2021 Volume 21 Issue 4 Pages 224-228
Overtime work is a nationwide issue of growing concern in the current medical system. Multiple attending doctor system has recently been considered as a possible way to reduce overtime work in comparison with single attending doctor system. We conducted a simulation study as a research for the work-style reform, under the Yokohama City University Hospital Management Program, which was certificated by the Ministry of Education, Culture, Sports, Science and Technology. The aim of the study was 1) to quantify the overtime work of cardiologists in a university medical centre with 49 beds for cardiology where their clinical practice includes advanced emergency/acute cardiovascular care completely under single attending doctor system and 2) to run a simulation to estimate the change in overtime work before and after administration of multiple attending doctor system. We performed a one-week time-study questionnaire from 11 cardiologists and run a simulation, where all attending doctors could do all the inpatient care together during an evening group-round (6-7 p.m.) instead of the current care by a single attending doctor. As results, an average overtime work was 11.3 hours/week for each cardiologist. When multiple attending doctor system was applied in the simulation, estimated overtime work became 8.3 hours/week with a reduction of 3.0 hours/week (27%) for 1 person. In the cardiovascular inpatient care, transition from single- to multiple-attending doctor system may reduce overtime work. However, further study is needed to elucidate if quality of care would be maintained, because the multiple attending doctor system can force the doctors to care more patients simultaneously.
