The surgical work day in the British Isles: some observations from a small sample studied in depth.
The daily activities of nine surgeons in the British Isles, representing a variety of practice settings, were observed. British surgeons had a mean total workweek of 45.8 hours, of which 34.5 hours were expended in professional activities. American community surgeons, as reported in the literature, had an analogous professional workweek of 28.7 hours, and American prepaid group surgeons, 50.7 hours. The American community surgeons performed many fewer operations, but the American prepaid group surgeons had operative loads similar to those of the British, although with a much greater time expenditure. Superior organization of British operating rooms in "lists," the designation of certain operating days each week, a more rapid anesthesia induction and case turnover, all aided more rapid completion of a number of sequential surgical operations. Non-operative professional time expended per patient was less for the British group than any of the reported American groups.