Work hours rise among physician mothers over past 2 decades

While the average number of hours that physicians worked weekly has decreased since 2001, physician mothers have experienced an increase, a new study in JAMA Internal Medicine found.

The rise “could indicate progress on gender parity in terms of career engagement,” Anna Goldman, MD, an assistant professor of medicine at Boston Medical Center, said in a press release, “but our findings may shed light on high rates of burnout among physician mothers found in previous studies, as physician mothers may be working longer hours while still managing significant responsibilities at home.”

According to Goldman and colleagues, physicians’ work hours are an “underexplored facet” of the workforce, which has faced staffing shortages, burnout and other disruptions during the COVID-19 pandemic.

The researchers used federal survey data from 2001 to 2021 to examine trends in weekly work hours. Of 36,137 physicians, 12,120 were women, and 9,890 were aged 35 to 44 years.

There were 14,729 total parents, 4,805 of whom were mothers. The majority of participants (n = 33,241) worked full time.

Goldman and colleagues found that the physician workforce grew by 32.9% over the study period overall but fell by 6.7% during the pandemic.

Weekly work hours dropped by 7.6% (95% CI, -9.1 to -6.1), from 52.6 hours in 2001 to 48.6 hours in 2021.

The downward averages were mainly driven by:

• male physicians, whose hours decreased from 54.1 to 49.7 (-8.1%);
• physician fathers, whose hours decreased from 56.3 to 49.6 (-11.9%);
• rural physicians, whose hours decreased from 52 to 47 (-9.7%); and
• physicians aged 45 to 54 years, whose hours decreased from 52 to 46.9 (-9.8%).

Female physicians had half the decrease that male physicians experienced, only dropping by 4.1%, from 48.8 to 46.8 hours, according to the researchers.

Meanwhile, weekly hours increased among physician mothers by 3%, from 42.7 to 43.9, a sharp contrast when compared with physician fathers.

“Restricting the analysis to physician parents with children younger than 6 years, we found similar results: a 9.6% decrease in weekly work hours for fathers and 3.0% increase for physician mothers,” the researchers wrote.

Goldman and colleagues wrote that the findings may help to address the physician compensation gender gap “but only in regard to total hours worked, as opposed to revenue generated per hour.”

They also pointed out that while longer hours may show improvements in workplace accommodation for physician mothers, it does not necessarily mean there has been progress in household gender equity in work-life balance.

“The gender gap in household labor has been declining since the 1960s, but women still do considerably more housework and childcare than men,” the researchers wrote.

They also noted that the pandemic has exacerbated poor work-life balance among physician mothers. A 2021 JAMA Open Network study previously reported that during the pandemic, 24.6% of physician mothers were responsible for child care and 31.4% were responsible for household tasks compared with 0.8% and 7.2% of physician fathers, respectively.

In the current study, Goldman and colleagues found that trends in physicians’ work hours were offset by a “rapid expansion” of the advanced practice professional workforce. When they assessed the clinician workforce as a whole — physicians, nurse practitioners and physician assistants — there was a 21.4% growth in total workforce hours.

“Nurse practitioners and physician assistants are playing a critical role in filling in the gap created by decreasing work hours and physician workforce losses during the pandemic, alleviating some of the provider access issues patients may encounter,” Goldman said in the release.

References:

• Frank E, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.34315.
• Goldman A, et al. JAMA Intern Med. 2022;doi:10.1001/jamainternmed.2022.5792.
• Physician work hours steadily decreased in the past 20 years but increased for physician mothers. https://www.bmc.org/news/physician-work-hours-steadily-decreased-past-20-years-increased-physician-mothers. Published Dec. 19, 2022. Accessed Dec. 28, 2022.