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

Background: Work hour restrictions for trainess are now commonplace, this suggests that  work hour restrictions for clinical faculty may be of value in assuring patient safety, but this has to 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 post policy change.  Factors assessed included faculty concern regarding productivity (RVU’s), stress level, resident teaching, autonomy, ability to function after a difficult call etc.  Statistical analysis was done with Chi Square test.

Results: 20 faculty started this project.  The data was averaged over all 3 survey time points. Fifty-six percent believed that their clinical production (RVU’s) 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.   

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

Topics: CREOG & APGO Annual Meeting, 2017, Faculty, Osteopathic Faculty, Patient Care, Systems-Based Practice & Improvement, GME, CME, Quality & Safety, Advocacy, Faculty Development,