Why Surgeons Log Less Pajama Time Than Internists? 

In today’s digital healthcare environment, physicians are spending more time than ever documenting care in electronic health records (EHRs)—often after hours. This after-hours EHR work, commonly referred to as pajama time EHR, has become a growing concern linked to burnout and declining job satisfaction. But not all physicians are affected equally. 

Studies show a consistent trend: surgeons log significantly less pajama time than internists. This disparity in after-hours EHR work raises important questions about clinical workflows, documentation expectations, and specialty-specific demands. Why does this gap exist? And what does it tell us about the broader physician documentation burden in modern healthcare? 

Understanding the difference in surgeon vs internist EHR time is crucial for designing smarter, more efficient documentation strategies. Internists often manage patients with complex, chronic conditions requiring detailed notes, medication management, and extensive care coordination—all of which increase time spent in electronic health records. In contrast, many surgeons have more procedure-focused practices with shorter, more structured documentation needs. 

Pajama time—a widely used term in healthcare—refers to the hours physicians spend completing documentation in the electronic health records (EHR) system outside of their regular clinical shifts, typically during evenings or weekends. This after-hours EHR work has become a silent yet significant contributor to the rising physician documentation burden, impacting both productivity and well-being. 

For many providers, pajama time is more than just a minor inconvenience—it’s a reflection of flawed workflows, inefficient EHR systems, and unrealistic documentation expectations. While EHRs were introduced to streamline care, they’ve often led to increased administrative tasks that extend beyond scheduled hours. 

Interestingly, data reveals a clear discrepancy in surgeon vs internist EHR time. Internists—who manage complex, long-term conditions and chronic disease management—typically log more pajama time EHR hours than surgeons. Internists must record detailed patient histories, medication changes, care coordination notes, and follow-up plans, all of which require extensive electronic health records time. 

Surgeons, on the other hand, often deal with more procedure-based cases. Their documentation is usually focused on pre-op evaluations, surgical notes, and post-op summaries—tasks that are often more templated and less time-consuming than ongoing care documentation required in internal medicine. 

Understanding this difference is key to reducing after-hours EHR work. It’s not about comparing workloads but acknowledging how specialty-specific demands shape documentation time. As we dive deeper, it becomes clear that reducing physician documentation burden—especially for internists—requires targeted workflow adjustments, technology support, and smarter use of medical scribes or AI tools. 

To understand why surgeons log less pajama time EHR compared to internists, it’s essential to examine how their day-to-day workflows differ. These variations in clinical duties significantly influence the amount of after-hours EHR work each group performs, contributing to the broader physician documentation burden. 

Internists are typically responsible for managing complex, chronic conditions that require detailed and continuous documentation. Their patient encounters involve multiple layers—symptom history, medication adjustments, lab interpretations, and long-term care planning. This naturally leads to more electronic health records time during and after clinical hours. For many internists, finishing notes during office visits is nearly impossible, resulting in increased after-hours EHR work and prolonged pajama time. 

Surgeons, in contrast, work within a more episodic care model. Their documentation tends to focus on preoperative evaluations, intraoperative findings, and postoperative outcomes. Much of their EHR input is task-based, templated, or handled through assistants or scribes, leading to reduced pajama time EHR involvement. Surgeons often complete their electronic health records time during brief windows between procedures, allowing them to stay on top of documentation without extending their workday. 

This surgeon vs internist EHR time gap highlights the need for specialty-specific documentation solutions. While surgeons may require less support with EHRs, internists can benefit significantly from medical scribes, AI documentation tools, or restructured workflows aimed at reducing the physician documentation burden. 

Recognizing these workflow differences is key to addressing burnout and improving work-life balance. EHR systems and documentation protocols should be tailored to the clinical realities of each specialty—not imposed as one-size-fits-all.