Hospitalists face an uphill battle to secure funding for research, admits Dr. Wiese: “There is not the same level of NIH [National Institutes of Health] funding for quality improvement that there is for basic science research. And the QI funding that is available does not bring the same salary coverage that the basic science researchers are bringing to the department.”
Hospitalists need to be creative in defining their research agenda and funding streams. Dr. Basaviah says that if hospital medicine leaders emphasize the value of their systems-based quality improvement efforts, they may be able to secure funding for QI research efforts from “the hospital/medical center administration, Department of Medicine, QI group/division, or from residency programs, depending on where their efforts are going to be the most closely aligned.”
Tapping into SHM’s resources can foster community and allow younger hospitalists a method for charting a career path. Dr. McKean’s Career Satisfaction Task Force will soon release a white paper relating to the four pillars of career satisfaction: control/autonomy, reward/recognition, workload/schedule, and community environment. Questionnaires for individual hospitalists and physician leaders will help both groups identify the best job for an individual or the most appropriate person for a position. Included in the group’s analysis of career sustainability and satisfaction are organizational, system, professional development, and marketing-relationship strategies to help hospitalists assess job satisfaction. It is the task force’s hope that the document can be a useful tool in interactions with hospital administrators as well, to demonstrate the elements necessary for staff satisfaction and retention.
“A surgeon would never operate without a multidisciplinary team in the operating room,” says Dr. McKean. “And yet, because they’ve done order entry, they’ve done resident-level duties, hospitalists across the country are expected to step up without any resources to meet service demands relating to a shortage of residents and high census conditions. Performing residency-level duties not only undermines job satisfaction but also [affects] how efficiently hospitalists can care for a large number of patients. Hospitalists need to be given the tools to be efficient and improve the quality of care in the hospital.”
Fulfillment of Teaching
When asked what keeps him in academics despite lower remuneration rates, Dr. Wiese expresses the same sentiment as his colleagues: “It’s all about fulfillment. I like interacting with people and seeing them get better. If you train residents in the right way and then train them to train others, then suddenly your affect in improving quality of care and education has an exponential effect around the country.”
Dr. Dressler agrees. “Obviously, not everyone wants to do academic medicine, and you must have some interest in teaching and training others,” he says. But more important than financial remuneration, he notes, is “overall job satisfaction and being happy with the people you work with, as well as the patients you’re taking care of and the teaching that you’re doing.” That’s why hospitalists and faculty should work toward building recognition into the system. Hospitalist leaders can advocate for the mechanisms necessary, “to make sure that physicians also have time to have a life, to relax, and to enjoy their profession,” says Dr. Dressler.
“When I hire hospitalists, my goal is to hire people interested not only in good quality, efficient inpatient care but also in teaching,” said Dr. Amin. “I will easily tell them that they can probably make more money and have a better lifestyle working as a community hospitalist if they don’t want to deal with this other mission [of teaching].”
“I think if we view our work as just a job rather than as a career or profession that can be fulfilling, we may be led to paths of potential burnout,” said Dr. Basaviah. “Many of us view the healthcare profession with a notion of service and a vision for a satisfying career. I think that it’s important for all of us to facilitate the ability of our colleagues to thrive in these careers.” TH