Robert Wachter, MD, MHM, chief of the Division of Hospital Medicine at the University of California San Francisco, in his annual address touched on some of the challenges for hospital medicine at the 20-year mark. The Hospitalist asked attendees: How can hospitalists continue to be change leaders and project leaders while also avoiding burnout?

Tamika Smith, MD

Tamika Smith, MD, hospitalist, Alta Bates Summit Medical Center, Berkeley, Calif.

“I actually consider myself the poster child for work-life balance. I’m a nocturnist. Honestly, I think the secret is to work less. I work 12 to 14 shifts a month; that is how I make it sustainable. … I know that’s my magic number.”

Nisheeth Rai, DO

Nisheeth Rai, DO, Aspirus Wausau Hospital, Wausau, Wis.

“I think you have to find a fair balance between your clinical duties. How do you balance the clinical aspect of things? How do you get into more of the management and more projects within the hospital system? We don’t know quite yet, but I think it’s an evolving thing where we’ll just see how the field evolves in the next couple years.”

Nathan Houchens, MD

Nathan Houchens, MD, hospitalist, VA Ann Arbor Healthcare System, Mich.

“It helps to know some of the fundamentals around change behavior. I think it’s also fundamental to recognize that it’s a relationship-based field and that without investment and capital in people it’s very difficult to make change sustainable.”

Janie Mathis, DO, cardiovascular hospitalist, Intermountain Medical Center, Salt Lake City

“I guess have some nonclinical time on the schedule. Schedule off from the nights and swing [shifts], and maybe have that as part of their contract and part of their job description. Have it as part of maybe your bonus, add that into your compensation, so you’re motivated to do it since you’re not going to get time off.”