Pro Bono Work and Nonmedical Volunteerism Among U.S. Women Physicians

Erica Frank, M.D., M.P.H., Jason Breyan, M.A., Lisa K. Elon, M.S., M.P.H.

Disclosures
In This Article

Results

Among women physicians, 71% participate (n 5 4501 respondents) in either pro bono work (among those participating in this service, a median of 4 hours/week), nonmedical volunteering (2 hours/week), or both ( Table 1 ). The total median number of hours per week given in either a medical or nonmedical setting for all women physicians (both those participating, and those not participating) was 2.2 (not shown). Among physicians, 19% provided >5 hours/week of pro bono care and 6% volunteered >5 hours/week (not shown).

Just over half of women physicians reported volunteering their time in patient pro bono work, and just under half reported volunteering their time in nonmedical volunteer work ( Table 2 ). Medical and nonmedical volunteering were highly intercorrelated. The youngest physicians were least likely and African American physicians were most likely to be nonmedical volunteers, and the youngest and oldest physicians were less likely to perform pro bono work. Those married to physicians were less likely and those with children (especially those with more children) were more likely to nonmedically volunteer. Mormons and Muslims (with sample sizes of only 11 and 55) were more likely than many other religious groups to perform pro bono work. Atheists and those with less religious fervor were less likely to nonmedically volunteer. Bivariately, marital status, sexual orientation, parental educational level, and stress levels at home were not significantly related to medical or nonmedical volunteering (data not shown). Conservative political orientation was marginally associated (p = 0.015) with more nonmedical volunteering.

Pro bono work was more likely to be performed by those in nonprimary care and by subspecialty-trained physicians (especially neurologists, ophthalmologists, psychiatrists, and surgeons), solo, two-physician, and rural practitioners, those working more clinical hours, with more work stress, or with more night call, and those reporting higher personal or household incomes ( Table 3 ). Family and solo practitioners, physicians working in rural locations or nonhospital work sites, those seeing patients part time, and those with less severe work stress were more likely to report nonmedical volunteering. Reported amount of control of one's work environment was not significantly related to either pro bono work or nonmedical volunteerism.

Using multivariate logistic regression to model the relationship of bivariately significant characteristics with the provision of pro bono service ( Table 4 ), the odds of providing any pro bono service were higher for subspecialty trained physicians, for solo practitioners and two-physician practices, and for those practicing in rural locations, taking call, or working over 40 hours a week. Additionally, the odds increased linearly with increasing nonmedical volunteering.

An additional model (not shown) was prepared for looking at characteristics associated with higher levels of pro bono giving (>5 hours/ week). Higher odds of extensive pro bono giving were associated with being nonwhite, having children, belonging to a religious group, volunteering >5 hours/week, being an anesthesiolo-gist or surgeon (compared with being in primary care), having subspecialty training, being a solo physician or rural practitioner, working >59 hours/week (compared with any other category), taking call, and higher work stress.

Using multivariate modeling, we found that higher odds of doing nonmedical volunteering ( Table 5 ) were associated with being 40-59 years old, being Black, being unmarried or married to a nonphysician, having 2 or more children, having a strong Christian identity or being Muslim (compared with atheist/agnostic/no religion), practicing in a rural setting, working fewer hours, being either politically conservative or liberal (compared with moderate), and performing pro bono service.

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