Identifying differences in GPs’ working hours according to gender and employment position: A time sampling study using SMS text messaging

In order to aid health workforce planning, we measured the number of hours worked by general practitioners (GPs). The twofold aim of this study consisted of assessing the feasibility, validity and reliability of an innovative method to measure working time and, second, to analyse differences in hours worked between six types of GPs divided by the combination of their gender and employment position. Our method was based on multiple time point observations using SMS text messaging. On average 19 GPs participated every week for 57 weeks. In total 1,051 GPs participated resulting in 61,320 valid measurements of time use. On average, GPs worked 44 hours per week. About 56% of this time was spent on direct patient-related activities, 26% to indirect patient-related activities, and 18% to activities not related to patients. There were substantial differences in working hours between male and female self-employed, those drawing a salary from a duo or group practice and locum GPs. For example, male self-employed GPs worked 51.6 hours per week, whereas male locum GPs worked 26.7 hours per week. Generally, differences in hours worked with regard to gender and employment position are smaller if we relate these hours to the number of FTE they worked. Furthermore, we conclude that the method of SMS text messaging based on the time sampling technique presents a limited degree of interference to the participants’ work and achieved reliable and valid results.