Sustaining a long career in emergency medicine: Issues for emergency physicians of all ages

Abstract

Emergency Medicine is a rewarding discipline but 'burnout' can be a problem that Emergency Physicians (EPs) wishing to sustain a long career should take steps to avoid. Particular issues affect those working in regional and remote areas where professional isolation and lack of support may potentially predispose to burnout. Issues specifically affecting senior EPs, especially cognitive and physical decline have largely been neglected. Allowances should be made for experienced EPs approaching retirement from clinical work but who may also still have much to offer.

Burnout and Stress Among Emergency Physicians in the Kingdom of Bahrain Using the Copenhagen Burnout Inventory (CBI) and Short Form-stress Overload Scale (SOS-S)

“…53 In fact, burnout in senior EPs has been neglected and measures to prevent and treat it must be provided to ensure maintaining a long career for the EPs of all ages and in particular for the seniors. 54 In contrast, Aldrees et al study in a tertiary hospital in Saudi Arabia stated that being a resident is one of the factors associated with burnout with OR=4.9. 39 EPs working more than 50 hours per week had signi cant patient-related burnout (p = 0.016) compared to the average 40 hours per week.…”

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

“…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. 48 Related to money, Xu and Veloski 38 and Xu et al 34 found that having educational debt was associated with staying in EM in the USA.…”

“…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.…”

Wellness Review 2019, Part 2

“…John Holmes argues that in order to retain the valuable experience, master clinicians should receive love in the form of certain allowances to their practice, e.g. decreased night shift allocation [11]. This is already a well-recognized problem in Europe, as the European Working Time Directive specifies shorter shifts and working hours for older doctors [11].…”

“…decreased night shift allocation [11]. This is already a well-recognized problem in Europe, as the European Working Time Directive specifies shorter shifts and working hours for older doctors [11].…”