{"id":1700,"date":"2015-09-25T10:37:41","date_gmt":"2015-09-25T14:37:41","guid":{"rendered":"http:\/\/blogs.nejm.org\/general-medicine\/?p=1700"},"modified":"2015-09-25T10:37:41","modified_gmt":"2015-09-25T14:37:41","slug":"more-work-hours-more-strokes","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/","title":{"rendered":"More Work Hours, More Strokes?"},"content":{"rendered":"
\"Andrew<\/a>

Andrew Ip, MD, is a 2015-16 Chief Resident in Internal Medicine at Emory University in Atlanta, Georgia.<\/p><\/div>\n

Do doctors work too much?\u00a0Residents\u00a0would probably say “Yes! I\u2019m burnt out,” and supplement it with some form of “I\u2019d much rather work less.”\u00a0Outside of residency, the answer may be a mix of yes, no, and maybe.<\/p>\n

Recently, Lancet<\/em> published a meta-analysis<\/a> on work hours and its effect on incident coronary disease and stroke.\u00a0The study showed that those who worked more than 55 hours weekly on average had an increased relative risk of 33% for stroke and 13% for coronary disease.\u00a0 Stroke risk increased linearly as average work hours rose.\u00a0NEJM Journal Watch\u2019s Dr. Bruce Soloway reviewed this article<\/a>;\u00a0his comment is below:<\/p>\n

\"work-life<\/a>\u201cMechanisms for an association between long working hours and incident CHD and stroke are unknown but might include prolonged or repetitive stress, physical inactivity, and excess alcohol consumption.\u00a0Average working hours vary widely among developed countries and represent modifiable social decisions.\u00a0Social policies encouraging or requiring people to work longer hours could have substantial health implications.\u201d<\/p>\n

These results must sit in the consciousness of nearly all residents, regardless of specialty, as our average work hours usually are greater than 50 and often average greater than 60 or 70 hours on a busy inpatient month.\u00a0At our residency program, we realize a personal work\/life balance is key, given our rigorous clinical demands.\u00a0Wellness initiatives at Emory this year include more happy hours, a research mentorship program,\u00a0Fitbit competitions, and food at conferences.\u00a0Even as residents graduate, attending\/fellowship life does not get any less stressful, although work hours usually are fewer.\u00a0But how do we prevent burn out?\u00a0After all, we are a primarily service-oriented occupation that often requires selfless sacrifice in the name of greater good for patients\u2019 well-being.<\/p>\n

\"Emory<\/a>

Emory residents at an August happy hour<\/p><\/div>\n

One solution might\u00a0be a Stanford ER program that relies on the concept of \u2018time-banking\u2019 to save physicians from burning out (Washington Post <\/em>article<\/a>).\u00a0This $250,000 2-year pilot rewarded ER attendings who spent extra time at work mentoring residents, covering shifts for colleagues, or spending time on committees.\u00a0The extra \u2018banked\u2019 time resulted in benefits such as grant-writing help, dry cleaning pick-up, or even food deliveries to home.\u00a0The result was astonishing, as most physicians improved their work-life balance and\u00a0job satisfaction and, importantly, wrote\u00a0more grant proposals (22 were submitted, with an above average 40% success rate for a whopping $10 million in support).\u00a0The latter alone is\u00a0a compelling reason to fund these types of time-bank pilots elsewhere, as they can very quickly pay for themselves.\u00a0A second reason is that the culture within this\u00a0emergency department became more collegial and friendly \u2014\u00a0many attendings volunteered to cover coworkers’ shifts as they realized their service would not go unappreciated because of the time-bank system.<\/p>\n

This innovative method to avoid burn-out and improve work-life balance may be a way to address the stress that can contribute to excess strokes, especially because work hours will not go below 55 anytime soon for residents or attendings. Physician-wellness curriculums are also key to teach physicians how to cope with stress or manage their time effectively.\u00a0My own personal tip to is to not lose whatever defines you as you go through medical training\u00a0\u2014 for me this included playing basketball or Frisbee, talking to loved ones, and attending church whenever possible.<\/p>\n

I would love to hear any other social-wellness initiatives that were successful for you personally or within your residency!<\/p>\n

 <\/p>\n

-Andrew<\/p>\n","protected":false},"excerpt":{"rendered":"

Do doctors work too much?\u00a0Residents\u00a0would probably say “Yes! I\u2019m burnt out,” and supplement it with some form of “I\u2019d much rather work less.”\u00a0Outside of residency, the answer may be a mix of yes, no, and maybe. Recently, Lancet published a meta-analysis on work hours and its effect on incident coronary disease and stroke.\u00a0The study showed […]<\/p>\n","protected":false},"author":1254,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[27,47,37],"class_list":["post-1700","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-healthy-choices","tag-mentors","tag-resident-experience"],"yoast_head":"\nMore Work Hours, More Strokes?<\/title>\n<meta name=\"description\" content=\"work-life balance for residents\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"More Work Hours, More Strokes?\" \/>\n<meta property=\"og:description\" content=\"work-life balance for residents\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2015-09-25T14:37:41+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2015\/07\/AU000_ip_andrew.jpg\" \/>\n<meta name=\"author\" content=\"Andrew Ip, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Andrew Ip, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/\",\"name\":\"More Work Hours, More Strokes?\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2015-09-25T14:37:41+00:00\",\"dateModified\":\"2015-09-25T14:37:41+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/7ea2be628b2a6358367252390eef77c6\"},\"description\":\"work-life balance for residents\",\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2015\/09\/more-work-hours-more-strokes\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"More Work Hours, More Strokes?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/7ea2be628b2a6358367252390eef77c6\",\"name\":\"Andrew Ip, MD\",\"description\":\"\\\"In west Philadelphia, born and raised \u2026\\\" \u2014 OK, not really, but very close! 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