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Ars longa, vita brevis.
But I was referring to some surgeons who work 50 hours a week and those surgeons think it's too much. I don't care or think about how much other people work, whether they think 50hours is too much or too little. Similarly, I don't care or think much about what 'most people' in America do or don't for work. Doesn't affect me.
To answer the second question, it takes long hours because surgery is a technical field and to achieve mastery you have to put in the time, period. Surgeries don't always happen between the hours of 9am and 4pm. Furthermore, to operate just takes time - you have to pre-op the patient, get them to the OR, they go to sleep, prep and drape, and then operate for however long (and some surgeries take >5hr), then post op orders, post op care, etc. Rinse and repeat for however many people you see/operate on that day. Sure, while the patient is getting ready and getting to the OR and waking up there is often time to dedicate to other tasks (as an attending - as a resident I'm still helping turn over, etc.), and residents and midlevels can decrease your out-of-OR burden, but it all requires time. If my work week *only* consisted of actual operating time and absolutely nothing else, it would be much closer to 40hr/week.
I'll be honest; as a resident, most of the time it's not the hours that cause me the most burnout or stress, it's the myriad of other things - nursing, staffing, patient issues, people dying, documentation, etc. Up to about 85hr, I don't mind the work load too much. After that it gets annoying and I get cranky about not seeing my family.
Yes, you can set hours better as an attending. But like dpmd said, in many payment systems in the US, if you aren't working, you aren't earning. It's a checks and balances system, all depends on what you want out of life. Many surgeons would rather work more and get paid more because they enjoy operating and they like the money. Operating is addicting.
