scholarly journals Out-of-hours workload among Norwegian general practitioners – an observational study

2019 ◽  
Author(s):  
Ingrid Keilegavlen Rebnord ◽  
Tone Morken ◽  
Kjell Maartmann-Moe ◽  
Steinar Hunskaar
Keyword(s):  
General Practitioners ◽  
Rural Areas ◽  
Linear Regression Analysis ◽  
Working Hours ◽  
Clinical Work ◽  
Working Time ◽  
Medical Work ◽  
Out Of Hours ◽  
Electronic Survey ◽  
Regular Work

Abstract Background Repeated studies of working hours among Norwegian regular general practitioners (RGPs) have shown that the average total weekly working hours have remained unchanged since 1994 until 2014. For both male and female RGPs the mean total weekly working hours were almost 50 hours in 2014. In recent years there has been an outcry of dissatisfaction among Norwegian RGPs. They experience significantly increased workload without compensation, such as more doctors or better payments. A study from the Norwegian Directorate of Health in 2018 (the RGP study) showed that Norwegian RGPs worked 55.6 hours weekly (median 52.5). 25% of the respondents worked more than 62.2 hours weekly. Based on data from the RGP-study we investigated Norwegian RGPs work out-of-hours (OOH), how the working time was distributed, and to which extent the OOH work affected the regular working hours.Methods In early 2018, an electronic survey was sent to all 4716 RGPs in Norway. Each RGP reported prospectively how many minutes per day they used on various tasks during one week. Working time also included additional tasks in the municipality, other professional medical work and OOH primary health care. Differences were analyzed by independent t-tests, and regression analyses.Results 1876 RGPs (39.8%) responded, 640 (34.1%) had registered OOH work. Male RGPs worked in average 1.5 hours more with regular work than females (p=0.001) and in average 2.3 hours more OOH work than females (p=0.079). RGPs with no OOH work registered a mean of 1.0 hours more clinical work than RGPs working OOH (p=0.043). There was a large variation in OOH working hours. A linear regression analysis showed that male RGPs and RGPs in rural areas had the highest OOH workload.Conclusions Every third of Norwegian RGPs participated in OOH work during the registration week in the RGP study. OOH work was done in addition to a high regular workload as RGP. We found small gender differences. OOH work did not lead to reduced regular RGP work.

scholarly journals Out-of-hours workload among Norwegian general practitioners – an observational study

2020 ◽  
Author(s):  
Ingrid Keilegavlen Rebnord ◽  
Tone Morken ◽  
Kjell Maartmann-Moe ◽  
Steinar Hunskaar
Keyword(s):  
General Practitioners ◽  
Rural Areas ◽  
Linear Regression Analysis ◽  
Working Hours ◽  
Clinical Work ◽  
Working Time ◽  
Medical Work ◽  
Out Of Hours ◽  
Electronic Survey ◽  
Regular Work

Abstract Background: Repeated studies of working hours among Norwegian regular general practitioners (RGPs) have shown that the average total number of weekly working hours has remained unchanged since 1994 and up until 2014. For both male and female RGPs, the mean total weekly working hours amounted to almost 50 hours in 2014. In recent years, Norwegian RGPs have become increasingly dissatisfied. They experience significantly increased workload without compensation in the form of more doctors or better payment. A study from the Norwegian Directorate of Health in 2018 (the RGP study) showed that Norwegian RGPs worked 55.6 hours weekly (median 52.5). 25% of the respondents worked more than 62.2 hours weekly. Based on data from the RGP study we investigated Norwegian RGP’s out-of-hours (OOH) work, how the working time was distributed, and to what extent the OOH work affected the regular working hours.Methods: In early 2018, an electronic survey was sent to all 4640 RGPs in Norway. Each RGP reported how many minutes that were spent that particular day on various tasks during seven consecutive days. Working time also included additional tasks in the municipality, other professional medical work and OOH primary health care. Differences were analysed by independent t-tests, and regression analyses. Results: 1876 RGPs (40.4%) responded, 640 (34.1%) had registered OOH work. Male RGPs worked on average 1.5 hours more doing regular work than did females (p=0.001) and on average 2.3 hours more OOH work than females (p=0.079). RGPs with no OOH work registered a mean of 1.0 hours more clinical work than RGPs working OOH (p=0.043). There was a large variation in OOH working hours. A linear regression analysis showed that male RGPs and RGPs in rural areas had the heaviest OOH workload. Conclusions: One in three Norwegian RGPs undertook OOH work during the registration week in the RGP study. OOH work was done in addition to a sizeable regular workload as an RGP. We found small gender differences. OOH work was not compensated with reduced regular RGP work.

scholarly journals Out-of-hours workload among Norwegian general practitioners – an observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ingrid Keilegavlen Rebnord ◽  
Tone Morken ◽  
Kjell Maartmann-Moe ◽  
Steinar Hunskaar
Keyword(s):  
General Practitioners ◽  
Rural Areas ◽  
Linear Regression Analysis ◽  
Working Hours ◽  
Clinical Work ◽  
Working Time ◽  
Medical Work ◽  
Out Of Hours ◽  
Electronic Survey ◽  
Regular Work

Abstract Background Repeated studies of working hours among Norwegian regular general practitioners (RGPs) have shown that the average total number of weekly working hours has remained unchanged since 1994 and up until 2014. For both male and female RGPs, the mean total weekly working hours amounted to almost 50 h in 2014. In recent years, Norwegian RGPs have become increasingly dissatisfied. They experience significantly increased workload without compensation in the form of more doctors or better payment. A study from the Norwegian Directorate of Health in 2018 (the RGP study) showed that Norwegian RGPs worked 55.6 h weekly (median 52.5). 25% of the respondents worked more than 62.2 h weekly. Based on data from the RGP study we investigated Norwegian RGP’s out-of-hours (OOH) work, how the working time was distributed, and to what extent the OOH work affected the regular working hours. Methods In early 2018, an electronic survey was sent to all 4640 RGPs in Norway. Each RGP reported how many minutes that were spent that particular day on various tasks during seven consecutive days. Working time also included additional tasks in the municipality, other professional medical work and OOH primary health care. Differences were analysed by independent t-tests, and regression analyses. Results One thousand eighty hundred seventy-six RGPs (40.4%) responded, 640 (34.1%) had registered OOH work. Male RGPs worked on average 1.5 h more doing regular work than did females (p = 0.001) and on average 2.3 h more OOH work than females (p = 0.079). RGPs with no OOH work registered a mean of 1.0 h more clinical work than RGPs working OOH (p = 0.043). There was a large variation in OOH working hours. A linear regression analysis showed that male RGPs and RGPs in rural areas had the heaviest OOH workload. Conclusions One in three Norwegian RGPs undertook OOH work during the registration week in the RGP study. OOH work was done in addition to a sizeable regular workload as an RGP. We found small gender differences. OOH work was not compensated with reduced regular RGP work.

scholarly journals Supply and Demand in Liver Transplantation Surgery: Implications for Training in the UK

2013 ◽  
Vol 95 (8) ◽  
pp. 1-5
Author(s):  
SJ McNally ◽  
RW Parks ◽  
SJ Wigmore
Keyword(s):  
Liver Transplantation ◽  
Supply And Demand ◽  
Significant Proportion ◽  
Working Hours ◽  
Working Time ◽  
Out Of Hours ◽  
Medical Graduates ◽  
Transplantation Surgery ◽  
European Working ◽  
The Uk

At the end of the 1990s there was a perceived crisis in the recruitment of transplant surgeons in the UK. transplantation surgery is a demanding specialty, requiring a significant proportion of time to be spent in out-of-hours work performing prolonged and technically demanding surgery. Other factors, such as reduced working hours associated with the implementation of the european Working time regulations and the changing expectations of new medical graduates, are thought to have contributed to making training in liver transplantation surgery an unattractive option.

Certain uncertainties: Modes of patient safety in healthcare

2012 ◽  
Vol 42 (5) ◽  
pp. 732-752 ◽  
Author(s):  
Sonja Jerak-Zuiderent
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
General Practitioners ◽  
Human Life ◽  
Clinical Work ◽  
Ethnographic Research ◽  
Out Of Hours ◽  
Georges Canguilhem ◽  
Care Facilities ◽  
Continuous Stream

The safety movement in healthcare approaches patient safety mainly by reducing uncertainty to prevent possible errors. This article is concerned with how this approach relates to other modes of conceptualising patient safety. Following the work of Georges Canguilhem, I argue that, depending on how we conceptualise knowing, acting and error, a different mode of patient safety is possible: one that involves ‘living with uncertainty’. Through ethnographic research on daily clinical work in Dutch primary care facilities, I show that the assumption that clinical work can be made safe by reducing errors not only is problematic, it also creates new forms of ‘unsafety’. My observations at general practitioners’ out-of-hours service units and other primary care facilities display a ‘continuous stream of knowing and acting’ in which care professionals adopt specific practices that avoid contradictions between uncertainty and safety. Although these practices differed in the various locations I studied, there were some common dimensions of ‘living with uncertainty’. By problematising the conceptions of safety and errors as antonyms I suggest that a reappraisal is in order, particularly of the notion of errors in healthcare. Keeping and protecting room for errors in a situated way is crucial for knowing and acting in a field riddled with uncertainty and dealing with human life.

The number of employed as a macroeconomic indicator of working time dynamics

2020 ◽  
Vol 16 (5) ◽  
pp. 935-945
Author(s):  
I.A. Zaikova
Keyword(s):  
Comparative Analysis ◽  
Manufacturing Sector ◽  
Working Hours ◽  
Working Time ◽  
Labor Costs ◽  
Factors Affecting ◽  
Time Dynamics ◽  
Developed Economies ◽  
The Relationship ◽  
Macroeconomic Indicator

Subject. The working time of workers at any stage of economic development is a value reflecting the level of labor productivity. Any progress in productivity contributes to changes in the volume of labor costs and the number of employed. Depending on the relationship between the total volume of labor costs and the number of employed, the duration of working time per one worker may change (it may increase, decrease, or remain unchanged). Objectives. The study aims to confirm the importance of such a macroeconomic indicator as the number of employed in varying working hours. Methods. The study rests on the comparative analysis of countries with developed economies based on some indicators like dynamics of the working time fund, dynamics of the number of employed, average number of hours worked during the year per employee, etc. The analyzed timespan is 25 years (from 1991 to 2016). Results. The comparative analysis revealed that in the non-production sphere and the economy as a whole the macroeconomic determinants correlate so that the length of working time per worker reduces. When considering the analysis results for the manufacturing sector, no single trend was identified. Conclusions. One of the key factors affecting the change in working hours is the number of employed. The relationship between the working time fund and the number of employed directly determines the dynamics of working time per worker.

Socio-Economic Analysis of the Proposal to Switch to a Four-Day Working Week in Russia

2019 ◽  
pp. 60-66
Author(s):  
R. A. Lugovskoy ◽  
E. V. Mikhaylov
Keyword(s):  
Public Administration ◽  
Russian Federation ◽  
Social Protection ◽  
Prime Minister ◽  
Working Hours ◽  
Working Time ◽  
Production Costs ◽  
Historical Background ◽  
Labor Legislation ◽  
The Russian Federation

The presented study analyzes the proposal of the Prime Minister of the Russian Federation D. A. Medvedev to switch to a four-day working week. In the context of the topic, the experience of dealing with this issue is examined, including international practices. A similar proposal was discussed by I.V. Stalin as far back as Soviet times, although in the context of switching to five- or six-hour working days, but only in 2019 did this issue become the subject of debate. In light of the pension reform, which has led to an increase in the retirement age in Russia, a number of experts believe that such proposals may entail potential changes that could have a negative effect on the situation of workers. This study examines the mechanisms of public administration in coordination with enterprises relating to changes in the working hours.Aim. The authors aim to analyze potential directions for the improvement of public administration in the field of labor legislation, which has a significant impact on the development of the economy, business, and the situation of workers.Tasks. This study determines the historical background of Russia’s switch to a four-day working week; examines the legal mechanisms and specific features of labor legislation in Russia in the context of the planned switch to a four-day working week; explores international practices in the field of regulation of working hours; analyzes the benefits and drawbacks of switching to a four-day working week in Russia; develops proposals associated with Russia’s switch to a four-day working week.Methods. The methodological basis for the consideration of the problems includes general scientific methods, systems, structural, functional, and institutional analysis.Results. The ongoing processes in the field of improvement of labor legislation and its impact on the economy, business, and the situation of workers are comprehensively analyzed. The historical background of Russia’s switch to a four-day working week is determined; fundamentals of Russian labor legislation are examined; benefits and drawbacks of the potential innovations in the field of regulation of working hours are identified with allowance for international practices. The authors formulate proposals, the implementation of which will bring Russia closer to the switch to a four-day working week.Conclusions. The proposals of the Prime Minister of the Russian Federation to switch to a four-day working week has raised a lot of questions. For instance, it is unclear whether the current wages will be maintained. It is also questionable whether it is a step towards artificially reducing unemployment, in which fields this idea is likely to manifest itself first, and so on. These questions need to be thoroughly discussed by the representatives of the Government of the Russian Federation, Ministry of Labor and Social Protection of the Russian Federation, trade unions, and the scientific community. It is necessary to conduct a sociological survey to determine and prevent concerns among citizens about the upcoming changes. That said, the authors believe that the idea itself is conceptually correct, but it still valid to doubt whether it can be successfully implemented at the time of capitalism, when entrepreneurs focus on profit and are not interested in reducing the working time of their employees. According to the authors, the plans of I.V. Stalin to reduce working time could faster come into fruition with the socialist economic model, which facilitated innovations in the machine tool industry that would boost GDP growth and significantly reduce production costs. Assessing the prospects of development of this idea at the present stage is difficult.

LEGAL REGULATION OF WORKING HOURS: HISTORY AND MODERNITY

2020 ◽  
Author(s):  
Тамила Магомедовна Нинциева
Keyword(s):  
Working Hours ◽  
Legal Regulation ◽  
Working Time

В представленной статье рассматриваются исторические особенности развития правового регулирования рабочего времени, анализируются отдельные нормативные акты, регулирующий данный вопрос. This article discusses the historical features of the development of legal regulation of working time, analyzes individual regulatory acts governing this issue.

scholarly journals Boundaryless working hours and recovery in Germany

2021 ◽  
Author(s):  
Laura Vieten ◽  
Anne Marit Wöhrmann ◽  
Alexandra Michel
Keyword(s):  
Working Hours ◽  
Working Time ◽  
Overtime Work ◽  
Psychological Detachment ◽  
Representative Study ◽  
Flexible Working ◽  
Recovery Experiences ◽  
High Level ◽  
And Control ◽  
Extended Work

Abstract Objective Due to recent trends such as globalization and digitalization, more and more employees tend to have flexible working time arrangements, including boundaryless working hours. The aim of this study was to investigate the relationships of various aspects of boundaryless working hours (overtime, Sunday work, and extended work availability) with employees’ state of recovery. Besides, we examined the mediating and moderating role of recovery experiences (psychological detachment, relaxation, mastery, and control) in these relationships. Methods We used data from 8586 employees (48% women; average age of 48 years) who took part in the 2017 BAuA-Working Time Survey, a representative study of the German working population. Regression analyses were conducted to test main effects as well as mediation and moderation. Results Overtime work, Sunday work, and extended work availability were negatively related to state of recovery. Psychological detachment mediated these relationships. Furthermore, we found that relaxation and control mediated the association between extended work availability and state of recovery. However, no relevant moderating effects were found. Conclusions Altogether, our findings indicate that various aspects of boundaryless working hours pose a risk to employees’ state of recovery and that especially psychological detachment is a potential mechanism in these relationships. In addition, the results suggest that a high level of recovery experiences cannot attenuate these negative relationships in leisure time. Therefore, employers and employees alike should try to avoid or minimize boundaryless working hours.

scholarly journals Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Patient Care ◽  
General Practitioners ◽  
Linear Regression Analysis ◽  
Chronically Ill ◽  
Disease Management Programs ◽  
Federal States ◽  
Set Up ◽  
Chronically Ill Patients

Summary Background Disease management programs (DMPs) were set up in Germany in 2003 to improve outpatient care of chronically ill patients. The present study looks at the attitudes and experiences of general practitioners (GPs) in relation to DMPs, how they rate them almost 20 years after their introduction and where they see a need for improvement. Methods A total of 1504 GPs in the Federal States of Rhineland Palatinate, Saarland and Hesse were surveyed between December 2019 and March 2020 using a written questionnaire. Results In total, 58% of respondents rate DMPs positively and regard them as making a useful contribution to primary care. The guarantee of regular, structured patient care and greater compliance are regarded as particularly positive aspects. It was also established that diagnostic and therapeutic knowledge was expanded through participation in DMPs. 57% essentially follow the DMP recommendations for (drug) treatment. Despite positive experiences of DMPs in patient care, the GPs surveyed mention various challenges (documentation requirements, frequent changes to the programmes, inflexibility). Univariant linear regression analysis revealed factors influencing the satisfaction with DMPs, such as improvement of compliance and clearly defined procedures in medical care. Conclusion Most of the GPs surveyed consider the combination of continuous patient care and evidence-based diagnosis and treatment to be a great advantage. To better adapt DMPs to the conditions of primary care, it makes sense to simplify the documentation requirements, to regulate cooperation with other healthcare levels more clearly and to give GPs more decision-making flexibility. Increased inclusion of GP experience in the process of developing and refining DMPs can be helpful.

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