Despite the survey suggestions linking workload to stress, Charles M. Balch, MD, professor of surgery at the Johns Hopkins University School of Medicine, says he doesn't particularly advocate restrictions on work hours. "There is no evidence that reducing hours would make all doctors more satisfied, or lead to better patient care," Balch says in a statement.
The survey shows that two-thirds of surgeons say they did not want limits put on their hours, including those who work more than 80 hours a week, or are on call more than three nights a week.
"If hours were regulated," he says, "the reality is that people would have to punch time clocks and I don't think surgeons necessarily want their workload monitored."
Co-author Julie Ann Freischlag, MD, senior investigator for the study, and head of the department of surgery at Johns Hopkins University School of Medicine, tells me, however, that while physicians may not want their workload monitored, there should be some flexibility, perhaps reduced work hours reflected in working arrangements with other physicians.
"Different kinds of physicians choose their specialties for all different sorts of reasons," Freischlag says. "Most people find surgeons tend to be aggressive; how much they do. It's just sort of their nature. They tend to move around a lot, don't sit in an office."
Long work hours, indeed, "do not correlate with burnout," Freischlag says. "Physicians like being busy. They like what they do. But sometimes when things go awry and things are conflicted—something is happening at home or work, and they want to be both places at the same time"—and the stress occurs, not unlike the rest of us.
But in the physician workplace, there is an increasing need for "self-regulation" of doctors' hours, particularly surgeons, to offset potential depression or burnout, she says. "There's got to be this realization—yes, it's ok for time off."
"You need time off," Freischlag, 55, says. "The new generation knows they should have time off. When I came up, there were 110-hour workweeks. Now they know they need time away from the office; they are smarter and know how to pace themselves."