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Background Prior research indicates that female physicians spend more time working in the electronic health record (EHR) than do male physicians. Objective To examine gender differences in EHR usage among primary care physicians and identify potential causes for those differences. Design Retrospective study of EHR usage by primary care physicians (PCPs) in an academic hospital system. Participants One hundred twenty-five primary care physicians Interventions N/A Main Measures EHR usage including time spent working and volume of staff messages and patient messages. Key Results After adjusting for panel size and appointment volume, female PCPs spend 20% more time (1.9 h/month) in the EHR inbasket and 22% more time (3.7 h/month) on notes than do their male colleagues (p values 0.02 and 0.04, respectively). Female PCPs receive 24% more staff messages (9.6 messages/month), and 26% more patient messages (51.5 messages/month) (p values 0.03 and 0.004, respectively). The differences in EHR time are not explained by the percentage of female patients in a PCP’s panel. Conclusions Female physicians spend more time working in their EHR inbaskets because both staff and patients make more requests of female PCPs. These differential EHR burdens may contribute to higher burnout rates in female PCPs.