What kind of hours should we ask our professionals to work?

When I hired the first advanced practitioner in my management career, she worked 5 days a week in our sickle cell center. Most days she worked 9-10 hours; occasionally more than that and sometimes less than that. After about a year, things got busier and her hours per day increased to 10-11. She began to get burned out. It wasn’t just the additional hour, it was what she was giving up (time with family, time to get personal things done, sleep). In addition despite putting in the extra time, she didn’t feel as if she was getting everything done. She left after being with us only 2 years. She was good at what she did and losing her hurt us terribly.

When I hired our 2nd advanced practitioner around the same time for our cancer center, she asked to work four 10-hour days. The operations director of the practices (a nurse by training – who had been in management for over 20 years) was against it. She told me that professionals ought to work 9-10 hours a day, 5 days a week, which is 45-50 hours, and to do that working 4 days a week, she’ll need to work 12-hour days, and she won’t do it, and the clinic is only open for 10 hours. The director said. “this is just a way to make the same amount of money working less, and she won’t be here everyday and someone else will need to do her duties that 5th day, which usually doesn’t work.”  The advanced practitioner worked with me for over 10 years, only leaving when I left.  She averaged 11-12 hours a day, and there were days she didn’t leave until I did, which was after 9pm most nights. The operations director was wrong. There were adjustments we needed to make to the practitioners workflows (she spent the last few hours of the day documenting, calling families with labs, handling refills and writing orders for the next day).

There are several morals to this story:

  • Yes, professionals need to work 45-50 hours a week, if they aren’t they are costing the system too much. Why should one professional be allowed a 40-hour week when the majority who are doing a good job work 10-20% more than that.
  • If professionals work 50-60 hours a week, burnout is a risk. That extra 5-10 hours is golden, and its not the work that’s burning them out, its what they’re giving up that’s killing them. And if they feel like they aren’t keeping up despite working extra, then they will surely burnout.
  • Working 4 days a week reduces burnout, but it doesn’t have to reduce productivity.
  • 20 years in management doesn’t mean you always know what you’re doing. To be wise requires managing your biases, thinking outside the box, and being open to the ideas of others just as much as having knowledge and experience.