Revised 8/31/21
This post is the last of a four-part series on how to acquire and retain emergency medicine doctors. It discusses the need for leadership to address the problem of EM physician burnout by offering true work-life balance.
Burnout is a problem for all clinician specialties, including emergency medicine. Since hospital administrators ultimately bear the burden of ED stability, installing safeguards against burnout is vital.
The causes of burnout are numerous, including: pandemic-related stress and fatigue, too many bureaucratic tasks, spending too many hours on the job, and insufficient income. These factors affect physician well-being and lead to poor performance, lower patient satisfaction scores, increased errors, alcohol and drug abuse, and even thoughts of suicide.
To retain the best EM clinicians, hospital administrators must make preventing burnout a priority. To do so, administrators must commit to providing strong ED leadership, appropriate staffing levels, a supportive practice environment, and perhaps most importantly: work-life balance.
As an administrator, you can’t avoid the ED’s inherent unpredictability. You can make a conscious effort to support your EM clinicians and create a culture that promotes work-life balance by considering the following:
Clinician Work Schedules
While you cannot control who walks through the ED door or when, you can ensure your ED team is ready. A humane clinician work schedule that allows for adequate balance with life outside the ED is a great starting point. That means ensuring EM schedules don’t require clinicians to flip from night to day and back again quickly, or work lengthy and unsafe shifts.
Although you can’t always avoid overtime, monitoring of patient volume by responsive leadership will ensure your ED is adequately staffed to handle swings in its patient load.
Fair and equitable scheduling, in which all clinicians share responsibility for working nights, weekends, and holidays, also goes a long way in promoting a stable, team-centric practice environment.
Clinician Income
Simply raising clinicians’ rates isn’t a magic bullet. The reality is that raising ED pay above the market rate for your region may not be feasible for your hospital, or even fruitful.
Experience shows that as with any relationship, long-term clinician-hospital commitments tend to be more strongly fortified by those things money can’t buy — shared values, capable leadership, a supportive practice environment, a collaborative ED team — than what it can.
That’s not to say money doesn’t matter. Signing bonuses and relocation reimbursements are often valuable draws for younger, less experienced clinicians with minimal savings post-residency but face daunting school loans.
For more established, experienced clinicians, signing bonuses and relocation money may not be as important as what they want or need in a practice environment, culture, medical director leadership, or team.
Other Considerations
Other burnout prevention strategies include improving the efficiency of the practice environment, reducing the administrative burden, and providing clinicians with greater flexibility and control over their work.
Regardless of the steps you take, making a conscious effort to support your clinicians during work and protect their personal time outside of work will show you value your physicians and take the problem of burnout seriously. This positive culture will not only benefit your clinicians by reducing burnout but also your emergency department’s overall care quality.