Changes in working hours and burnout levels among physicians: a cohort study

Currently, the health care system in Germany is facing a serious physician shortage. Previous research reported changes in working hours and a tendency towards a reduction in clinical hours. The aim was to investigate the relationship between changes in working hours and symptoms of burnout in German physicians over two time points.

In 2020, a random sample of physicians from the Federal State of Saxony (Germany) was drawn. The current analyses are based on data from a longitudinal survey conducted in 2020 and 2024. Overall, a sample of n = 333 physicians working in both inpatient and outpatient care was investigated using descriptive and regression analyses. In a multivariate analysis predicting burnout symptoms (overall, patient-related, work-related, personal burnout) in 2024, sociodemographic factors such as age, sex and work-related aspects (i.e. medical setting and working hour characteristics), as well as burnout level in 2020, were controlled for.

Overall, 19.2% (n = 64) of the sample reported no changes in working hours over 4 years, whereas 27% (n = 90) reported an increase in working hours and 53.8% (n = 179) reported a decrease in working hours. In fact, a working hour reduction was significantly linked to lower overall burnout, lower personal burnout and lower work-related burnout at follow-up (p < 0.001 for all regression models), while controlling for covariates. No significant association between change in working hours and the third burnout dimension-patient-related burnout at follow-up-was found.

The present findings emphasize that physician burnout remains a critical issue, especially in the context of clinical working hours. Reducing actual working hours and decreasing overwork may help to improve physician well-being. Future efforts should also focus on optimizing working conditions beyond hours alone-such as increasing schedule flexibility and addressing systemic stressors-to sustainably protect physicians' health and ensure high-quality patient care.