Challenges and implications of dual employment among physicians in Japan

Physicians in Japan have traditionally worked long hours, but the 2024 revision of the Labor Standards Law introduced limits on physician working hours, including time spent in side jobs. This study examines how side jobs affect physicians’ professional lives and well-being. In August 2023, we surveyed 333 physicians (252 men, 81 women) who graduated from Sapporo Medical University between 1993 and 2016. The survey gathered data on primary and side jobs, including earnings, weekly hours, commuting time, and subjective well-being. This study was approved by the SAPMED Ethics Committee (Approval No. 4-1-77). Physicians with side jobs worked similar hours in their primary jobs to those without side jobs but earned less. They devoted an average of 11.5 h weekly to side jobs, reported shorter sleep, and lower satisfaction with compensation from their primary job. They also noted insufficient time for primary job tasks. Among physicians in Hokkaido, men were more likely to hold side jobs in remote areas requiring longer commutes, whereas women typically worked in Sapporo City. In light of the new overtime regulations, this study emphasizes the need for healthcare system reforms to ensure sustainable healthcare delivery. Proposed measures include hybrid models integrating telemedicine with visits to reduce commuting and further address pay disparities between physicians with and without side jobs. Additionally, it is crucial to address imbalances in working conditions for side jobs, as these disparities place greater burdens on male physicians and may impact workplace equity and sustainability.