Background:
Physician burnout poses a critical threat to the United States health care system. Finding a solution to this problem is a leadership imperative, as studies report that nearly half of physicians in the U.S. experience burnout. Emotional exhaustion, depersonalization, and decreased personal accomplishment are characteristics of burnout and can lead to dire consequenses if unaddressed. Increasing demands on physicians on national, state, and local levels contribute to stress and burnout. Physicians providing front-line care, such as hospitalists, are at greatest risk. Management of these demands can prevent burnout and foster engagement. Engaged, healthy physicians are best able to deliver compassionate care, which leads to value for patients, providers, and the health system.
Purpose:
To objectively assess stress and burnout within an academic hospitalist group and identify areas to focus interventions on both personal and systemic levels to decrease stress, prevent burnout, and increase physician engagement.
Description:
In 2014, a large academic hospitalist group acknowledged increased levels of provider stress in the setting of continued practice expansion. The response was the creation of the Hospitalists Wellness Committee. Members included representatives of the teaching and direct care services from mutliple hospitals, ranging from clinical instructors to the director of the hospitalist group, and a member of the University Medical Staff Health Program. The mission of the Hospitalists Wellness Committee is to support the health and well-being of hospitalists within the group. Its focus is on organizational development with a continuous improvement project addressing the question of how to thrive while being productive in an ever-changing health care environment. A survey to assess hospitalists’ burnout was not readily available when the committee was created. Within a year, the committee developed and implemented the Hospitalists Well-being Survey to collect baseline data from the group and to identify root causes of sensed discontent and areas to intervene. 54 hospitalists (77%) completed the survey. 74% and 52% of respondents express satisfaction with their current job and work-life balance, respectively. Nonetheless, 43% agreed that they feel a great deal of stress because of their job. Only 17% disagreed. The survey identified opportunities for individual and organizational interventions to address this stress, which fall into three broad categories of mentoring, feedback, and resilience strategies. Direct interventions by the committee focused on supporting providers within these categories. Additionally, the creation of this committee and survey influenced leadership within the group and at higher levels within the Department of Medicine to make organizational changes.
Conclusions:
Stress is an inherent component of being a front-line provider of medical care. Awareness of provider stress at group and individual levels leads to opportunities for intervention and continuous improvement in organizational development. Objective data of a hospitalist group’s culture, needs, stressors, and values can balance demands of the job by identifying supportive measures and areas that yield more control to the providers over management of their work. Reassessment of the group and adjustments of interventions are required to meet the continually changing demands on providers. These efforts are to increase value for all within the health care system.