Changes in Physician Work Hours and Implications for Workforce Capacity, 2001 to 2021

Abstract

To the Editor We read with interest the recent cross-sectional study by Drs Goldman and Barnett 1 on the gap in physician work hours between men and women, which has gradually narrowed during the past 20 years. We agree with the authors that a lack of information on physician specialty in the Current Population Survey was an important study limitation. In the US, the most influential confounder on physician work hours from 2001 to 2021 was the introduction of the hospitalist workforce. A study in 2022 2 reported a 50% growth rate of adult hospitalists, defined strictly by the claims pattern in 2012 to 2019. The authors identified 44 037 actively practicing adult hospitalists in 2019, comprising 1 of the top 5 largest physician specialties in the US.The hospitalist workforce compared with all other medical specialties pays tremendously higher attention to the design of scheduling and workload. 3 Hospitalists typically use block schedules of 7 days consisting of 12-hour shifts, followed by 7 days off; although 14-day block schedules are also used in some programs. Notably, to our knowledge, no significant differences in hospitalist scheduling or shift design between men and women have been reported. With the growth of hospitalists and women physicians who dominate the hospitalist workforce, the average weekly work hours will undoubtedly equalize among genders, converging to the mean with time. Therefore, the growth of hospitalists may explain the decrease in work hours and the gap between genders.