Doctors work fewer hours, but the EHR still follows them home

Physicians are reporting fewer hours spent in clinical settings each week—a trend that might suggest progress in easing the heavy workloads often associated with modern medicine. However, an exclusive AMA survey shows a more troubling undercurrent: despite fewer reported hours on the clock, the volume of work physicians handle outside of normal hours remains high. The findings underscore a critical challenge in U.S. health care: administrative burdens continue to weigh heavily on doctors, eroding time meant for rest and recovery. 

Nearly 18,000 responses from physicians across 43 states were received from more than 100 health systems and organizations who participated in the AMA Organizational Biopsy® last year. The AMA national physician comparison report—which is exclusive data to the AMA that is not published anywhere else—reflects 2024 trends on six key performance indicators—job satisfaction, job stress, burnout, intent to leave an organization, feeling valued by an organization and total hours spent per week on work-related activities (known as “time spend”). 

The purpose of the aggregated data is to provide a national summary of organizational well-being and to serve as a comparison for other health care organizations. The results represent data from all organizations that surveyed with the AMA in 2024. 

As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine®.

In 2024, 43.2% of physicians reported experiencing at least one symptom of burnout, down from 48.2% in 2023 and 53% in 2022. Contributing to burnout is time spent on tasks outside of work hours. For 2024, physicians reported having a 57.8-hour workweek, spending 27.2 hours on direct patient care, 13 hours on indirect patient care—such as order entry, documentation, interpretation of test results and referrals—and 7.3 hours on administrative tasks, which include prior authorization, insurance forms and meeting attendance. This is slightly lower than the 2023 levels, when the average workweek was 59 hours.

For 2024, here is what AMA data reveals about total hours spent per week on work-related activities and how they vary based on physician specialty: 

• Hospital medicine: 62.8 hours, down from 67.3.
• Obstetrics and gynecology: 58.4 hours, down from 59.1.
• Internal medicine: 56.5 hours, down from 59.8.
• Family medicine: 53.8 hours, down from 55.5.
• Pediatrics: 52.8 hours, down from 54.3.
• Emergency medicine: 52.3 hours, down from 53.3.

Respondents who were 11–15 years out of residency or fellowship reported a 59.1-hour workweek while physicians more than 20 years out of training reported a 56.5-hour workweek.

Additionally, 22.5% of physicians reported spending more than eight hours on the EHR outside the normal work hours of 5:30 p.m. to 7 a.m. on weekdays, which is up from 20.9% in 2023. Meanwhile, 13.6% spent six to eight hours outside of work on the EHR last year, down from 14% in 2022. Also, about 24.5% of respondents reported spending zero to two hours a week on work outside of work.

Health systems improve efficiency

Many health systems are making changes to ensure physicians can unplug and relax after work without spending their “pajama time” on the EHR managing their inbox or completing documentation needs. These examples from organizations that are part of the AMA Health System Member Program show commitment to reducing administrative burdens physicians are facing.

1. Baptist Health ensures physicians come back to an empty inbox

   1. As part of its efforts to reduce the burden on physicians to manage their inboxes while they’re on paid time off, Baptist Health Medical Group has created a pilot program to tackle EHR use on vacation. As part of the program, a team—which consists of a physician, nurse practitioner or nonphysician provider—helps to offload some of the messages received by physicians who are out of the office.

2. Geisinger strategically deploys AI to let physicians focus on care

   1. Augmented intelligence (AI)—often called artificial intelligence—has emerged as a transformative technological force in health care, offering promising solutions to alleviate the growing burden on physicians while enhancing patient care. By harnessing the power of health care AI, physicians and other health professionals at Geisinger can streamline processes, optimize workflows and ultimately reclaim valuable hours in the day.

3. HCA Healthcare takes a systemic approach to improving efficiency

   1. When it comes to physician well-being, leaders at the nation’s largest health system say they’ve learned that efforts need to focus on the larger picture, shifting away from simply supporting individuals and toward changing the organization itself for the better. HCA Healthcare undertakes a systematic approach to finding and then addressing hindrance job demands—the "pebbles in the shoe" that contribute to physician frustration and burnout. Examples of “hindrance” demands might include broken equipment or EHR inefficiencies. 

4. Northwell Health embedded clinical pharmacists

   1. It can be challenging in a large neurology practice that treats patients with complex conditions to find ways to improve both care and practice workflows. A neurology practice within Northwell Health has found a way: integrating a clinical pharmacist. When clinical pharmacists are embedded into a practice to help manage the patient volume, they can take on tasks that would otherwise stretch the availability of neurologists. 

5. Ochsner Health uses AI to fine-tune physician EHR messages 

   1. With so many patient messages coming into a portal, it’s possible to miss important details, especially if a message were long and convoluted. But by using AI as a tool, physicians get an assist in message analysis. At Ochsner Health, physicians and other care team members can use AI prompts to help draft responses to patient portal messages. 

6. Sutter Health thinks creatively about reducing administrative burdens

   1. At Sutter Health, ob-gyns were bringing in chaperones for appointments, so they opted to train medical assistants to be both chaperones and scribes, combining work and freeing up the physician to attend to patient care. They’ve also tackled so-called “note bloat” by educating physicians about the ability to use time-based billing instead of note-documentation billing. Find out how Sutter Health gives physicians time back in their days.

7. Texas Children’s Pediatrics uses AI-supported documentation

   1. To reduce the burden of rote note taking, Texas Children’s Pediatrics launched a pilot program that used AI. Members of the first cohort embedded it into their daily practice as a practical everyday tool. Their forward-thinking embrace of AI is now on its way to transforming how more than 250 pediatricians in over 50 locations throughout the Houston area treat patients, connect with families and provide higher levels of personalized care to both.

8. The Permanente Medical Group embraces AI scribes

   1. Clinical documentation has long been a leading contributor to physician burnout. Time spent outside normal hours—often called “pajama time”—completing notes, orders and reviews has steadily eroded physician satisfaction and interfered with patient relationships. Ambient AI scribes at The Permanente Medical Group aim to reverse this trend by transcribing and summarizing patient-physician conversations in real time, freeing doctors from the keyboard and giving them more face-to-face time with patients. 

9. The Southeast Permanente Medical Group engages IT to remove "pebbles"

   1. Bringing IT to the table began with The Southeast Permanente Medical Group’s previous work to improve operational inefficiencies with its “Pebbles in the Shoe” campaign. This effort set out to identify and reduce inefficiencies and documentation burdens by offering a three-week challenge period for physicians and teams to submit ideas, or “pebbles,” for improving efficiencies. 

10. University of Iowa Health Care offers AI ambient documentation

    1. Physicians are increasing their use of digital tools enabled by AI to assist in the documentation of billing codes, medical charts and visit notes. A reason for this growth in the use of technology, according to AMA research (PDF), is that physicians are learning how AI can streamline workflows, create efficiencies and improve physician well-being. At University of Iowa Health Care, AI-enabled ambient documentation and chart-review tools help reduce the burden physicians face.

Time-saving strategies to follow

Implementing efficient workflows and embracing team-based care are essential to enhancing both clinical productivity and patient satisfaction. AMA STEPS Forward^® offers a curated set of evidence-based strategies designed to help health care teams reduce administrative burdens, optimize operations and reclaim valuable time. 

Whether your goal is to improve staff coordination, reduce physician burnout or refine patient flow, here are some time-saving playbooks and toolkits that provide practical tools that deliver measurable impact across your health system or practice.

1. “Saving Time Playbook”

   1. This playbook will provide strategies to organizational leaders to enhance processes, implement time-saving workflows, increase the efficiency of their practice and improve physician well-being.

2. “Taming the EHR Playbook”

   1. This playbook shows learners how to develop a comprehensive plan that minimizes redundant tasks, streamlines workflow, and enhances EHR proficiency to reduce the burden of the EHR on physicians and enhance overall productivity and well-being. The playbook includes the “De-implementation Checklist” (PDF), which offers examples of what EHR tactics can be removed or changed. 

3. “Annual Prescription Renewal”

   1. This toolkit explains how to implement an annual synchronized prescription renewal process in your clinic. This approach saves time for your practice and improves medication adherence.

4. “Pre-visit Planning”

   1. Understand how pre-visit, team-based workflows can save time, improve care and strengthen satisfaction among the care team.

5. “Embedding Pharmacists Into the Practice”

   1. This toolkit explains how to integrate a clinical pharmacist into your practice, optimizing drug therapy and improving patient care.

6. “Getting Rid of Stupid Stuff”

   1. This toolkit will help your practice identify and eliminate the “stupid stuff” that adds unnecessary burden to the daily workload and contributes to clinician burnout. The toolkit provides a structured process for recognizing wasteful tasks, particularly within EHR systems, and includes real-world examples and actionable steps. 

Download the 2024 AMA Joy in Medicine® magazine (log into your AMA account to view) to see whether your organization is part of the prestigious group of 130 organizations across 35 states that are currently recognized for their dedication to physician well-being.

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