(February 23, 2010 - Insidermedicine)

Insight into why physicians have worked steadily fewer and fewer hours over the previous decade is provided by research published in the Journal of the American Medical Association.

According to the World Health Organization:

•       By 2015 the global supply of physicians will be roughly in balance with demand

•       Distribution problems will likely persist, however, causing surplus is some regions and shortages in others

•       Countries facing demand-based and needs-based shortages in health care workers should re-evaluate recruitment and training policies

Researchers out of Dartmouth College in Hanover retrospectively analyzed trends in work hours among US physicians between 1976 and 2008 using nationally representative data from the US Census Bureau Current Population Survey. They then compared trends in hours with trends in physician fees.

While mean per week work hours remained stable throughout the early 1990s, they dropped by 7.2% between 1996 and 2008, from 54.9 to 51.0. Resident hours decreased by 9.8%, while nonresident physician hours decreased by 5.7%. The decrease was greatest among nonresident physicians under 45 and those working outside of hospitals. It was smallest among physicians aged 45 and older and those working in a hospital. After adjusting for inflation, mean physician fees decreased nationwide from 1995 to 2006 by 25%. In 2001, physician weekly work hours were less than 49 among those in metropolitan areas where fees are at their lowest.

Today's research suggests that lower fees and increased market pressure may drive physicians to work fewer hours, an effect that should be taken into account when developing healthcare reform policies.