Changes in Doctors’ Working Hours

Joyce, Catherine M.; Wang, Wei Chun; Cheng, Thomas W.

doi:10.1177/1077558715589705

Cited by 15 publications

(13 citation statements)

References 23 publications

(27 reference statements)

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“…Such gendered working patterns are important considerations for medical workforce planners, particularly given women’s increasing representation in the medical workforce [ 2 ]. Recent studies, however, have shown that doctors of both sexes are working fewer hours than in the past [ 4 – 6 ], with male doctors showing the greater rate of decline in working hours [ 7 , 8 ]. In the UK, requests to enter LTFT training have increased, facilitated by recent legislation granting all employees the right to request flexible and LTFT working hours (not just parents) [ 4 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the UK, requests to enter LTFT training have increased, facilitated by recent legislation granting all employees the right to request flexible and LTFT working hours (not just parents) [ 4 , 9 ]. Authors of some studies have indicated that this move to reduced working hours for doctors represents a cultural shift in valuing time over money and prioritising work-life balance above career progression [ 7 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation

et al. 2016

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BackgroundThe greater participation of women in medicine in recent years, and recent trends showing that doctors of both sexes work fewer hours than in the past, present challenges for medical workforce planning. In this study, we provide a detailed analysis of the characteristics of doctors who choose to work less-than-full-time (LTFT). We aimed to determine the influence of these characteristics on the probability of working LTFT.MethodsWe used data on working patterns obtained from long-term surveys of 10,866 UK-trained doctors. We analysed working patterns at 10 years post-graduation for doctors of five graduating cohorts, 1993, 1996, 1999, 2000 and 2002 (i.e. in the years 2003, 2006, 2009, 2010 and 2012, respectively). We used multivariable binary logistic regression models to examine the influence of a number of personal and professional characteristics on the likelihood of working LTFT in male and female doctors.ResultsAcross all cohorts, 42 % of women and 7 % of men worked LTFT. For female doctors, having children significantly increased the likelihood of working LTFT, with greater effects observed for greater numbers of children and for female doctors in non-primary care specialties (non-GPs). While >40 % of female GPs with children worked LTFT, only 10 % of female surgeons with children did so. Conversely, the presence of children had no effect on male working patterns. Living with a partner increased the odds of LTFT working in women doctors, but decreased the odds of LTFT working in men (independently of children). Women without children were no more likely to work LTFT than were men (with or without children). For both women and men, the highest rates of LTFT working were observed among GPs (~10 and 6 times greater than non-GPs, respectively), and among those not in training or senior positions.ConclusionsFamily circumstances (children and partner status) affect the working patterns of women and men differently, but both sexes respond similarly to the constraints of their clinical specialty and seniority. Thus, although women doctors comprise the bulk of LTFT workers, gender is just one of several determinants of doctors’ working patterns, and wanting to work LTFT is evidently not solely an issue for working mothers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-016-0162-3) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation

et al. 2016

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“…Our scenario, which assumed an increase in the number of male GPs working in urban areas moving to part-time work based on research by Joyce et al [34, 35], reduced the surplus and resulted in a balanced workforce by 2033. While this was a non-policy scenario, incentives to move GPs to part-time work could be investigated to reduce existing surpluses.…”

Section: Discussionmentioning

confidence: 99%

What will make a difference? Assessing the impact of policy and non-policy scenarios on estimations of the future GP workforce

Laurence

Karnon

2017

Hum Resour Health

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BackgroundHealth workforce planning is based on estimates of future needs for and supply of health care services. Given the pipeline time lag for the training of health professionals, inappropriate workforce planning or policies can lead to extended periods of over- or under-supply of health care providers. Often these policy interventions focus on one determinant of supply and do not incorporate other determinants such as changes in population health which impact the need for services.The aim of this study is to examine the effect of the implementation of various workforce policies on the estimated future requirements of the GP workforce, using South Australia as a case study. This is examined in terms of the impact on the workforce gap (excess or shortage), the cost of these workforce policies, and their role in addressing potential non-policy-related future scenarios.MethodsAn integrated simulation model for the general practice workforce in South Australia was developed, which determines the supply and level of services required based on the health of the population over a projection period 2013–2033. The published model is used to assess the effects of various policy and workforce scenarios. For each policy scenario, associated costs were estimated and compared to baseline costs with a 5% discount rate applied.ResultsThe baseline scenario estimated an excess supply of GPs of 236 full-time equivalent (FTE) in 2013 but this surplus decreased to 28 FTE by 2033. The estimates based on single policy scenarios of role substitution and increased training positions continue the surplus, while a scenario that reduces the number of international medical graduates (IMGs) recruited estimated a move from surplus to shortage by 2033. The best-case outcome where the workforce achieves balance by 2023 and remains balanced to 2033, arose when GP participation rates (a non-policy scenario) were combined with the policy levers of increased GP training positions and reduced IMG recruitment. The cost of each policy varied, with increased role substitution and reduced IMG recruitment resulting in savings (AUD$752,946,586 and AUD$3,783,291 respectively) when compared to baseline costs. Increasing GP training costs over the projection period would cost the government an additional AUD$12,719,798.ConclusionsOver the next 20 years, South Australia’s GP workforce is predicted to remain fairly balanced. However, exogenous changes, such as increased demand for GP services may require policy intervention to address associated workforce shortfalls. The workforce model presented in this paper should be updated at regular intervals to inform the need for policy intervention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-017-0216-1) contains supplementary material, which is available to authorized users.

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“…We therefore instrument hours worked with a set of indicators capturing GP family type. Family circumstances, such as having young dependent children and the working status of the spouse, have been shown in previous studies to be strongly correlated with hours worked (Becker, 1985;Bertrand & Hallock, 2001;Joyce, Wang, & Cheng, 2015;Schurer et al, 2016). For these family characteristics to be valid instruments, in addition to being correlated with the GP's hours worked, they should not impact on the demand for GP consultations and hence waiting times through any mechanism other than the hours worked by GPs.…”

Section: Econometric Strategymentioning

confidence: 92%

Hours worked by general practitioners and waiting times for primary care

et al. 2018

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The decline in the working hours of general practitioners (GPs) is a key factor influencing access to health care in many countries. We investigate the effect of changes in hours worked by GPs on waiting times in primary care using the Medicine in Australia: Balancing Employment and Life longitudinal survey of Australian doctors. We estimate GP fixed effects models for waiting time and use family circumstances to instrument for GP's hours worked. We find that a 10% reduction in hours worked increases average patient waiting time by 12%. Our findings highlight the importance of GPs' labor supply at the intensive margin in determining the length of time patients must wait to see their doctor.

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Changes in Doctors’ Working Hours

Cited by 15 publications

References 23 publications

Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation

Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation

What will make a difference? Assessing the impact of policy and non-policy scenarios on estimations of the future GP workforce

Hours worked by general practitioners and waiting times for primary care

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