Introduction The balance between adequate time spent on patient care and maintaining work-home balance is challenging for doctors. Both for treatment outcomes and for doctors´ wellbeing we need longitudinal studies of total work hours and of time spent on direct patient care.

Objectives To compare the weekly working hours and time spent on direct patient care in 2016 and 2019 for doctors working in different job positions in Norway.

Methods Repeated postal surveys (2016 and 2019) based on representative samples of approximately 2,200 doctors in Norway. Main outcome measures were self-reported weekly working hours and time spent on direct patient care. Analyses included linear mixed models and proportions with 95% CI. Response rates were 73% both years.

Results From 2016 to 2019, the weekly working hours increased significantly for male GPs (48.7 h to 50.9 h) and male doctors in hospital management (48.2 h to 50.5 h). It remained significantly unchanged for female GPs (48.3 h to 49.3 h), female doctors in hospital management (45.8 h to 49.3), female senior consultants (45.4 h to 45.6 h), and for female (44.4 h to 43.6 h) and male (44.9 h to 46.6 h) specialist registrars. The proportion of the total work time spent on direct patient care were similar between genders and did not change significantly from 2016 to 2019. In 2019 it was highest for GPs (65.5%) followed by senior hospital consultants (43.5%), specialty registrars (39.8%) and doctors in hospital management (34.3%).

Conclusion Compared to stipulated work hours in Norway (37.5 h/week), doctors of both genders work long hours, and length has increased significantly for some groups from 2016 to 2019. Hospital doctors spend less than 50% of the time on direct patient care. Monitoring and regulating work hours can be a useful intervention for patient care and for doctor well-being.