Less than half (46%) of respondents to the survey spend 40 hours at most seeing patients each week, with slightly over half (51%) spending more time. (The remaining physicians see no patients at all.) A 2010 study in JAMA[22] found that after no significant change between 1977 and 1997 in the hours per week that physicians spend with patients, these hours decreased steadily from 54.6 to 51 between 1997 and 2007. The decline was seen regardless of gender or employment status, but it was largest for nonresident physicians under 45 and for those working outside of hospitals. The study authors attributed the decrease to a parallel 25% inflation-adjusted decline in fees between 1996 and 2006. They pointed out that some physicians may have compensated by increasing ancillary services at the expense of patient time. This study also found that time spent on patients by physicians working in relatively low-hour specialties, such as dermatology, pathology, and emergency medicine, changed by less than 1% during the past decade.