19 Dec Physician Weekly Work Hours Fall Especially for Doctor Fathers
MedicalResearch.com Interview with:
Anna L. Goldman, M.D., M.P.A., M.P.H
Assistant Professor of Medicine
General Internal Medicine
Boston University Chobanian & Avedisian School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians. In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic.
MedicalResearch.com: What are the main findings? Were there gender differences in hours worked?
Response: The average hours worked per week by physicians decreased 7.6% in the two decades between 2001 and 2021. On average, physicians worked 52.6 hours per week in 2001-2003 and 48.6 hours per week in 2019-2021. This decrease did not appear to be caused by the COVID-19 pandemic, as the trend continued on the same steady trajectory that was present prior to the pandemic. The observed decreases were driven by reduced work hours among male physicians, full-time physicians, and younger physicians. Male physicians decreased work hours twice as much as female physicians. Physician mothers were the only group to increase weekly work hours, with a 3% increase over 20 years. Physician fathers, by contract, decreased work hours by 12%. The number of part-time physicians remained flat throughout the study period. Broadly decreasing trends in work hours were similarly present among non-physician holders of doctoral degrees, suggesting a broader trend among highly-educated professionals in their approach to work hours.
The physician workforce grew by 32.9% over two decades, but then fell by 6.7% during the COVID-19 pandemic, or a drop of 1 in 14 physicians. The physicians who left the workforce during the pandemic were disproportionately white and from rural areas.
Work hours generated by the physician workforce, as a whole, grew 7% over the study period, which was about half the rate of population growth in the same period (16.6%). This sluggish growth in physician workforce hours was entirely offset by large increases in the work hours contributed by nurse practitioners and physician assistants. When the clinician workforce was assessed as a whole (combining hours from physicians, nurse practitioners, and physician assistants), growth in total workforce hours was 21.4%, exceeding the population growth rate.
MedicalResearch.com: What should readers take away from your report?
- Physician weekly work hours fell 8% from 2001-2021, with a particularly large drop for physician fathers (-12%) vs. a small increase for physician mothers (+3%).
- Because of this decline in hours, total weekly hours contributed by the physician workforce lagged far behind US population growth, an increase of 7% in work hours vs. 16.6% increase in US population. This gap was entirely offset by a large increase in nurse practitioner and physician assistant hours.
- From 2019 to 2021, the physician workforce fell by 7%, which represents 1 in 14 physicians leaving the workforce during the COVID-19 pandemic.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Research on work hours in individual physician specialties is needed to better understand the distribution of work hour changes across the spectrum of physician types. Measurement of these trends can help predict burnout in specialties where hours may be lengthening vs. shortages in fields with rapidly decreasing work hours.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: Our findings may shed light on the high rates of burnout that has been identified among physician-mothers in other research. While increasing work hours among mothers may indicate progress on gender parity in terms of career engagement, this change may not have been sufficiently offset by a reduction in domestic responsibility. Further research should examine the balance of household duties as physician mothers spend an increasing amount of time at work.
Goldman AL, Barnett ML. Changes in Physician Work Hours and Implications for Workforce Capacity and Work-Life Balance, 2001-2021. JAMA Intern Med. Published online December 19, 2022. doi:10.1001/jamainternmed.2022.5792
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