Doctors Working Long Hours
23rd August 2005
I was talking to this new friend who is an E.R. (Emergency Room) physician. He was describing how ER doctors work twelve hour shifts. I asked him why that is the case. He told me that the reason is that doctors do not want to work shorter, but more frequent, shifts because of the high level of stress in the job. It turns out that if they worked three 12 hour shifts a week, therefore putting in 36-hour weeks, it’s less stressful than to do five 8-hour shifts.
“But are you effective?” I blurted out before I could think further about it.
After a slight, almost uncomfortable, pause, he said, “Well, it’s quite hard. Especially during some shifts when it gets really busy. That is why we always have another “backup” doctor around the last four hours of the shift just to ensure that the pressure doesn’t get to us.”
Which makes me think. But because this guy was a new friend whom I just met, I decided not to continue that line of questioning with him, in case he gets more uncomfortable. Plus, although I like ruffling feathers, I wasn’t in the mood to do so at that point in time. I did ask a little more about him and his work so as to try to understand him and his profession a little more.
But I still can’t help but think, so I post my questions to you. Why do ER doctors have such long shifts? Is it really so that they have four days to recuperate from their long shifts so as to reduce their stress of having to work at an ER, or is it because someone decided that working three 36-hour shifts a week allows them to have a four-day weekend? In other words, is it really about providing quality patient care, or is it about allowing the doctors to have a better lifestyle, since they have to endure such pressure as to work in the ER? Does having the backup physician the last four hours help in this situation, or does it increase the cost of providing quality medical care? Are these questions really important, or am I asking them because I am envious of my new found friend’s four-day weekends?
August 23rd, 2005 at 10:45 pm
To be honest with you, that’s a little scary.
August 24th, 2005 at 5:05 am
I think I would prefer the longer shifts, too — something about fewer transitions between high adrenalin and rest. Being at high adrenalin is stressful, but the transitions back and forth are even more stressful.
August 24th, 2005 at 6:50 am
Twelve hours doesn’t sound all that long to me. When I used to work in public hospitals I’d often have to work 16 hours or sometimes longer, and often working for up to 20 days in a row.
Definitely the 3×12 system is better than 5×8, in terms of happier doctors, and in reality a 12 hour shift is not long enough for significant fatigue to kick in. Actually a 36 or 40 hour week for an hospital doctor is reasonably mild. Emergency work is not like the ER TV show. It’s not high adrenaline all the time. Generally it’s hours of routine, everyday stuff which is occaisionally punctuated by something exciting or stressful.
If you want to worry about something, worry about the trainee surgeon who works a 80+ hour week, and is on call for 24 hours 2-3 times a week, often needing to operate in the middle of the night and not getting any time off the next day. This was the life I very nearly ended up in.
August 24th, 2005 at 7:38 am
I would wonder of those 4 days off, how much of it is on-call time in a month?
August 24th, 2005 at 8:13 pm
Interesting thoughts, everyone.
Baggas, thanks for offering your perspective. The question still bugs me though, why is it acceptable to structure the long hours for doctors?
It’s interesting to hear you say 3×12 hour schedule is reasonably light for doctors. I’m not sure if this is universal for the US or it is just the city I live in (Irvine, CA, a rather well-off upper middle-class college town in the heart of high tech corridor in one of the most affluent counties in the US).
August 25th, 2005 at 6:58 am
I’m sure it’s quite different in the US - at least from what I’ve seen on telly the “E.R.” work looks a lot more stressful than in is here in Australia.
There are a lot of reasons why doctors work long hours. Most often it is a combination of a shortage of doctors plus the need for doctors to work long enough hours to get experience for training purposes. It is almost never because we actually want to work those hours, or because of money.
Dawn has a point about on-call. I remember one job where I was only rostered for about 4 days a week in emergency (I think they were 10 hour shifts in that particular hospital) but then I’d have another 2 days on-call in case someone was sick or the E.D. got really busy. Most often I’d get called in on at least one, if not two, or those days.
August 25th, 2005 at 7:12 pm
Sleepy Docs
The bloke in the outer has an interesting blog post on Doctors Working Long Hours, where he was talking to an Emergency (”E.R.” for any Americans reading) physician about the hours he worked. The Bloke was surprised by the fact that he works three 12…
July 27th, 2006 at 9:59 am
The 36 hour weeks allow for 4 days for relaxation and having a life. I dont think anybody has the right to complain whether it is fair or not for physicians to have 4 days off a week. As far as quality patient care goes, 12 hours a shift is nothing. The most anyone should work nonstop is 16 hours straight by some state laws. Most EMTs, paramedics, nurses, and physicians work 12 hour shifts and that is considered the industry standard nowadays.
April 26th, 2008 at 10:42 pm
12 Hour shifts… what a joke…
My wife is a Gynecology student in South Africa, She does a 28 hour shift Once a week, performs a 28 hour shift every second weekend, and still work at least 4 hour days from Monday to Friday.