The task force is focusing on job engagement rather than burnout—its antithesis. A profile of engagement is expected to include a sustainable workload, empowered decision-making, appropriate recognition and compensation, a supportive work environment, a sense of fairness, and meaningful and valued responsibilities appropriate to level of experience.2 Learning opportunities are highly correlated with engagement. Promising approaches to career satisfaction focus on organizational changes that enhance the capacity of hospitalists to cope with the demands of caring for hospitalized patients.

Review of data specific to hospital medicine support the need to define a sustainable workload. Findings on burnout and satisfaction from an Agency for Healthcare Research and Quality-Funded Multicenter Trial of Academic Hospitalists (David Meltzer, MD, PhD, is the principle investigator) at six medical centers provide new information, but may not be applicable to other hospitalist programs. Additional research is needed to identify the key ingredients for a long and professionally rewarding career in hospital medicine and to examine the link between clinician burnout and patient safety in diverse hospital settings.

Short-Term Next Steps—By Jan. 2006

One of the major goals of the Career Satisfaction Task Force is to establish national benchmarks for sustainable work conditions for hospitalists so they are engaged in a career of hospital medicine. The task force identified the following workplace domains:

• Control/autonomy;
• Workload/schedule;
• Community/environment; and
• Reward/recognition.

The task force will:

1. Articulate predictors of job satisfaction and engagement in terms of the key domains of work life;
2. Define and prioritize educational outreach programs to assist in the development of Core Competencies; and
3. Develop a tool kit for building engagement and identifying modifiable factors in the workplace.

Building on the work of other SHM committees, the task force will make specific recommendations about education and practice management support to promote high productivity and career satisfaction despite high workload. Value-added information will be incorporated into the recommendations to promote adequate and fair compensation. The tool kit would be an “ideal model” that SHM would support with an explanation of how to bridge the gap between existing practice and a new flexible work structure that would meet the individual needs of hospitalists. Future revisions of the tool kit would be based on research findings.

Long -Term Next Steps: Two-Year Concurrent Time Line

Dr. Wetterneck will lead an effort to survey the SHM membership about work-life, satisfaction, and burnout to further define key aspects of hospital medicine programs and work life that maximize physician career satisfaction. Information from interviews, focus groups, and prior hospitalist surveys will guide the development of a Hospitalist Worklife and Satisfaction Survey that will be administered to the SHM membership in 2006. The SHM Board has approved funding for this initiative.

The task force will:

• Promote future research into career satisfaction and engagement in hospital medicine to understand the magnitude of the problem of career satisfaction;
• Specify how to structure hospital medicine programs based on actionable data;
• Recommend how SHM can participate in improving the hospital setting as a patient care environment that not only facilitates improved patient outcomes, but also clinician workplace satisfaction for hospitalists;
• Draft a consensus statement for the peer reviewed SHM Journal of Hospital Medicine similar to the Task Force Report on Continuous Personal, Professional and Practice Development in Family Medicine;3 and
• Hold a workshop at the 2006 SHM Annual Meeting on Career Satisfaction.