title: Workplace factors leading to planned reduction of clinical work among emergency physicians.
abstract: OBJECTIVE
  There is anecdotal evidence that ACEM Fellows are reducing or planning to reduce their clinical workload. We investigated the extent of, and reasons for, these reductions.
  
  
  METHODS
  An anonymous, cross-sectional postal survey utilizing a study-specific questionnaire.
  
  
  RESULTS
  Three hundred and twenty-three Fellows (63.5%) responded. Most were recently graduated males. In the last 5 years, the mean number of clinical hours worked per week has reduced significantly (P < 0.001) for both junior (40.6-28.9 h) and senior Fellows (30.4-23.1 h). Further significant (P < 0.001) reductions are planned. The most frequently reported reasons for reducing clinical workload were excessive workload, family life and emotional health effects, shift work and work stress. The most stressful aspects of work reported were access block, dealing with management, insufficient staffing, workload pressures and staff supervision. Clinical work reportedly impacts most upon family life, social life and emotional health.
  
  
  CONCLUSIONS
  Fellows are significantly reducing their clinical workload largely in response to excessive workload and lack of resources. These findings have important implications for professional longevity and work force planning. Re-evaluation of workplace practice, especially identified stressors, is indicated.
authors.affiliation: Emergency Department, Ballarat Health Services, Royal Melbourne Hospital, Parkville, Vic 3050, Australia.
authors.forename: Heather D
authors.initials: HD
authors.lastname: Crook
authors.forename: David McD
authors.initials: DM
authors.lastname: Taylor
authors.forename: Julie F
authors.initials: JF
authors.lastname: Pallant
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D044362:Australasia; D002055:Burnout, Professional / Q000517:prevention & control / Q000523:psychology; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D009042:Motivation; D016272:Occupational Health; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D012919:Social Behavior; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology*; D017132:Workplace / Q000458:organization & administration / Q000523:psychology