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The Never-Ending Physician Work Week

Evan Winter

Labor Day is upon us, and most of the American population is preparing for a long weekend of relaxation, likely spent outdoors or at the local pool in order to fully savor what remains of summer. Much of the workforce will enjoy an extra day off, or even two, and some newly settled college students will make the trek back to their parents, already missing the comforts of home. While these people are free to travel and unwind as they please, there are some who will continue working tirelessly.

The non-stop grind

There has been a long history of those in medical practice working extremely long hours without significant breaks or even proper sleep. Residents have been hit the hardest, sometimes working over 100 hours per week, including reported 48-hour shifts. Some relatively recent restrictions have attempted to curb the outrageous number of hours worked by residents but had little effect. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) reduced residents’ average number of hospital hours per week to 80 and capped single shifts at 30. In 2011, the ACGME further restricted shift lengths to 16 hours for first-year residents and 28 hours for all others. Despite such restrictions on hours, workloads failed to adjust. Instead, residents have simply been forced to complete the same amount of work within shorter time frames, and if that cannot not be achieved, work shifts from the hospital to off-duty periods. 

The wrong type of work

Residents are not the only doctors pushed to work outside of their normal hours. Around half of physicians in the United States report logging onto their electronic health records (EHR) to complete documentation from home. One Annals of Internal Medicine study found that physicians on average spent twice the amount of time working on EHRs as they did seeing patients directly. The time imbalance further increased for certain specialties. These responsibilities are made more difficult by the lack of proper systems for each healthcare practice. Many of today’s one-size-fits-all EHRs do not always provide proper input fields or billing codes. This not only makes entering information tedious but also inhibits the transfer of data from one system to another. Altogether, this adds extra time to physicians’ busy schedules, and that is time spent away from helping patients. 

Burnout

Working long hours, which often includes non-clinical duties, quickly pushes physicians toward burnout, an ever-growing concern in medicine. In a 2019 Medscape study, 44% of physicians reported feeling some sort of burnout, with Urology and Neurology specialties being the most affected. That same study cited “bureaucratic tasks”, such as charting and general paperwork, as the largest contributing factors. The combination of being overworked and completing too much of the work not meant for them often leaves physicians feeling underappreciated and depressed. 

Where to find help

While doctors absolutely acknowledge their own struggles, they have difficulty helping themselves out of a bad situation due to the very nature of their positions. There has always been a huge divide between the amount of education and training required for medical jobs and that required of the remaining American workforce. The physician role is also widely considered an exceptional mark of distinction. A 2014 Harris poll found that 88% of adults in the United States consider doctors to hold the most prestigious job in America. Due to the great deal of training and prestige involved in becoming a physician, the competition is fierce at all levels. Physicians are forced to work extremely hard to remain relevant in their field and frequently just to keep their jobs. Some have unionized to fight for greater regulation, but spending time and energy protesting for themselves detracts from providing exceptional treatment for patients. The vast majority of physicians are practicing for a noble cause: they want to help people. 

Empowering Physicians

Over the past few decades, some institutional progress has limited the weekly hours worked. However, it has not been enough to make physicians’ schedules any less full and lives any less stressful. Overworked, sleep-deprived doctors are not only a danger to themselves but to those they treat. More reasonable hours will prevent physicians from experiencing burnout so easily and may attract more individuals to the field of medicine, thus fighting the growing shortage of licensed practitioners. Giving physicians power over their work schedules is essential to improving their individual lives and the state of healthcare overall.