title: Physician work intensity among medical specialties: emerging evidence on its magnitude and composition.
abstract: BACKGROUND
  Similarities and differences in physician work intensity among specialties are poorly understood but have implications for quality of care, patient safety, practice organization and management, and payment.
  
  
  OBJECTIVE
  To determine the magnitude and important dimensions of physician work intensity for 4 specialties.
  
  
  METHODS
  Cross-sectional assessment of work intensity associated with actual patient care in the examination room or operating room.
  
  
  METHODS
  A convenience sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons, located in Kansas, Kentucky, Maryland, Ohio, and Virginia.
  
  
  METHODS
  Work intensity measures included the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), Subjective Work Assessment Technique (SWAT), and Multiple Resource Questionnaire. Stress was measured by the Dundee Stress State Questionnaire.
  
  
  RESULTS
  Physicians reported similar magnitude of work intensity on the NASA-TLX and Multiple Resource Questionnaire. On the SWAT, general internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists (P=0.035). Surgeons reported significantly higher levels of task engagement on the stress measure than the other specialties (P=0.019), significantly higher intensity on physical demand (P < 0.001), and significantly lower intensity on the performance dimensions of the NASA-TLX than the other specialties (P=0.003). Surgeons reported the lowest intensity for temporal demand of all specialties, being significantly lower than either family physicians or neurologists (P=0.014). Family physicians reported the highest intensity on the time dimension of the SWAT, being significantly higher than either general internists or surgeons (P=0.008).
  
  
  CONCLUSIONS
  Level of physician work intensity seems to be similar among specialties.
authors: Department of Public Health Sciences, University of Cincinnati, Cincinnati, OH 45219, USA. Ronnie.Horner@uc.edu
authors: Ronnie D
authors: RD
authors: Horner
authors: Jerzy P
authors: JP
authors: Szaflarski
authors: Jun
authors: J
authors: Ying
authors: Karthikeyan
authors: K
authors: Meganathan
authors: Gerald
authors: G
authors: Matthews
authors: Brian
authors: B
authors: Schroer
authors: Debra
authors: D
authors: Weber
authors: Marc
authors: M
authors: Raphaelson
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data*; D009462:Neurology / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D010821:Physicians, Family / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D016526:Workload / Q000706:statistics & numerical data