title: Less work: more burnout? A comparison of working conditions and the risk of burnout by German physicians before and after the implementation of the EU Working Time Directive.
abstract: OBJECTIVE
  The present study is a 10-year comparison (1997 vs. 2007) of occupational and health aspects before and after the implementation of the European Working Time Directive on German hospital physicians. A major focus is whether the changes in working conditions are accompanied by a lower risk for burnout.
  
  
  METHODS
  Three hundred and twenty-eight physicians from the Medical Register of the city of Hamburg completed the survey in 1997 and 994 physicians in 2007. The response rates were 55.4 and 46.5 %, respectively. All participants filled in a 22-item version of the German translation of the Maslach Burnout Inventory. Results of multivariate covariance analyses are reported.
  
  
  RESULTS
  The work of physicians has changed significantly within the 10-year period, for example, work time decreased by 4.5 h on average to 55.8 h per week in 2007. Junior physicians profited more from this development, but on-call duties increased for senior physicians in particular. The reduced hours were at the expense of fewer rests. Junior, as well as senior, physicians reported significantly higher rates on the burnout scale for emotional exhaustion (mean 21.8, SD 10.7) in the latter survey and senior physicians also on the depersonalization scale (mean 9.7, SD 6.3).
  
  
  CONCLUSIONS
  Changes in working conditions in accordance with the European Working Time Directive are not accompanied by reduced strain and risk of burnout for physicians. Rather, our data argue for greater intensification in work, especially for senior physicians. Further studies are suggested in order to explore interventions for a sustainable improvement in the working conditions of physicians.
authors: Institute for Occupational and Maritime Medicine, Ministry of Health and Consumer Protection in Hamburg, Hamburg, Germany, zfam@bgv.hamburg.de.
authors: Astrid
authors: A
authors: Richter
authors: Petya
authors: P
authors: Kostova
authors: Xaver
authors: X
authors: Baur
authors: Ralf
authors: R
authors: Wegner
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology*; D004630:Emergencies; D004644:Emotions; D005062:European Union; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence* / Q000639:trends; D010820:Physicians / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D018582:Sick Leave / Q000639:trends; D012890:Sleep; D013997:Time Factors; D016526:Workload / Q000523:psychology*; D017132:Workplace / Q000523:psychology