Perceived impact of the 80-hour workweek: five years later

We aimed to assess perceptions of the effects of the 80-hour workweek (80hWW) restriction on patient care, education, and resident quality of life.

In April 2007, attending surgeons and residents in nine surgical specialties at our institution were surveyed. Respondents were categorized into three groups: (1) attending surgeons; (2) residents beginning their training before the 80hWW implementation (ResBefore); and (3) residents beginning training after the 80hWW implementation (ResAfter). Differences between groups were assessed with univariate analysis.

The overall response rate was 57%. A minority in all three groups (< or =33%) believed the 80hWW improved patient care. Fifteen percent of attending surgeons, 30% of ResBefore, and 67% of ResAfter believed patients were safer (P < 0.001). Eighty-three percent of attending surgeons, 74% of ResBefore, and 41% of ResAfter (P < 0.001) believed continuity of care was compromised. All groups (> or =84%) agreed that midlevel providers were now critical to successfully deliver health care (P = 0.40). Fewer attending surgeons (21%) and ResBefore (29%) perceived improvements in education compared with ResAfter (68%; P <0.001). A majority perceived improved work-life balance for residents (attending surgeons [85%], ResBefore [71%], and ResAfter [92%]; P = 0.008), but 76% of attending surgeons reported decreased job satisfaction.

We showed a discrepancy between perceptions of attending surgeons and residents regarding the effect of the 80hWW on patient care and surgical education. Quality of life was improved for residents but not for attending surgeons. The impact of the 80hWW on patient care and surgical education needs to be quantified.