NCPA - National Center for Policy Analysis


March 19, 2010

Physicians are working fewer hours than they once did, the result of a decade-long decline that coincided with lower fees for their services, according to a new study reported in the Feb. 24 issue of the Journal of the American Medical Association. 

After two decades of stable hours, a steady decrease began in 1997, according to the researchers.  The decline coincided with a marked drop in physician fees, as measured by an inflation-adjusted fee index.

For nonresident physicians, the decline is equivalent to the loss of 36,000 doctors working at the previous hour levels, the researchers said.  The finding may have implications for health reform, they added.

Other findings: 

  • The researchers found that from 1977 through 1996, work rates for all doctors were relatively stable at 55 hours a week, on average.
  • But from 1996 through 2007, average hours fell 7.2 percent, reaching a low of 51 hours by the end of 2007.
  • The drop was significant at P<0.001. 


  • Resident physicians saw their hours fall sharply due to duty hour limits imposed in 2003; the decline was 9.8 percent.
  • At the same time, average work hours for nonresident doctors fell by 5.7 percent.
  • Among nonresident physicians, the decrease was largest for those who were younger than 45 (at 7.4 percent) and working outside the hospital (at 6.4 percent).
  • The decrease was smallest for those 45 years or older (at 3.7 percent) and working in the hospital (at 4 percent). 

Between 1995 and 2006, researchers found average physician fees nationwide fell by 25 percent. 

They also found that in 2001 (the only year for which the comparison was available), doctors in metropolitan areas with the lowest physician fees worked less than 49 hours a week on average, while those elsewhere worked more than 52 hours a week. 

Source: Michael Smith, "Why physicians are working fewer hours," Medpage, March 8, 2010. 

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