The 2024 Time Use Survey conducted by the National Statistical Office — it was published in February 2025 — concluded that “Indians are working more and resting less than they were five years ago.” For some, this may be cause for celebration as a sign of greater productivity. Think of the call by the Larsen & Toubro chairman, S.N. Subrahmanyan, for a 90-hour workweek. As a medical professional for the last 45 years, I am no stranger to a 90-hour workweek. The ‘overwork epidemic’ is rampant in the medical profession. The mantra of workaholism is drilled into medical students as sacred. It not only hurts their long-term aspirations as doctors and human beings but also reflects adversely in the care of patients. In a major survey of 7,905 members of the American College of Surgeons, nearly 9% self-reported a major medical error in the previous three months. Over two-thirds of these were attributed to individual factors such as depression and burnout. Contrastingly, in a trial of six-hour workdays for nurses instead of the conventional eight hours in Sweden’s Gothenburg district, those working shorter hours had better health, logged less sickness absence, and boosted their productivity by organising 85% more activities for their patients.
Balance and moderation, the keys to a healthy life as we tell our patients, are not medicines we take ourselves. Even as the National Education Policy speaks of holistic education, we blindly extol the virtues of sweating blood to our medical students.
But do we really need to work to death to justify our commitment to the profession? It is time for some serious self-reflection on work culture in the medical profession. We must be nuanced in our demands of diligence and perfection from physicians. Even the idea of altruism in the medical profession needs to be revisited. I do not mean to suggest that the Epicurean doctrine of self-interest should prevail over all else. Social responsibility and an ethic of care are pillars of the profession. But blind industriousness to the peril of personal health and well-being should not be construed as a moral attribute. What this ethos creates is not humane and competent doctors but robotic physicians with half-lives. With the impending AI revolution, we are told that doctors will in any case be replaced by robots. Albert Einstein dreaded “the day that technology will surpass... human interaction” because the “world will have a generation of idiots.” Let us not hasten that eventuality by asking our young doctors to worship at the altar of a work culture that demands they sacrifice their creativity, family and sanity. We have taken the ‘work is worship’ ideal too far.
Perhaps 16-hour workdays were needed during the Industrial Revolution or other periods in history when circumstances demanded it. The Covid pandemic, for example, was one time when healthcare professionals had to forget about their own health and put themselves in the line of fire. But beyond these exceptional situations, the idea of overwork has lost its relevance. Today, in the medical profession, technology allows us to achieve efficiencies in patient care, testing and surgical outcomes.
The medical profession has some important choices to make. Should we go down the path of Japan where 9,000 companies breached overtime laws last year, where they have had to coin new words such as karoshi, meaning death due to overwork? Let me end with a confession. Reflecting on my 45 years as a workaholic surgeon, I can’t help but feel that the philosopher, Democritus, had a point: “if you want to be happy,” he said, “do little.”