Important for doctors: The Working Hours Act & its limits
The Working Hours Act (ArbZG) sets clear framework conditions for the maximum working time of doctors in Germany. In principle, doctors may not work more than 48 hours a week, although exceptions are possible through collective agreements or special regulations.
The rest periods required by law between layers amount to at least 11 hoursto ensure health and performance.
However, the Working Hours Act often reaches its limits in medical practice. Especially in clinics with heavy workloads or staff shortages, it can be difficult to comply with the prescribed breaks.
In order to maintain clinic operations nonetheless, there is the option of a so-called opt-out regulation. Under certain conditions, this allows doctors to voluntarily work beyond the 48-hour limit — but only if they expressly agree to this.
While the law is intended to strengthen occupational safety, in reality there are often discussions about the extent to which it is actually being complied with and what consequences this has for doctors:
What are the benefits of the opt-out rule for doctors?
The opt-out rule allows doctors to make their working hours more flexible and can provide benefits in certain situations — both financially and for professional development:
- More practical experience: By working longer hours, interns and specialists can gain valuable experience more quickly in continuing education.
- Higher income: Overtime is often paid additionally, which is financially attractive for many doctors.
- Better patient care: Fewer changes of doctor during treatment ensure greater continuity and quality of care.
- Flexibility in the organization of working time: Some doctors appreciate being able to determine their own weekly working hours, particularly in specialist areas with high demand.
The risks of the opt-out regime for longer working hours
Despite the potential benefits, the opt-out rule naturally also entails significant risks — both for doctors' health and patient safety.
Risks:
- Exhaustion and exhaustion: Longer shifts can lead to chronic fatigue and loss of performance.
- Higher potential for error: Overwork impairs concentration and decision-making, which increases the risk of medical errors.
- Psychological stress and burnout: Lack of recovery time can contribute to stress, frustration, and mental illness in the long term.
- Restricted work-life balance: Less free time and social isolation can severely impair professional and private life satisfaction.
- Possible pressure from the clinic: In theory, the opt-out is voluntary, but in practice, many doctors feel obliged to accept longer working hours.
Every doctor should carefully consider whether the personal benefits outweigh the risks.
What is the opt-out policy for on-call services & care services?
The opt-out rule not only concerns regular working hours, but also plays a crucial role in areas with heavy workload, such as on-call services in hospitals and care services.
Here in particular, being able to exceed regular working hours can present both opportunities and challenges.
1. Opt-out in on-call service:
- In principle, on-call time is part of working time, even if no active activity is carried out during this time.
- Without an opt-out rule, a maximum of 48 hours per week is allowed, including on-call service.
- As a result of the opt-out rule, this limit can also be exceeded here if the doctor agrees voluntarily.
In theory, there is no fixed upper limit for additional hours, as the regulation requires a voluntary decision by the doctor. In many clinics, working hours of up to 60 to 72 hours per week made possible with the opt-out rule.
2. Opt-out in the care service:
- There is often a shortage of staff in the care sector, which may require longer shifts.
- The opt-out rule can be used to work beyond regular maximum working hours. This can be financially attractive but often results in heavy burdens.
- Long working hours can have a negative impact on the quality of care, particularly in geriatric care or intensive care.
Unfortunately, there is indirect pressure in many institutions to opt out in order to close staffing gaps.
Termination: How can doctors revoke the opt-out rule?
Doctors who have opted for the opt-out regime can withdraw their consent, but not immediately. In most cases, there is a notice period of 6 monthsbefore the withdrawal takes effect.
This means that after the written withdrawal, a doctor may have to work longer working hours for another six months before the regular 48-hour week takes effect again.
Information on the form of withdrawal:
The revocation should be made in writing, ideally with confirmation from hospital management or HR. Legally, such a decision must have no negative consequences for the doctor, but in practice, there is occasionally indirect pressure or changes in shift planning.
Tip: Anyone who has concerns should consult the works council, a medical association or an employment law specialist at an early stage.
At the end of the 6 months, the statutory working time limit of maximum 48 hours per week, and on-call or overtime must be within this framework. Repeated consent to the opt-out rule is possible in principle, but not mandatory.
Practice optimization instead of opt-out: Work more efficiently instead of longer
Our recommendation: Instead of relying on long working hours and overtime, clinics should make their processes more efficient. digitization plays a decisive role in this:
Modern technologies enable optimized duty planning, automated documentation and improved internal communication — all factors that relieve hospital staff and optimize patient care.
With providers like Nelly clinics can use digital solutions to reduce administrative tasks, automate processes and reduce the workload for medical staff.
Electronic health records, digital document management and automated invoicing save valuable time and minimize sources of error.
Digital medical history sheets too and automated patient communication can help to reduce waiting times and to make processes more efficient.
By using innovative solutions, clinics can not only reduce workloads, but also Staff job satisfaction increase — without health risks due to excessive working hours.
Start now with Nelly and optimize your clinic sustainably! You can find more information about this here.
Common questions
What does the opt-out rule mean in connection with on-call services?
The opt-out rule allows doctors to voluntarily work beyond the statutory maximum working time of 48 hours per week (up to 58—60 hours). As a result, they can be divided into more emergency services. The consent is voluntary and can be withdrawn within 6 months.
How does the opt-out regulation in nursing affect working hours?
The opt-out regulation allows nurses to work voluntarily beyond the statutory 48-hour week. It is voluntary, cannot be enforced and can be withdrawn within 6 months.
How can doctors protect their health instead of using the opt-out rule?
Doctors can protect their health by consciously limiting their working hours and using alternative strategies:
- Optimize working hours: Set efficient work schedules and clear limits.
- Plan breaks and relaxation: Rest for at least 11 hours between shifts.
- Establish healthy routines: Prioritize regular exercise, healthy eating, and getting enough sleep.
- Stress management: Use relaxation techniques such as meditation or mindfulness.
- Seek support: Exchange with colleagues, works councils or professional associations to improve working conditions.
- Use digitization: Clinics can digital systems use to reduce documentation costs and relieve the team.
How does the opt-out policy in data protection work for patients?
In data protection, opt-out means that patient data is processed by default, unless the patient actively objects.
- Consent not required: Data processing is carried out automatically as long as there is no objection.
- Right to object: Patients can object to the use of their data at any time.
- Areas of application: Often applies to electronic health records, research or personalized advertising in the healthcare sector.
- Statutory basis: General Data Protection Regulation (GDPR) regulates when and how opt-out procedures are permitted.
Patients should learn about their rights and actively adjust their data protection options as needed.
