January 22, 2024
Emergency medicine physicians Jesse M. Pines, MD, MBA, MSCE, and Amer Aldeen, MD, address the rising issue of burnout within their specialty. According to a recent survey, nearly two-thirds of emergency medicine physicians report burnout, the highest among all specialties. The authors present four unique strategies to address this challenge:
- Addressing ED Inefficiencies:
- Hospitals should focus on fixing Emergency Departments (EDs), addressing issues like boarding, insufficient capacity, and inefficient processes.
- Proposed solutions include push versus pull tactics, full capacity protocols, surgical schedule smoothing, early hospital discharges, and the involvement of emergency physicians in the process.
- The government, as a regulator and funder of EDs, should hold hospitals accountable for delivering functional care, and standards like those from The Joint Commission should be enforced.
- Promoting Career Development:
- Despite burnout concerns, the authors recommend developing a niche or area of expertise within emergency medicine.
- Having a balanced approach, such as 80% clinical work and 20% in a niche area, can combat burnout by providing cognitive challenges, problem-solving opportunities, respite from empathy fatigue, and positive relationships with colleagues.
- Advocating for the Specialty:
- Addressing the faulty implementation of the No Surprises Act is crucial, including fixing the arbitration process and creating disincentives for insurers withholding payments.
- Organized action, including joining professional societies like the American College of Emergency Physicians, is encouraged to advocate for emergency physician interests and address external drivers of burnout.
- Increasing Resiliency:
- Resilience is highlighted as a key factor in combating burnout, emphasizing self-care through nutritious diets, regular exercise, enhanced sleep, stress reduction strategies, and boundary rituals.
- Emergency physicians are encouraged to take restorative actions during shifts and consider reframing their view of the job, recognizing the privilege of caring for patients and the high-income status within the profession.
The authors acknowledge the challenges faced by emergency physicians but emphasize empowerment through pushing for improvements in the work environment, career development, the specialty’s standing, and personal well-being. They encourage a proactive approach to combat burnout rather than succumbing to a victimhood mentality.