(February 23, 2010 - Insidermedicine)

Insight into why physicians have been working fewer and fewer hours over the past decade is provided by research published in the Journal of the American Medical Association.

According to the World Health Organization:

•       An estimated 57 countries are short 2.3 million physicians, nurses, and midwives

•       Many countries do not have enough skilled health care workers to provide basic, essential care

•       Africa has, and will likely to continue to have, some of the worst problems with regards to health care worker shortages

Researchers from Dartmouth College in Hanover used US census data to track changes in the number of hours per week worked by physicians between 1976 and 2008. The investigators also looked at the relationship between changes in work hours and per hour fees.

While the number of hours worked per week by US physicians remained steady in the early 1990s, it dropped by 7% between 1996 and 2008. The steepest drop in hours occurred among residents, nonresident physicians under the age of 45, and those working outside of hospitals. It was smallest among physicians aged 45 and older and those working in hospitals. After adjusting for inflation, physician per hour fees also dropped by 25% between 1995 and 2006. In 2001, hours worked per week were among the fewest for physicians working in metropolitan areas where fees are among the lowest.

Today's research suggests that lowering of physician fees and increasing market pressure may drive physicians to work fewer hours, an effect that should be taken into account when developing health care reform policies.