In an age of rapid physician burnout, one clinical cardiologist is calling for stronger practice policies to ensure a better work-life balance.

Emelia Benjamin, MD, ScM, is the assistant provost for faculty development at Boston University’s School of Medicine and a practicing clinician at Boston Medical Center. At the American College of Cardiology’s annual conference in Orlando, she presented findings from two decades of ACC professional life surveys—and they weren’t comforting.

The greatest disparity, Benjamin said, was the percentage of ACC U.S. cardiovascular physicians who were women. From 2006 to 2015, the number of female cardiologists rose just 2 percent—from 19 to 21 percent—and by 2017 less than 20 percent of cardiology fellows were women.

“The fact that we’ve make so little progress is very striking,” Benjamin said. “We’re probably going to be in the next century before we get parity, and that’s disturbing.”

Though nearly half of internal medicine residents are female, fewer continue into a specialized cardiology field, and women are 29 percent more prone to burnout than their male colleagues. Practice administrators shouldn’t ignore that, Benjamin said—data have shown burned out physicians do leave, and losing a cardiologist can cost a practice hundreds of thousands of dollars.

The professional life surveys also identified female cardiologists as the busiest during off-hours, with greater numbers of women than men reporting they have to invest in childcare and are restricted from advancing in their careers due to family-related roadblocks.

While just 20 percent of male cardiologists said parenting or other family responsibilities have had a negative effect on their career advancement, 37 percent of women said the same thing. Thirty-eight percent of women—compared to 29 percent of men—also said their family responsibilities disrupted their ability to work, and more female cardiologists said professional advancement opportunities were hindered by family duties.

The sexes agreed more closely with their administrative unit’s family leave policy. While few respondents said they were dissatisfied with their practice’s policy, just 18 percent of female cardiologists said they were satisfied, Benjamin said. Women were also 5 percent less likely than men to be very satisfied with their professional life and 9 percent less likely to be satisfied with their family life.

Benjamin said one of the greatest gender gaps is apparent in salary comparisons, since female cardiologists earn, on average, $33,000 less per year than their male counterparts. They also appear to be discriminated against more often in the office, with 65 percent of women reporting workplace discrimination in 2015 compared to 23 percent of men. Women were more likely to experience gender discrimination, while men were more commonly discriminated against for race and, to a lesser extent, religion.

Better family policies will be key to improving these rates, Benjamin said, since it’s clear that family dynamics play an influential role in cardiologists’ professional lives. And though women cardiologists seem to be more drastically underpaid and underappreciated, administrators should work to maintain a healthy work-life balance in both men and women.

“We’re at the bottom of the barrel,” Benjamin said. “We can do better.”