Physicians report 15 hours of ‘pajama time’

By Andrea Fox for Healthcare IT News

Some 93% of physicians feel burned out, but 83% said AI has the potential to reduce administrative burdens, according to athenahealth’s third Physician Sentiment Survey, conducted by the Harris Poll.

For this year’s measurement of physician sentiments, atheneahealth added a new line of questioning focused on artificial intelligence in its survey of 1,003 primary care (750) and specialist (253) physicians nationwide.


The electronic health vendor announced Wednesday that eight in 10 physicians who participated in athenahealth’s 2023 Physician Sentiment Survey between October 23 and November 8 are looking to AI to address the burnout they say has become the norm.

In the online survey, the physicians cited excessive administrative workloads, reduced staffing, concerns over financial viability and rising patient expectations around communications as major challenges.

Spending considerable time outside their normal work hours could be one reason why when asked about their current employment situation, 56% said they have considered leaving the field or remaining in the field but no longer seeing patients.

“Physicians are also overwhelmed by excessive patient communications – 60% say they are expected to be available ‘all hours of the day, every day of the week,'” Dr. Nele Jessel, chief medical officer of athenahealth, said in a blog about the results and how technology can help with rising burnout.

Atheneahealth said the physicians who use a fee-for-service model said the average amount of time they work after normal business hours – which they call “pajama time” – is 15 hours each week. While it was slightly lower among those who use a value-based care payment model at 12 hours per week, physicians who used both models reported the highest rate of pajama time, at 16 hours per week.

Sixty-five percent of the physicians polled indicated EHRs (5% of total respondents identified as athenahealth customers, the company said) help them provide high-quality care. However, Jessel said “they need to experience more advantages and fewer added complexities or burdens.”

The majority of physicians (63%) are currently so overburdened by information that it raises their stress levels, the company reported.

But nearly all physicians – 94% – agree getting the right clinical data at the right time is very important. Most – 80% – also said they don’t believe more clinical data is “always the answer” to achieving higher-quality care. 

The bottom line on data: Information overload is a growing cause of rising burnout, cited by 30% of this year’s respondents compared to 24% in the 2022 poll, which was a blind baseline study conducted from January 4-26, 2022, among 743 practicing physicians.

Financial concerns, however, echo a little louder.

Atheneahealth said over the past 12 months, half of the physicians said they have had at least one day per week where they felt they have been unable to provide quality care based on volume and cost.

Four in 10, or 38% of the doctors, said they believe their organization or practice has solid financials, and 55% did not agree they believe they have the resources and tools to deliver quality care. 

Also, four in 10 physicians reported concern will further complicate healthcare (42%) and it’s overhyped and underwhelming (40%). Interestingly, atheneahealth said the physicians polled who were pessimistic about AI’s benefit to healthcare also expressed a greater degree of burnout.

Those who said AI would address their challenges – twice as many physicians saw AI as part of the future than those who said it is part of the problem, the company said – also indicated more hope healthcare is “headed in the right direction” than the counterparts, and felt less burned out. 


While information and technology may be perceived by some doctors as causes for rising clinician burnout, IT is underleveraged as a way to help clinicians spend more time with their patients, according to Julie Frey, director of product strategy at Wolters Kluwer Health, a developer of clinical decision support tools.

She told Healthcare IT News when organizations end up with tools clinicians don’t like to use, it may be because they don’t often engage multidisciplinary teams. 

“We see this a lot with our health system customers when the IT organization makes a decision based on criteria that aren’t aligned with what their clinicians want and need – they end up onboarding and offboarding another solution,” said Frey.

Looking to AI to reduce clinician burnout is something the government and care delivery agencies like the U.S. Department of Veterans Affairs are looking at. 

The VA AI tech challenge to address clinician burnout – a sprint for documenting VA clinical encounters and integrating community care data challenge – was announced shortly after the AI executive order from the Biden Administration.

In the announcement, the VA said employing trustworthy AI is critical to “delivering more care and more benefits to more veterans than ever before.” 


“One of the top concerns physicians have with regard to AI is the potential loss of human touch [60%]; that is an incredibly important signal to which we need to pay attention,” Jessel said in a statement.

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