Department of Economics, Centre for Health Economics & Policy Analysis (CHEPA), and Health Policy PhD program (Kralj, Sweetman); Department of Health Research Methods, Evidence, and Impact (Islam), McMaster University, Hamilton, Ont.
CMAJ. 2024 Mar 24;196(11):E369-E376. doi: 10.1503/cmaj.231166.
Physician work hours directly influence patient access to health care services and play a vital role in physician human resource planning. We sought to evaluate long-term trends in hours worked by physicians in Canada, overall and by subgroup.
We used Statistics Canada's Labour Force Survey to identify physicians via occupation and industry coding information. We estimated descriptive statistics and performed graphical analysis of the average weekly hours worked by physicians over the 1987-2021 period.
Overall, weekly physician work hours remained stable from 1987 until 1997, after which they declined. Average weekly hours decreased by 6.9 hours ( < 0.001), from 52.8 in 1987-1991 to 45.9 in 2017-2021. Among male physicians, work hours declined notably after 1997, while those of female physicians remained relatively stable at around 45 per week. Hours worked by married physicians declined significantly, amounting to 7.4 fewer hours per week ( = 0.001). In contrast, unmarried physicians displayed a statistically insignificant decline of 2.2 hours ( = 0.3). The COVID-19 pandemic was associated with a sharp but brief disruption in weekly hours; by the end of 2020, physicians' work hours had returned to prepandemic levels.
These findings may indicate a long-term shift in work preferences among Canadian physicians; male physicians may be seeking a better work-life balance, which, in turn, has narrowed the gap in hours worked by sex, with potential implications for pay equity. Policymakers and planners should carefully consider changes in hours worked, rather than just the total number of physicians, to ensure an accurate evaluation of the physician workforce.
医生的工作时间直接影响患者获得医疗服务的机会，并在医生人力资源规划中起着至关重要的作用。我们试图评估加拿大医生工作时间的长期趋势，包括总体趋势和按亚组划分的趋势。
我们使用加拿大统计局的劳动力调查，通过职业和行业编码信息来识别医生。我们估计了 1987 年至 2021 年期间医生每周平均工作时间的描述性统计数据，并进行了图形分析。
总体而言，1987 年至 1997 年期间，医生每周工作时间保持稳定，此后开始下降。每周平均工作时间减少了 6.9 小时（<0.001），从 1987-1991 年的 52.8 小时降至 2017-2021 年的 45.9 小时。在男性医生中，1997 年后工作时间明显下降，而女性医生的工作时间相对稳定，约为每周 45 小时。已婚医生的工作时间显著下降，每周减少了 7.4 小时（=0.001）。相比之下，未婚医生每周工作时间仅略有下降，减少了 2.2 小时（=0.3）。COVID-19 大流行导致每周工作时间出现短暂而明显的中断；到 2020 年底，医生的工作时间已恢复到疫情前的水平。
这些发现可能表明加拿大医生的工作偏好发生了长期转变；男性医生可能在寻求更好的工作-生活平衡，这反过来又缩小了性别工作时间差距，这可能对薪酬公平产生影响。政策制定者和规划者应仔细考虑工作时间的变化，而不仅仅是医生总数的变化，以确保对医生劳动力的准确评估。
