A National Survey of Academic Emergency Medicine Leaders on the Physician Workforce and Institutional Workforce and Aging Policies

Takakuwa, Kevin M.; Biros, Michelle H.; Ruddy, Richard M.; Fitzgerald, Michael; Shofer, Frances S.

doi:10.1097/acm.0b013e31827c026e

Cited by 8 publications

(12 citation statements)

References 20 publications

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“…A 2009 survey of general ED leaders revealed similar findings. In that study over 60% reported some accommodation for aging faculty, including reduced or eliminated night shifts, reduced clinical time, or an altered shift complement …”

Section: Discussionmentioning

confidence: 95%

Current Workforce Characteristics and Burnout in Pediatric Emergency Medicine

Gorelick¹,

Schremmer

Ruch‐Ross

et al. 2015

Academic Emergency Medicine

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Objectives: Changes in health care delivery and graduate medical education have important consequences for the workforce in pediatric emergency medicine (PEM). This study compared career preparation and potential attrition of the PEM workforce with the prior assessment from 1998.Methods: An e-mail survey was sent to members of the American Academy of Pediatrics (AAP) Section on EM and to non-AAP members board certified in PEM. Information on demographics, practice characteristics and professional activities, career preparation, future plans, and burnout (using two validated screening questions) was analyzed using standard descriptive statistics.Results: Of 2,120 surveys mailed, 895 responses were received (40.8% response). Over half (53.7%) of respondents were female, compared with 44% in 1998. The majority (62.9%) practiced in the emergency department (ED) of a free-standing children's hospital. The distribution of professional activities was similar to that reported in 1998, with the majority of time (60%) spent in direct patient care. Half indicated involvement in research, and almost half had dedicated time for other activities, including emergency medical services (7.3%), disaster (6.9%), child abuse (5.0%), transport (3.6%), toxicology (2.3% of respondents), and other (13.6%); additionally, 21.3% had dedicated time for quality/safety. Respondents were highly satisfied (95.6%) with fellowship preparation for clinical care, but less satisfied with preparation for research (49.2%) and administration (38.7%). However, satisfaction with nonclinical training was higher for those within 10 years of medical school graduation. Forty-six percent plan to change clinical activity in the next 5 years, including reducing hours, changing shifts, or retiring. Overall, 11.9% of all respondents, including 20.1% of women and 2.6% of men (p < 0.001), report currently working part time. Large majorities endorsed feeling burned out at work (88.5%) or more callous toward people as a result of work (67.5%) at least monthly, with one in five reporting such feelings at least weekly.Conclusions: While satisfaction with fellowship preparation for professional activities in PEM is improving, gaps remain in training in nonclinical skills. Symptoms of burnout are prevalent, and there is likely to be substantial attrition of PEM providers in the near future.ACADEMIC EMERGENCY MEDICINE 2016;23:48-54

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Section: Discussionmentioning

confidence: 95%

Current Workforce Characteristics and Burnout in Pediatric Emergency Medicine

Gorelick¹,

Schremmer

Ruch‐Ross

et al. 2015

Academic Emergency Medicine

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“…36 Takakuwa et al found that policies related to ageing were inconsistent for the EPs approaching the final years of their career. 50 While both studies were from the USA, this message is mirrored in Holmes' opinion piece from Australia. 47 In their large study of French EPs, Estryn-Behar et al found that working conditions may be more important than pay.…”

Section: Systematic Reviewmentioning

confidence: 94%

“…Lack of quality teamwork 48 Teamworking and non-hierarchical structure 39 Harassment by supervisors 48 and incivility 43 Job satisfaction 35 49 Excessive workloads 37 Poor working condition 37 Peer support 40 46 and professional links 47 Diagnostic challenges 38 39 Errors 43 Lack of influence at work 48 Training and education Absence of continuing professional education 48 Lifelong learning 46 47 Lack of training and supervision 37 Board certification (higher training) in EM 33 36 Board certification in another specialty 33 36 Fellowship in another specialty 36 Work with trainees 33 Teaching 39 New roles 40 Subspecialty training 47 Impact of work Worry about mistakes 48 Musculoskeletal complaints 48 Physical and emotional strain 40 Burnout 42 45 46 48 Occupational stress 42 Stress 46 Work-life balance Debt 34 Income 33 36 38 Flexible working 39 and predictable hours 38 Strategic approach to shift work 50 Antisocial working patterns 43 Receiving a job offer outside of medicine 48 EM, emergency medicine.…”

Section: Experience Of Workmentioning

confidence: 99%

Retention of doctors in emergency medicine: a scoping review of the academic literature

et al. 2021

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IntroductionWorkforce issues prevail across healthcare; in emergency medicine (EM), previous work improved retention, but the staffing problem changed rather than improved. More experienced doctors provide higher quality and more cost-effective care, and turnover of these physicians is expensive. Research focusing on staff retention is an urgent priority.MethodsThis study is a scoping review of the academic literature relating to the retention of doctors in EM and describes current evidence about sustainable careers (focusing on factors influencing retention), as well as interventions to improve retention. The established and rigorous JBI scoping review methodology was followed. The data sources searched were MEDLINE, Embase, Cochrane, HMIC and PsycINFO, with papers published up to April 2020 included. Broad eligibility criteria were used to identify papers about retention or related terms, including turnover, sustainability, exodus, intention to quit and attrition, whose population included emergency physicians within the setting of the ED. Papers which solely measured the rate of one of these concepts were excluded.ResultsEighteen papers met the inclusion criteria. Multiple factors were identified as linked with retention, including perceptions about teamwork, excessive workloads, working conditions, errors, teaching and education, portfolio careers, physical and emotional strain, stress, burnout, debt, income, work–life balance and antisocial working patterns. Definitions of key terms were used inconsistently. No factors clearly dominated; studies of correlation between factors were common. There were minimal research reporting interventions.ConclusionMany factors have been linked to retention of doctors in EM, but the research lacks an appreciation of the complexity inherent in career decision-making. A broad approach, addressing multiple factors rather than focusing on single factors, may prove more informative.

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“…20,21 While dedicated nocturnal clinician-educators might be best positioned to enhance nighttime teaching, clinical care, and supervision, we anticipate that many inpatient programs would use a combination of faculty and moonlighters to staff nights. 20,21 While dedicated nocturnal clinician-educators might be best positioned to enhance nighttime teaching, clinical care, and supervision, we anticipate that many inpatient programs would use a combination of faculty and moonlighters to staff nights.…”

Section: Staffing To Enhance Educationmentioning

confidence: 99%

The New Education Frontier

2014

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Regulations that restrict resident work hours and call for increased resident supervision have increased attending physician presence in the hospital during the nighttime. The resulting increased interactions between attendings and trainees provide an important opportunity and obligation to enhance the quality of learning that takes place in the hospital between 6 PM and 8 AM. Nighttime education should be transformed in a way that maintains clinical productivity for both attending and resident physicians, integrates high-quality teaching and curricula, and achieves a balance between patient safety and resident autonomy. Direct observation of trainees, instruction in communication, and modeling of cost-efficient medical practice may be more feasible during the night than during daytime hours. To realize the potential of this educational opportunity, training programs should develop skilled nighttime educators and establish metrics to define success.

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A National Survey of Academic Emergency Medicine Leaders on the Physician Workforce and Institutional Workforce and Aging Policies

Abstract: EM leaders have considered the implications of issues related to clinical shift work and aging physicians. The findings of this report indicate some of the ways that leaders have begun to adapt their programs to ensure the field's future success.

Cited by 8 publications

References 20 publications

Current Workforce Characteristics and Burnout in Pediatric Emergency Medicine

Current Workforce Characteristics and Burnout in Pediatric Emergency Medicine

Retention of doctors in emergency medicine: a scoping review of the academic literature

The New Education Frontier

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