More Evidence Doctors' Work Hours Dropped During the Pandemic

Jake Remaly

June 23, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Physicians' weekly work hours decreased significantly after COVID-19 emerged in the United States, according to a research letter published online June 23 in JAMA Network Open. Researchers also found a decline in the percentage of physicians working full time and a rise in the percentage who were laid off.

"[P]hysicians' work hours have significantly decreased since the start of the COVID-19 pandemic in the US, accelerating an existing, gradual decline," write Xiaochu Hu, PhD, and Michael J. Dill, both with the Association of American Medical Colleges, in Washington, DC. "These observed changes may reflect the decrease in health care utilization and the increased flexibilities instigated by COVID-19–driven regulations."

For the study, Hu and Dill analyzed monthly data from the Current Population Survey administered by the US Bureau of the Census. Participants were interviewed eight times over 16 months. The analysis included 8853 observations from 2563 physicians.

In January 2019, the average number of hours worked per week was 50.8. By March 2020, the average had dropped to 49.2 hours per week. It reached the lowest point in May, at 47.5 hours per week, according to the researchers' estimates.

Hours stabilized over the summer and declined again in November 2020. The average number of weekly work hours in December 2020 was 47.8, about 6% less than in January 2019, the researchers report.

The proportion of doctors working full time declined from 84.17% before COVID-19 to 80.65% during the pandemic. The percentage who reported to still have the same activities at work fell from 83.9% to 78%. In addition, the percentage of doctors who were laid off increased from 0.05% to 0.45% during the pandemic.

The survey data show a disproportionate effect on female physicians with children, which the researchers suggest may be the result of increased childcare responsibilities. Although the percentage of full-time physicians who were parents of preschool-aged children did not significantly change among men, that percentage decreased from 17.98% to 14.10% among women.

The authors note that the sample size was relatively small and that further work is needed to understand the effects of the pandemic on the physician workforce.

The data are generally consistent with the Medscape Physician Compensation Report 2021. Published in April, the Medscape report is based on survey responses from nearly 18,000 physicians between October 2020 and February 2021. Doctors answered questions about the hours they worked, income, bonuses, and challenges.

Twenty-two percent saw a reduction in their hours, 6% had to work part time instead of full time, 5% were furloughed, and 2% were laid off.

For physicians whose work hours declined at points during the pandemic, their work hours appeared to be back to where they were before COVID-19. Respondents reported working an average of 50 hours per week prior to the pandemic, vs 51 hours per week currently.

Despite working similar hours, physicians may be seeing changes in patient volumes. The Medscape survey showed relatively large declines in dermatology (141 patients per week before; 119 now) and ophthalmology (from 132 to 117), for example. At the same time, those in critical care saw an increase (from 56 to 66), as did those in infectious diseases (from 66 to 78).

The study authors have disclosed no relevant financial relationships.

JAMA Netw Open. Published online June 23, 2021.

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