![\"\"](\"http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-1024x492.jpg\")
<\/p>\n<\/p>\n
I finished my first year as an attending! I work in an academic and urban setting and do a unique version of full-spectrum family medicine: I see patients of all ages in a clinic, I take care of adults in the inpatient setting as a hospitalist, and I deliver pregnant women as a laborist in addition to post-partum rounding on newborns in the hospital (I am not obliged but often come in to see my personal patients in these hospital settings as well); I work days and nights; moreover, part of my job is to teach medical students and resident family physicians.<\/p>\n
Many residents comment, “Henry, you work a lot!” I love what I am doing and simply can’t imagine doing anything else; but the question remains, “Do I work more than the average family doctor?”<\/p>\n
In order to calculate how many hours I spend working, I needed to estimate how my work days are spent. Some days I do clinic, some days I do OB (obstetrics) and MCH (maternal child health), other days I do FMIS (family medicine inpatient service), and some days I do all three! A quick run-down:<\/p>\n
Sometimes I work these settings for a whole day or part of a day. I also do a considerable amount of nights. To make my calculations easier, I portioned these settings into “shifts”: morning, afternoon, and night. I then calculated hours spent per shift. With data I recorded over 6 months, I created a spreadsheet (that anyone could view if you are really piqued): link here<\/a>.<\/p>\n Assumptions and notes for my calculation:<\/strong><\/span><\/p>\n I did a quick literature review<\/a> of studies about physician work hours. The hours worked “average” ranged from 52 to 60 hours per week. A 2011 study in JAMA, using 2004-2005 data of physicians working, set the family physician hours worked in a year as the “average” in which other specialties are compared to: family doctors work 2,524 hours per year total. Comparisons for example: vascular surgeons work 888 more hours; while dermatologists work 346 less hours, relative to family doctors. (If I extrapolated my data and assume I work 48 weeks per year, I would work 2,635 hours per year; which is 111 more hours than the 2011 JAMA article family doctor average).<\/p>\n I think that overall my personal data is likely underestimating how much I work– I was fairly conservative with my estimations. However, it is within a reasonable range compared to the estimates in the studies I read. If I have more time, I would like to see a breakdown of how much doctors work overnight. As not<\/strong> a designated nocturnist, I am guessing I work more nights than most family doctors (18.3% of my total working time is overnight; 52% of my OB time is overnight).<\/p>\n In conclusion, I work marginally more than the average family doctor, but well within the range of average.<\/strong> I can make a similar statement if I compare my hours to other specialties as a whole (all doctors vs. just family doctors). I likely am working nights above the average for family doctors.<\/p>\n The next step would be comparing my quality of life to others in relation to hours worked. Burnout, well-being, and resilience are topics in full vogue right now (and rightly so). Interestingly, an article summarized a study from The Annals of Family Medicine, showing that the more full-spectrum a family physician works, the less burnout: “comprehensiveness is associated with less burnout, which is critical in the context of improving access to good quality, affordable care while maintaining physician wellness.” Here, I quote formally from that study: “practice characteristics significantly associated with lower odds of burnout were practicing inpatient medicine (OR = 0.70; 95% CI, 0.56\u20130.87; P<\/em> = .0017) and obstetrics (OR = 0.64; 95% CI, 0.47\u20130.88; P<\/em> = .0058).”<\/p>\n Clayton Christensen’s book, “How Will You Measure Your Life?” talks about satisfaction<\/strong> in the context of work. There are two types of factors contributing to this: hygiene factors and motivation factors. “<\/strong>Hygiene factors” if not done right, will causes us to be dissatisfied: poor status, compensation, job security, work conditions, company policies, supervisory practices make workers unhappy. However, even if hygiene factors are improved, you won’t automatically love your job; you just won’t hate it anymore. Christensen recalls Frederick Herzberg’s research and names “motivators” as another factor for job satisfaction. Motivation factors include: challenging work, recognition, responsibility, personal growth– very inward qualities. Problems arise when you prioritize hygiene factors over personal motivators (ie. “I’ll work a high-paying job and then when I pay off my loans, will work to save the world!”). Deferring real passions can lead to burnout.<\/p>\n I don’t have the data, but qualitatively I am pretty sure I am pretty happy so far. :D Paper work is a drag, but I seldom feel like I am not doing what I am called to do in this life. My favorite weeks (and even days) are when I get to see patients in all different settings and teach residents at the same time. A particularly memorable day, mixed the joy of delivering two babies in the morning, with the privilege of being with the family of a personal patient of mine passing away in the ICU, and the excitement of precepting residents in clinic in the afternoon (including doing some procedures); all ending with a quick lecture. It was hard, but I can’t imagine doing anything else!<\/p>\n I finished my first year as an attending! I work in an academic and urban setting and do a unique version of full-spectrum family medicine: I see patients of all ages in a clinic, I take care of adults in the inpatient setting as a hospitalist, and I deliver pregnant …<\/p>\n","protected":false},"author":1,"featured_media":2105,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"ngg_post_thumbnail":0,"footnotes":""},"categories":[19],"tags":[28,31,34],"class_list":["post-2104","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-verbal","tag-health-care","tag-medical-school","tag-residency","column","threecol","has-thumbnail"],"uagb_featured_image_src":{"full":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387.jpg",1600,769,false],"thumbnail":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-150x150.jpg",150,150,true],"medium":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-300x144.jpg",300,144,true],"medium_large":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-768x369.jpg",660,317,true],"large":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-1024x492.jpg",660,317,true],"1536x1536":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387.jpg",1536,738,false],"2048x2048":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387.jpg",1600,769,false],"slider-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-1140x395.jpg",1140,395,true],"blog-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-700x300.jpg",700,300,true],"teaser-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-332x205.jpg",332,205,true],"gallery-1-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-432x432.jpg",432,432,true],"gallery-2-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-268x268.jpg",268,268,true],"gallery-3-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-268x164.jpg",268,164,true],"image-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-700x336.jpg",700,336,true],"video-thumb":["http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/IMG_0387-700x393.jpg",700,393,true]},"uagb_author_info":{"display_name":"Del Rosario Henry","author_link":"http:\/\/www.henrydelrosario.com\/?author=1"},"uagb_comment_info":2,"uagb_excerpt":"I finished my first year as an attending! I work in an academic and urban setting and do a unique version of …","_links":{"self":[{"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=\/wp\/v2\/posts\/2104","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2104"}],"version-history":[{"count":10,"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=\/wp\/v2\/posts\/2104\/revisions"}],"predecessor-version":[{"id":2293,"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=\/wp\/v2\/posts\/2104\/revisions\/2293"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=\/wp\/v2\/media\/2105"}],"wp:attachment":[{"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2104"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2104"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.henrydelrosario.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2104"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
\n
Statistics<\/h2>\n
![\"\"](\"http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/hoursworked.png\")
<\/p>\n![\"\"](\"http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/workapportioned2.png\")
<\/p>\n![\"\"](\"http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2018\/12\/timepsentperday.png\")
<\/p>\n\n
\n
\n
\n
\n
\n
Discussion<\/h2>\n
Burnout & Well-being<\/h2>\n
\u00a7\u00a7\u00a7<\/div>\n <\/div>\n\n
![\"HD\"](\"http:\/\/www.henrydelrosario.com\/wp-content\/uploads\/2015\/06\/Screen-Shot-2015-06-13-at-10.11.40-AM.png\")
<\/div>\n","protected":false},"excerpt":{"rendered":"