physicians who are delivering this care.

So as we think about the administrative challenges, EHR adoption, quality metric reporting, billing, prior auths, you name it, portal messages, all of that has grown astronomically.

And the doctors who are doing it have not grown that much.

One of the stats that was this incredible paper that was called, Call Me Dr. Ishmael.

And it was about the note count.

This has sort of happened during my career.

It has, in fact, happened during my career.

So if you go now to the emergency department to see a patient, if you went in 2006 to go see a patient, the chart that you had to review had five notes.

If you go in 2022 when the study was done, that same chart had 359 notes.

How we've delivered medicine over that last 20 years or 15 years has not changed that much, but what we have to consume and how we have to consume it has changed dramatically.

The reason for the title of the paper was they actually say that 20% of charts now are longer than Moby Dick, which is just an extraordinary volume for what is needed to be consumed.

Even in the last five years from 20 to 2025, there was also a study that actually demonstrated the number of portal messages that people are receiving and that that portal message volume has gone up by two and a half fold just in the last five years.

Patients know that they can hit click and reach a physician.

And so AI actually has a lot of promise to decrease the administrative burden, to decrease what we have to take in or how we can consume it and to help with the portal messages.

But I'm guessing for the docs who are listening, that's no big surprise.

But what might be a surprise is just how disproportionately that shift seems to impact women.

And also some stats in the paper about women physicians spending more time in the EHR and on documentation and getting more portal messages.

This one was harder for me to get my mind around.

I mean, why would there be such a gender difference?

So I think you're highlighting several studies done by different people looking at different things, like how much time people are spending in the EHR.

Over 40 minutes more per women compared to men spent in the EHR.