By J. JASON JAMES, DO, FACOI
The rise of burnout among hospitalists is a problem more of us have experienced than we care to admit. While not as high as burnout among Emergency Department physicians, which is up to 60 percent, hospitalist burnout rates hover between 13 and 25 percent risk. For hospitalist teams, it’s likely at least one physician is experiencing burnout or is close to the edge.
Tosha Wetterneck, MD, in her presentation at the Society of Hospital Medicine (SHM) Annual Meeting in 2005, defined burnout as “an erosion of engagement with the job,” which includes emotional exhaustion, depersonalization and reduced personal accomplishment. The reasons behind burnout are as varied as those suffering from it. They may not feel in complete control of their situation. They are affected by volatility in workload, time constraints, and lack of available resources to do the job right. The lack of patient engagement to improve their own situation, or blaming the hospitalist for not reversing 30 years of poor habits, is a frequent challenge.
The job changes daily. In fact, constant change does not allow a hospitalist the ability to be “centered,” and therein lies a big part of the problem. For the dauntless hospitalists laboring in the trenches daily, here are a few steps to forestall burnout.
Re-examine the structure of the schedule and get everyone’s input on possible schedule changes. Encourage the group to consider shaking up the schedule and at least trying something different for a short time to see if it helps everyone.
When a group is large enough, consider a “zone defense.” Some groups do well by having regular spheres of operation. For the hospitalist who likes taking care of the critical patients, consider zoning that hospitalist in the CCU/PCU/ Stepdown areas and place those who prefer lower acuity on the med-surg/telemetry/rehab areas. Rotation is also another consideration.
If a hospitalist has been identified as having burnout symptoms, your team should consider huddling around that team member and helping with personal encouragement, trading shifts or trading time off. Sometimes just a personal acknowledgement goes a long way, and a hospitalist’s understanding that the rest of the team undergoes the same struggles builds the support system and strengthens the camaraderie key in doing the job.
Change of Atmosphere
Find a way to get out, if at all possible, even if its two yards past the door of the hospital. Getting out of the hospital for lunch or to get a breath of fresh air can sometimes go a long way.
Exercise & Good Nutrition
Exercise and eat right. What a concept! We should practice what we preach. Sometimes getting up a little earlier and exercising for 15-20 minutes helps reduce stress and gets you back in fight mode.
Regular Team Meetings
Meet as a team regularly. Monthly meetings should be established to discuss the issues at hand and get everyone’s ideas about how to improve the job. The group leader should bring up pending changes to keep everyone aware and less likely to feel the sting of an upcoming challenge.