Physicians Working Fewer Hours a Week

Physicians in various specialties, of all ages, both genders and employed in different settings are working fewer hours a week, but the largest decrease in the number of hours is among younger physicians, according to a recent study published in the Journal of the American Medical Association, or JAMA.

The decrease in hours among physicians bridges the spectrum, according to the JAMA study "Trends in the Work Hours of Physicians in the United States," but the largest decrease has been for nonresident physicians who are younger than 45 years old, perhaps reflecting the younger cohort's preference for balanced lifestyles.

According to the study, from 1977 to 1997, physician hours were stable at about 55 hours a week. But between 1996 and 2008, the mean, or average, number of hours physicians worked per week decreased from almost 55 to 51, or 7.2 percent.

"The decrease in hours worked by nonresident physicians during the last decade was broad-based and not concentrated among physicians with particular demographic characteristics or working in particular settings," the study says. "Between 1996-1998 and 2006-2008, hours worked decreased significantly among younger and older physicians, male and female physicians, physicians employed in hospital and nonhospital settings, and among self-employed and non-self-employed physicians."

The largest decrease during this decade, however, was for nonresident physicians younger than 45 years old, according to the study. Their hours declined from about 54 to about 50 hours a week, or 7.4 percent. "Decreases in hours were larger for younger physicians, which might suggest that preferences for balanced lifestyles among younger cohorts are a partial explanation," for the decrease in work hours, says the study.

In addition to lifestyle preferences, another possible reason for the decline is lower physician fees, which decreased substantially from 1995, according to the study. When fees decrease, a physician earns less for working an additional hour and may have less incentive to work long hours. However, the relationship between fees and work hours is "mixed," the study says.

The study's findings are no surprise to Chris Lupold, M.D., of Lancaster, Pa., new physician member of the AAFP Board of Directors. Lupold, 34, told AAFP News Now in an e-mail interview that it's a good thing physicians want to balance their professional and family lives.

Lupold practices with four other physicians at Strasburg Family Medicine, which is part of the multispecialty Lancaster General Medical Group. He says he works about 50 hours a week, which is close to the average number of hours of physicians in various specialties revealed by the study.

"I personally think it is good news that doctors are trying to find a better work-life balance. I enjoy the time I am able to spend with my 3-year-old son and wife," Lupold says, adding that flexible hours allow him to get involved in a number of professional activities.

Lupold, who works about 50 hours a week, says he logs 32 scheduled patient care hours a week. The remainder of the workweek is spent completing charts, reviewing test results, and providing inpatient pediatric and maternity care.

The addition of computer and communications technology and mobility, however, means that he actually may be devoting more hours to work each week, says Lupold. Nevertheless, he believes balance is important to family physicians.

"My first job after residency required many more hours of work and was less than desirable when my son was born. I also think the intensity of the time spent in the office and the level of care provided necessitates fewer hours worked to prevent burnout," Lupold says. "I do agree that family doctors in general are interested in balance in life."

In fact, in his practice, which has two male and three female physicians, only one is working 36 patient care hours a week, or full-time, he says.