Long Hours Are Not Paying Off Like Before

Emergency physicians are working more hours, spending more time on paperwork, and earning lessFigure: emergency medicine, salary, job satisfaction, paperwork, patientsEPs have always been a hardworking bunch, and our 2022 salary survey data show many have taken on more hours over the past five years, and they often have less to show for it. Only a quarter of EPs said they clocked less than 40 hours at work per week in 2022, a drop from 47 percent in the 2017 survey. The weekly norm for time spent in the ED is now 41 to 45 hours, which applies to 34 percent of EPs, up from 24 percent before. The number of emergency physicians who work even more than that has gone up as well. About 21 percent reported putting in 46 to 50 clinical hours compared with 13 percent in 2017. Eight percent said they worked 51 to 55 hours, and another eight percent worked 56 to 60 hours, up from six percent and five percent, respectively, in 2017. EPs will be happy to know, though, that almost the same percentage of those who spend less than 40 hours at work still make more than $350,000 a year (25% in 2022 versus 24% in 2017). Just as the results of our previous survey demonstrated, more hours in the ED equal more money earned, but that seemed to hold true for fewer people this time around. Nineteen percent of those who picked up 61 to 65 hours a week had an annual salary of more than $350,000 compared with 41 percent before, while 12 percent of EPs who worked more than 70 hours made that much compared with 39 percent in 2017. EPs are also logging less time at the bedside, and that's nothing new—we noticed the same trend five years ago. Only nine percent spent more than 40 hours a week seeing patients in 2022, while 21 percent reported having the same amount of time with patients in 2017. The number who said they saw patients for 31 to 40 hours also fell to 26 percent in 2022 from 38 percent in our previous survey. On the flip side, EPs are getting more face time with patients, with 12 percent getting one to 10 hours, up from four percent. Those who spend more time interacting with patients still earn more, but those numbers are shrinking. The percentage of those who see patients for more than 40 hours a week and make more than $350,000 dipped to 34 percent from 37 percent. Slightly fewer EPs who spend 31 to 40 hours at the bedside fall in the same income category at 20 percent compared with 30 percent before. The good news is many EPs—41 percent—cap time spent on paperwork at one to 10 hours, even though that's a drop from 51 percent in 2017. But administrative tasks are eating up more of EPs' shifts than before, with 33 percent counting 11 to 20 hours and 17 percent reporting 21 to 30 hours of desk work compared with 25 percent and 10 percent in 2017, respectively. The silver lining is that many more docs are now being compensated for that labor: 71 percent in 2022 versus 44 percent before. Paperwork for the most part falls mostly on the highest paid of the bunch. About 27 percent of EPs who make more than $350,000 a year spend more than 40 hours pushing paper compared with 28 percent before, while 18 percent of those making between $325,001 and $350,000 put in 31 to 40 hours to do the same, up from nine percent. Interestingly, more of the folks who get a bigger paycheck don't see any returns for admin time, with 20 percent of those who bring home more than $350,000 saying they don't get paid for nonclinical work. Overall EPs seem happier with their workload in 2022—31 percent said they're very satisfied while 23 percent said the same in our last survey. One interesting finding: 22 percent of those earning more than $350,000 say they're very dissatisfied with how much work they have, but 21 percent of those who make $100,001 to $150,000 report feeling very content. Next month: Part 4: How did COVID-19 affect hours worked, job satisfaction, and changes in salary? We'll cross-reference EPs' employers with hours spent seeing patients, how hours changed during the pandemic, and COVID's impact on income. We are also publishing all of the salary survey articles ahead of print in our enews. Sign up for the enews (totally free!) at http://bit.ly/EMNenewsSignup. Ms. Spenceris a freelance writer in New York City.

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