As such, it is incumbent upon hospitalists and hospitalist group leaders to promote healthy work environments. In most cases, this doesn’t mean making changes to reinvigorate a burned-out employee (although this may be necessary). Rather, it involves targeting the larger organizational structure to mitigate the factors that promote burnout in the first place.
A successful group must provide individuals control over its work environment to help offset the hefty demands the job levies on hospitalists. Individual hospitalists should have a voice in the group’s decision-making and scheduling process. This encourages ownership in the group’s future; ownership is inversely associated with burnout. Further, attempts should be made to reduce the unpredictability of the job as much as possible. This should include setting and maintaining clear expectations, having back-up systems to deal with unexpected spikes in volume or an ill colleague, and placing hard caps on the number of encounters per day. Finally, a group should strive to provide hospitalists with flexible scheduling so that, when necessary, they can care for a child or a sick relative, limit the number of consecutive shifts worked and ensure adequate time away from work.
Which brings us back to balance.
It ultimately falls to each of us to ensure that we remain on kilter. As the summer draws to a close, take a quick biopsy of your level of balance. If you’re a bit out of whack, make an effort to realign. Take some extra time with your kids, spend a night alone with your spouse, go to bed early and read by yourself. Take a left turn. TH
Dr. Glasheen is associate professor of medicine at the University of Colorado, Denver, where he serves as director of the Hospital Medicine Program and the Hospitalist Training Program, and as associate program director of the Internal Medicine Residency Program.
- Gopal R, Glasheen JJ, Miyoshi T, Prochazka AV. Burnout and internal medicine resident work-hour restrictions. Arch Intern Med. 2005;165:2595-2600.
- Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Arch Intern Med. 2002;136(5):358-67
- Hoff T, Whitcomb WF, Nelson JR. Thriving and surviving in a new medical career: the case of hospitalist physicians. J Health Soc Behav. 2002;43(1):72-91