Working Conditions of Employed Physicians:

An Interview Survey on Working Hours, Free Time and Income

Abstract

The government of Japan is now implementing a policy aimed at reducing the occupational working hours, for all types of labor in Japan, to 40 hrs/week and 1, 800 hrs/year. The implementation of this policy began in 1988 and is scheduled to be completed in 1997. In fact, average working hours have decreased, reaching 1, 904hrs/year in 1995, a level comparable to those of the USA and the United Kingdom. Physicians have, however, been dealt with differently from other hospital workers. Even physicians employed in large hospitals seem to work harder for a longer time than ever. The authors attempted to ascertain the working conditions of physicians employed in large hospitals in Gunma Prefecture, Japan. Twenty-four male physicians in their 30s of age, working in national university hospitals and relatively large private and public hospitals, were randomly selected from the membership list of the alumni association of a national medical school in the same prefecture. A questionnaire was prepared to include the following items: working hours, number of holidays, annual income, actual time budget on seven successive days. The questionnaire was distributed by an interviewer after obtaining each subject's consent to participate in the survey. After a week or more the interviewer retrieved the filled-in forms. Intotal, 19 physicians responded. Average working hours for 11 university hospital physicians (UP) and 8 other hospital physicians (HP) were 2, 781 and 2, 346 hrs/year, or 66.3 and 57.7 hrs/week, respectively. Average weekly working hours of approximately 5, 000 general and non-general physicians sampled in the USA were 51 hrs in 1980, based on a periodic survey conducted by the American Medical Association.Numbers of holidays per year for UP and HP were 57.8 and 69.6 days, respectively, though the number for workers employed in Gunma Prefecture was 107.5 days. Incomes per year for UP were 3.79 million yen from the university hospital and 4.86 from hospitals employed as part timers, a total of 8.65 million yen, while that of HP was 12.56 million yen. The UP time budgets for primary (sleep, etc.), secondary (work, etc .) and tertiary (learning, etc.) activities were 70.4, 71.2 and 24.4 hrs/week, respectively; these figures were almost the same as those of HP. The longer the secondary activity time the shorter the primary and tertiary activity times. The shift system and the team approach for physicians employed in hospitals are so inadequate that they cannot take enough holidays and have little time to study or to refresh the knowledge essential to their professional lives.