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Trends in Hours Worked in General Pediatrics 1993 to 2010: Age, Gender and Practice Type

Lynn Olson1, Karen O'Connor1, Alicia Merline1 and William Cull1

1American Academy of Pediatrics, Elk Grove Village, United States. 

Presented at the April 2012 Pediatric Academic Societies Annual Meeting

Background: In general pediatrics, the growing interest in greater work-life balance and part-time work has been documented, but relatively little attention has been given to the broader trends in hours worked.

Objective: Assess the trends in hours worked among general pediatricians and variation by age, gender and type of practice.

Design/Methods: Cross-sectional data from 58 Periodic Surveys of AAP members conducted from 1993 to 2010 were pooled (response rates: 46%-76%). The analysis excluded residents and retired members, and was limited to respondents practicing > 60% time in primary care, n = 27,618. Hours worked was based on self-report of time in a typical week spent on all professional activities and clustered in 3-year intervals. Linear regression was used to examine trends for the total sample and subgroups by age (30s, 40s, 50s, 60s & older), gender, and practice type (solo/two person, group, hospital/clinic).

Results: Overall, respondents' reported hours worked dropped from 49.6 to 43.3 hrs/week between 1993-96 and 2008-10. The largest proportional drop was among those in their 40s (50.5 to 42.4 hrs) and the smallest among those in their 60s (47.0 to 45.1 hrs). However, the decline was significant across all ages [30s: coefficient (B) = -.49, p<.001; 40s: B = -.54, p<.001; 50s B = -.39, p<.001; > 60 B = -.13, p<.05.] Decreases were found for men [54.0 to 48 hrs, B = -.38, p<.001] and women [43.7 to 40.1 hrs, B = -.24, p<.001], for pediatricians in solo/2-person [53.2 to 49.0 hrs, B = -.34, p<.001], group [49.3 to 42.0 hrs, B = -.46, p<.001], or hospital/clinic settings [46.8 to 43.5 hrs, B = -.22, p<.001], and those reporting they work full-time [56.6 to 46.5 hrs, B = -.66, p<.001].

Conclusions: Over 17 years the hours worked by the average general pediatrician declined 13%. While pediatricians still work many hours, there has been a clear shift toward more work-life balance across age, gender and practice types. This important trend and its relationship to workforce issues will need ongoing monitoring.