Work Hours and Depression in U.S. First-Year Physicians.
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ABSTRACT:
SUBMITTER: Fang Y
PROVIDER: S-EPMC9807271 | biostudies-literature | 2022 Oct
REPOSITORIES: biostudies-literature
Publications
Work Hours and Depression in U.S. First-Year Physicians.
Fang Yu Y Lodi Sara S Hughes Tasha M TM Frank Elena E Sen Srijan S Bohnert Amy S B ASB
The New England journal of medicine 20221001 16
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Project description:Background: Physicians marry other physicians at a high rate, and theories suggest being married to a physician (MTP) may impact a physician's productivity in different ways. This impact may differ by gender and rurality of work location. This study empirically examines MTP's effects by gender and rurality of physicians' work location. Data and Method: This study uses both the Association of American Medical Colleges (AAMC) 2019 National Sample Survey of Physicians (n = 6,000) and the American Community Survey data 2006-2017 (n = 72,900). We conducted cross-sectional, multivariate analysis with interaction terms between MTP, gender, and rurality, controlling for various work and personal characteristics. Results: A female MTP physician works 2.9 fewer hours (95% confidence interval [CI]: -4.3 to -1.4, p = 0.000) per week than a female non-MTP physician, while a male MTP physician's weekly work hours are not significantly different from a male non-MTP physician's. Compared to non-MTP counterparts, male MTP physicians are more likely to have on-call work, and female MTP physicians are much less likely to have on-call work; male MTP physicians earn $6,635 more (95% CIs: $1,613-$11,657, p = 0.010) per year, while female MTP female physicians earn $5,018 less (95% CIs: -$10,684 to $648, p = 0.083). Furthermore, the MTP-associated gender differential effects are more prominent for physicians in rural areas than in urban areas. Results from both datasets are highly comparable. Conclusions: MTP's effects widen the gender gap in physicians' work hours, on-call probability, and earnings. Understanding and examining the mechanisms for these gender differential effects are essential to promote equity in the physician workforce.
| S-EPMC8524735 | biostudies-literature
Project description:ObjectiveTo characterize variation in clinical documentation production patterns, how this variation relates to individual resident behavior preferences, and how these choices relate to work hours.Materials and methodsWe used unsupervised machine learning with clinical note metadata for 1265 progress notes written for 279 patient encounters by 50 first-year residents on the Hospital Medicine service in 2018 to uncover distinct note-level and user-level production patterns. We examined average and 95% confidence intervals of median user daily work hours measured from audit log data for each user-level production pattern.ResultsOur analysis revealed 10 distinct note-level and 5 distinct user-level production patterns (user styles). Note production patterns varied in when writing occurred and in how dispersed writing was through the day. User styles varied in which note production pattern(s) dominated. We observed suggestive trends in work hours for different user styles: residents who preferred producing notes in dispersed sessions had higher median daily hours worked while residents who preferred producing notes in the morning or in a single uninterrupted session had lower median daily hours worked.DiscussionThese relationships suggest that note writing behaviors should be further investigated to understand what practices could be targeted to reduce documentation burden and derivative outcomes such as resident work hour violations.ConclusionClinical note documentation is a time-consuming activity for physicians; we identify substantial variation in how first-year residents choose to do this work and suggestive trends between user preferences and work hours.
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Project description: Not available
| S-EPMC1914065 | biostudies-literature
Project description:ObjectivesLong working hours in Japan is a social concern. This is also true for the working hours of physicians, who often do side work in addition to working at their main hospital. New physician work regulations to be implemented in Japan require work-hour management, including side work. This study examined the association between physicians' overtime and side work hours and their health outcomes.MethodsWe conducted a cross-sectional study using data from a survey of working physicians conducted by the Japan Medical Association from 2021 to 2022. Questionnaires completed by 2906 full-time working physicians aged 24-69, excluding junior resident doctors, were analyzed. Depressive symptoms and the presence of thoughts of death or suicide using the Quick Inventory of Depressive Symptomatology - Japanese version was used to assess health outcomes. Logistic regression analysis was performed using overtime at the main place of employment and side work hours as exposure factors.ResultsBoth depressive symptoms and thoughts of death or suicide increased in the group with longer overtime hours at the main place of work. A similar tendency was observed for side work but adjusting for overtime hours eliminated the association. In other words, total working hours had an impact on health, regardless of whether overtime work at the main place of employment or side work.ConclusionsDespite the existence of multiple hurdles to managing working hours, including side work, the working environment for physicians needs to be improved to protect their health and quality of medical care.
| S-EPMC9717704 | biostudies-literature
Project description:Analyses of physician well-being typically rely on small and unrepresentative samples. In April 2011, the UK Office for National Statistics incorporated subjective well-being metrics (SWB) into the Annual Population Survey (APS), a well-established survey. This survey includes variables from the labor market, making APS an ideal source for measuring the association between work hours and SWB metrics and comparing among different professionals. Using APS data from 2011/12 to 2014/15, this study examined the association between SWB levels and work hours using multiple linear models for physicians (primary care physicians and hospital doctors), lawyers, and accountants. Of the 11,810 observations, physicians were more satisfied, happier, and less anxious; females were more stressed (10.7%); and age was negatively associated with happiness and satisfaction. Incorporating information on preferences to work more hours (underemployment) did not affect physicians' but worsened the well-being of other professionals (lawyers and accountants). Surveyed physicians were less anxious, happier, and more satisfied than lawyers or accountants before Covid. Although the total work hours did not alter the SWB metrics, overtime hours for other professionals did. Increasing the working hours of underemployed physicians (with appropriate compensation) could be a relatively inexpensive solution to tackle the shortage of health workers in the short run.
| S-EPMC10723739 | biostudies-literature
Project description:BackgroundWork-home conflicts (WHC) threaten work-life balance among physicians, especially those in dual career relationships. In this study, we analyzed factors associated with WHC for physicians and their employed partners.MethodsWe surveyed 89,831 physicians from all specialty disciplines listed in the Physician Masterfile. Of the 7,288 (27.7 %) physicians who completed the survey, 1,644 provided the e-mail contact information of their partner. We surveyed these partners and 891 (54 %) responded. Burnout, quality of life (QOL), and depression were measured using validated instruments in both surveys. Satisfaction with career, work-life balance, and personal relationships, as well as experience of WHC were also evaluated.ResultsWHC within the previous 3 weeks were commonly experienced by physicians and their employed partners (44.3 % and 55.7 %, respectively). On multivariate analysis, greater work hours for physicians and their employed partners were independently associated with WHC (OR 1.31 and 1.23 for each additional 10 h, respectively, both p < 0.0001). Physicians and partners who had experienced a recent WHC were more likely to have symptoms of burnout (47.1 % vs. 26.6 % for physicians with and without WHC; 42.4 % vs. 23.8 % for partners with and without WHC, both p < 0.0001).ConclusionsWHC are commonly experienced by physicians and their employed partners. These conflicts may be a major contributor to personal distress for physicians and their partners.
| S-EPMC3889954 | biostudies-literature
Project description:IntroductionThe number of sick days taken from work due to depression is steadily rising. A successful return to work (RTW) is essential for sustainable reintegration. This study aims to identify factors to optimize RTW and to investigate approaches for sustainable RTW (sRTW) after depressive episodes.MethodsSemi-structured expert interviews with senior occupational physicians (OPs, N = 5) served to develop two surveys among OPs (N = 180) and employees after depressive episode (N = 192). Predictors of RTW rating, workplace-based RTW interventions and sRTW interventions were analyzed using multiple hierarchical regression, chi-square difference and t-tests.ResultsFor OPs, employee training on mental illness prevention was found to be the strongest predictor of overall RTW rating, whereas understanding and appreciation in conversations and stigmatization were strongest predictors of overall RTW rating by the employees. Compared to the employees, OPs reported significantly more availability of workplace-based interventions. To prevent relapse, the employees prioritized sufficient time and financial security during the RTW process more than OPs.ConclusionsThe study identified facilitating and hindering factors that can inform further research and practice to improve RTW after depressive episodes. To redress the awareness gap about the availability of workplace-based interventions, regular contact between OPs and employees is crucial. Several factors were considered to be of varying importance for relapse prevention by the two groups. Multiple perceptions and needs ought to be taken into account during RTW.
| S-EPMC9583521 | biostudies-literature
Project description:ObjectiveTo examine associations between stress and work hours with sleep duration and insomnia symptoms among U.S.-born and Foreign-born Black adults.DesignA cross-sectional analysis of the National Health Interview Survey.ParticipantsBlack adults (N = 16,315) with a mean age of 40 ± 0.1 years, mostly women (52.7%), college graduates (40.7%), and U.S.-born (82.5%).MeasurementsParticipants self-reported sleep duration, insomnia symptoms, frequent stress (yes/no), and work hours in the prior week (1-39 hours, 40 hours, ≥41 hours). Poisson regression with robust variance was used to test associations overall and by nativity.ResultsWorking ≥41 hours, frequent stress, and short sleep duration (<7 hours) were reported by 22%, 24.9%, and 43% of participants, respectively. U.S.-born and Foreign-born Black adults who reported frequent stress and working ≥41 hours vs. 40 hours had 60% and 19% higher prevalence of short sleep duration (adjusted prevalence ratio [aPR] = 1.60, 95% confidence interval [CI]: 1.47, 1.74 and aPR = 1.19, 95% CI: 1.12, 1.25, respectively). Foreign-born Black adults who worked 1-39 hours vs. 40 hours, had higher prevalence of short sleep duration, aPR = 1.18, 95% CI: 1.01, 1.37. U.S.-born Black adults who worked ≥41 hours vs. 40 hours had higher prevalence of insomnia symptoms (trouble falling asleep: aPR = 1.33 [95% CI: 1.13, 1.56], trouble staying asleep: aPR = 1.33 [95% CI: 1.16, 1.53]).ConclusionFrequent stress and working ≥41 hours are likely salient determinants of sleep health for U.S. and Foreign-born Black individuals. Further, less work hours (Foreign-born) while longer work hours (U.S.-born) were associated with short sleep duration. Stress and work hours may be factors for sleep health interventions among Black adults.
| S-EPMC9991989 | biostudies-literature
Project description:ObjectivesThis study sought to assess the association between long working hours, psychosocial safety climate (PSC), work engagement (WE) and new major depression symptoms emerging over the next 12 months. PSC is the work climate supporting workplace psychological health.SettingAustralian prospective cohort population data from the states of New South Wales, Western Australia and South Australia.ParticipantsAt Time 1, there were 3921 respondents in the sample. Self-employed, casual temporary, unclassified, those with working hours <35 (37% of 2850) and participants with major depression symptoms at Time 1 (6.7% of 1782) were removed. The final sample was a population-based cohort of 1084 full-time Australian employees.Primary and secondary outcome measuresThe planned and measured outcomes were new cases of major depression symptoms.ResultsLong working hours were not significantly related to new cases of major depression symptoms; however, when mild cases were removed, the 41-48 and ≥55 long working hour categories were positively related to major depression symptoms. Low PSC was associated with a threefold increase in risk for new major depression symptoms. PSC was not related to long working hours, and long working hours did not mediate the relationship between PSC and new cases of major depression symptoms. The inverse relationship between PSC and major depression symptoms was stronger for males than females. Additional analyses identified that WE was positively related to long working hours. Long working hours (41-48 and ≥55 hours) mediated a positive relationship between WE and major depression symptoms when mild cases of major depression were removed.ConclusionThe results suggest that low workplace PSC and potentially long working hours (41-48; ≥55 hours/week) increase the risk of new major depression symptoms. Furthermore, high WE may increase long working hours and subsequent major depression symptoms.
| S-EPMC8211051 | biostudies-literature
Project description:BackgroundIn the manufacturing industry, work-family conflict (WFC) is related to working hour characteristics. Earlier studies on the relationship between working hour characteristics and WFC in the manufacturing industry have been limited to some regions in Korea. No study has addressed the data on a national scale. Thus, this study investigated the impact of weekly working hours, weekend work, and shift work on WFC using national-scale data.MethodsThis study was based on the fifth Korean Working Conditions Survey of 5,432 manufacturers. WFC consists of 5 variables; WFC1 "kept worrying about work"; WFC2 "felt too tired after work"; WFC3 "work prevented time for family"; WFC4 "difficult to concentrate on work"; WFC5 "family responsibilities prevented time for work". As WFC refers to the inter-role conflict between the need for paid work and family work, WFC has been measured in two directions, work to family conflict (WTFC: WFC1, 2, 3) and family to work conflict (FTWC: WFC4, 5). With these WFC variables, we conducted multiple logistic analyses to study how working hours, weekend work, and shift work impact WFC.ResultsKorean manufacturers' prolonged working hours increased all aspects of WFCs. Odds ratios (ORs) of WFCs based on working hours (reference of under 40 hours) of 41-52, 53-60, over 61 were 1.247, 1.611, 2.279 (WFC1); 1.111, 2.561, 6.442 (WFC2); 1.219, 3.495, 8.327 (WFC3); 1.076, 2.019, 2.656 (WFC4); and 1.166, 1.592, 1.946 (WFC5), respectively. Shift-work in the WFC2 model showed a significantly higher OR of 1.390. Weekend work 'only on Saturday' had significant ORs with WFC2 (1.323) and WFC3 (1.552).ConclusionsAn increase in working hours leads to the spending of less time attending to problems between work and family, causing both WTFC and FTWC to increase. As weekends, evenings, and nighttime are considered to be family-friendly to people, working on weekends and shift-work were highly correlated to WTFC.
| S-EPMC9483637 | biostudies-literature