Surgeon workhours in the era of limited resident workhours

BACKGROUND: Resident workhours have received much attention, yet there is little information concerning faculty workhours. In addition, the perspectives of surgical faculty on the anticipated effects of reducing resident hours have not been studied. STUDY DESIGN: An anonymous survey was distributed to all clinical faculty in the Departments of Surgery, Neurosurgery, Orthopaedics, and Otolaryngology at a single, large academic institution. Surgeons completed a detailed retrospective report of hours worked during a 1-week period. Opinions regarding resident workhour restrictions were also elicited. Chi-square or Student's t-tests were used to determine p values as appropriate, with p ≤ 0.05 considered significant. RESULTS: Of 120 surveys distributed, 102 (85%) were returned. Subspecialty departments comprised 51% of respondents with 49% from general surgeons. The mean number of hours worked per week by faculty was 70.4 ± 12.5 (SD) (73.8 ± 14.1 for general surgeons versus 67.1 ± 9.9 for subspecialists, p = 0.006), with only 44.1% having at least 1 day per week free from clinical duties. Up to 95% of general surgeons are paged overnight at least once per week (mean 13.6 ± 11.2 calls/week), with 73% returning from home at least once during the week (mean 1.8 ± 1.1 returns/week). Importantly, 84% of general surgeons believe reducing resident workhours will increase faculty hours, compared with 57% of subspecialists (p = 0.004). In addition, 87% predict that reducing resident hours will compromise surgical education, with only 11% believing the benefits of hour reduction will outweigh the negatives. CONCLUSIONS: The recommended limit for resident workhours closely approximates the average number of hours worked by surgical faculty in an academic center. Despite this, significant concern exists among the majority of surgical faculty regarding the impact of resident workhour restriction, both on faculty workhours and on resident education.