Journal Article

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

Jung, Franziska Ulrike, Pabst, Alexander, Luppa, Melanie, Riedel-Heller, Steffi G., Bodendieck, Erik

2026

Overview

Background 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. Method 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. Results 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. Discussion 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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Age / Analysis / Burn out (Psychology) / Burnout / Burnout, Professional - epidemiology / Cohort analysis / Cohort Studies / Fatigue / Female / Full-time / Germany - epidemiology / Health Administration / Health aspects / Health care / Health Services Research / Human Resource Development / Human Resource Management / Humans / Longitudinal Studies / Male / Marital status / Medical care / Medical personnel / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Part-time / Personnel Staffing and Scheduling / Physicians / Physicians - psychology / Practice and Hospital Management / Professionals / Psychological aspects / Quality management / Questionnaires / Risk factors / Self employment / Shift work / Social Policy / Sociodemographics / Stress / Surveys / Surveys and Questionnaires / Variables / Well being / Work hours / Work Schedule Tolerance - psychology / Working hours / Working time / Workload - psychology