Early survey data on hospitalists, which suggest high levels of job engagement and low turnover rates, may not be as relevant as programs mature in a competitive marketplace to meet important needs such as rising census and Accreditation Council for Graduate Medical Education (ACGME) requirements. There is also a paucity of data on how different models of compensation affect hospitalists’ career satisfaction.
In 2005 the role of the hospitalist has evolved from simply improving throughput (average length of stay) to one of leadership, quality improvement, and teaching that extends beyond direct patient care. Compensation for hospitalists should not, therefore, be based solely on billing revenue. Improving the efficiency of the hospitalists work environment, which may include IT support, adequate office space, and administrative support, may not only enhance productivity but also job satisfaction. More research is needed to examine these questions.
One of the Career Satisfaction Task Force’s major initiatives has been developing a toolkit for the SHM membership with the purpose of providing members with an action plan for attaining a long and satisfying career in hospital medicine. The following steps are being taken in the creation of the toolkit:
- Needs assessment—questionnaire at the SHM 2005 Annual Meeting;
- Monthly conference calls;
- Toolkit draft completion—Sept. 2005;
- Review SHM Membership Committee—Oct. 2005;
- Further revision;
- Submission to SHM Board for review—Nov. 2005;
- Further revision; and
- Dissemination at SHM Annual Meeting—May 2006.
- Content—four workplace domains:
- Community/Environment; and
- Elements comprising each domain:
- Definition: specific description of workplace domain;
- Background: review of literature, expert opinion, experience-based observation, executive summary of background content;
- Guidelines: practical actionable recommendations and educational initiatives;
- Pitfalls: specific examples;
- Examples: application to different settings (community, academic, pediatric); and
Research and Timeline
In parallel to the development of the work domains for the toolkit, the Career Satisfaction Task Force is developing a questionnaire to survey hospitalist physicians on career satisfaction and “worklife.” The last survey of this type was performed in 1999. This questionnaire will allow us to assess changes in hospitalist quality of working life over time to further explore how hospitalists are faring during this critical time of rapid growth of our specialty.
The task force is developing a list of important aspects of worklife, satisfaction, and stress for hospitalists. This list will be supplemented by semi-structured interviews of SHM members and leaders in hospital medicine to include a representative viewpoint of hospitalist worklife: adult and pediatric medicine, academic and community, gender and age, directors of programs, and different employer types.
The interviews were expected to be completed in the fall of 2005. Qualitative data analysis will allow us to ascertain important themes for job performance and satisfaction to be highlighted in the survey. The questionnaire development will also consider inclusion of aspects from the prior surveys to follow results over time and when possible will use validated questions from the quality of working life literature.
We anticipate completion of the questionnaire in spring 2006 followed by surveying of a random sample of hospitalists from the SHM membership through a Web-based survey. Sampling of groups of hospitalists based on job characteristics will occur because there is significant interest and need for information about hospitalist worklife in certain work settings. The questionnaire dissemination time will overlap with the annual meeting to maximize survey response. The task force will work with SHM annual meeting committee to discuss having a dedicated computer for filling out the Web-based survey on-site.
Any SHM member who would like to participate in the questionnaire on-site, even if they were not selected for the random sample, will be encouraged to do so. Data analysis will occur in mid-late 2006. The task force will use information from the analyses to update the SHM Worklife Toolkit. We will also provide numerous forums for dissemination of the data. In particular, we plan to showcase this data at the 2007 SHM Annual Meeting followed by journal publication and Web site posting. It is our hope that this data will provide key information on the current quality of working life of hospitalist physicians to support worklife recommendations that promote sustainable, enjoyable careers in hospital medicine.