Lifestyle issues, an aging workforce, and more women are all affecting physicians’ hours and the number of patients they see.
Physicians may feel like they've been working longer hours, but they aren't, according to the Medical Economics Continuing Survey of MDs and DOs in office-based practices. The median workweek of primary care doctors in 2004 is 50 hours, just what it was last year. That plateau is a far cry from the 55 hours doctors averaged in 2001, though. But if hours have stabilized, the number of patients primary care doctors see during those hours continues to fall-to a median of 108 in 2004 from 112 just last year.
Of course, not all physicians are working fewer hours or seeing fewer patients. In fact, some country doctors are doing just the opposite, says Kenneth Bowden, a practice management consultant in Pittsfield, MA. "I work primarily in rural areas, and our clients are tending to work more hours and see more patients to make up for the lower payments from managed care plans," he says.
Our data show that primary care doctors in rural areas work 55 hours a week, five hours more than their urban and suburban colleagues. But that's down from 60 hours a week in 2001.
A changing workforce translates to fewer hours But the chief reasons for the shrinking workweek appear to be lifestyle factors, the aging of the workforce, and the increasing number of female physicians.
Consultants point out that as the proportion of women doctors has risen-from 21 percent of all physicians in 1995 to 25 percent in 2002-the median workweek has fallen. They note that full-time female physicians tend to work fewer hours than men, and that more of them work part time in order to help raise their families. And our data bear that out. Among all survey respondents, men put in 55 hours a week and women, 47.
Some physicians of both sexes cut back their hours as they grow older, notes Anders, and the physician workforce as a whole is aging. By the time they approach retirement, many are practicing part time or are dividing their time between clinical practice and administrative or teaching duties, says Steve Messinger, a consultant in Arlington, VA.
"Ten years ago, you either worked full bore or you were out. But now I have a good number of cardiology and ob/gyn groups that permit partial retirement," observes Anders.
This trend underlines another reason why doctors are working less: they want a life. Doctors who started practicing in the '70s and '80s would routinely toil 60 to 80 hours a week, notes Anders. But today's doctors "understand the toll there was on medical marriages because their predecessors worked so hard and so long. And I don't think they want to do that. They want to have a family and coach their kids in Little League."