Time tracking in German hospitals is the focus of this study, which examines the impact and perceptions of surgeons on legally required working time recording, exploring its effects and consequences among surgical staff.

This study, based on situational theory, conducted an online survey over three months, using a 24-question format and ANOVA analysis. It targeted German hospital surgeons, with responses from 188 participants between September and December 2023.

The survey shows strong support for working time recording among surgeons, with 79.3% overall approval and consensus across all levels, from residents to medical directors, favoring transponder-based tracking.

However, 70.6% of surgeons aged 60-70 years identify staffing and time off as key challenges, a concern less prevalent among younger surgeons (41.4%). Perceptions of fairness vary, with 28% of women and 37.17% of men viewing time recording as fair, particularly among younger surgeons (60% of 20-30 year-olds), though this declines with age.

Medical professionals have mixed views on the transparency of time recording: less than half of residents (45%) and specialists (50%) see an enhancement in transparency, compared to senior physicians (29.4%) and medical directors (14.3%) (p=0.03). Additionally, compensatory time off poses more of a burden for residents (52.5%) and senior physicians (53.2%), particularly in larger hospitals (60% in large vs. 42.6% in small).

40% of residents face difficulties in taking compensatory time off, a problem reducing with skill levels (31.3% specialists, 19.3% senior physicians, 9.3% medical directors, p=0.019). A majority (72.1%) usually have the opportunity for time off, often limited by staff shortages. Transparency in working hours is perceived differently (p=0.009), with 76.2% of medical directors noticing increased transparency, in contrast to 30% of residents, and this varies across different hospital sizes.

The study reveals the complex impact of electronic working time recording in surgery. Although popular, particularly among surgeons with long hours, its effectiveness and preference for transponder-based systems vary. However, it doesn't fully address fairness and staffing concerns, indicating a gap between management's efforts and surgeons' experiences. The issues of transparency and compensatory time off, often tied to staffing shortages, emphasize the need for enhanced communication and strategic planning.