Physician work hours dropped in last decade

Following a 20-year period of stability, the average weekly hours worked by physicians have decreased by about 7% between 1996 and 2008, according to the results of a recent study.

After adjusting for inflation, Douglas O. Staiger, PhD, and his colleagues also found a 25% nationwide drop in average physician fees between 1995 and 2006 which coincided with the decrease in physician work hours. The results of the study, which appear in the February issue of the Journal of the American Medical Association, may have implications regarding the way that reform efforts and market forces impact the physician workforce in the future.

“Our findings are consistent with the possibility that economic factors such as lower fees and increased market pressure on physicians may have contributed, at least in part, to the recent decrease in physician hours,” Staiger and colleagues wrote in their study. “Further reductions in fees and increased market pressure on physicians may, therefore, contribute to continued decreases in physician work hours in the future. Whatever the underlying cause, the decrease in [average] hours worked among U.S. physicians during the last decade raises implications for physician workforce supply and overall health care policy.”

U.S. Census Bureau data

The researchers examined physician work hours using U.S. Census Bureau data between 1976 and 2008. They also analyzed whether work trends were associated with trends in physician fees, according to a JAMA press release. The study included 116,733 monthly surveys of physicians from 27,874 households.

The researchers discovered that work hours for physicians remained stable at about 55 hours per week between 1977 and 1997, according to the release. However, they found that the hours steadily declined to 51 hours per week between 1997 and 2007.

Resident hours

In addition, they discovered that the work hours significantly decreased for the decade spanning between 1996 and 1998 and 2006 and 2008 for resident physicians (9.8%) and all other physicians (5.7%). They found that resident work hours were high through 2002, but decreased after resident work hour restrictions were implemented in 2003.

“Between 1996 to 1998 and 2006 to 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 nonself-employed physicians,” the researchers wrote. “[Among nonresident physicians], the decrease in hours during this period was largest for [those] younger than 45 years (7.4%) and those working outside of the hospital (6.4%), and the decrease was smallest for those aged 45 years or older (3.7%) and for those working in the hospital (4%).”

Staiger DO. JAMA. 2010;303:747-753.