Post-call Faculty Work Restriction: A Balance Between Patient Safety and Physician Workload & Satisfaction

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Abstract

BACKGROUND:

Work hour restrictions for trainees are now commonplace, this suggests that work hour restrictions for clinical faculty may be of value in assuring patient safety, but this has to be balanced taking into account physician workload and productivity and physician perception of autonomy and satisfaction.

METHODS:

In August 2015, the department of Obstetrics & Gynecology at Cooper University Hospital instituted a no-clinical-work policy following faculty night on call. A survey of 12 questions with Likert scales was sent to all faculty in the department involved in night call. The survey was repeated at 2, 6, and 10 months after the policy change. Factors assessed included faculty concern regarding productivity (RVUs), stress level, resident teaching, autonomy, and ability to function after a difficult call. Statistical analysis was done with χ2 test.

RESULTS:

Twenty faculty started this project. The data were averaged over all three survey time points. Fifty-six percent believed that their clinical production (RVUs) worsened, conversely 66% felt that resident teaching improved after the policy change. Of the respondents, 59% felt it was unsafe to work the day after call, 48% felt it was difficult to work in the office setting after a difficult call and 73% felt it was not safe to perform complex surgical procedures after call. Improvement in family life was reported by 73% and 54% felt it would extend their careers.

DISCUSSION:

This survey shows that physician satisfaction is improved and teaching is enhanced, but work productivity is decreased in the setting of a required postcall faculty work restriction.

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