Can't always get what you want, but hospitalists come close


Satisfaction with one's job can be a difficult thing to quantify—do the good days outweigh the bad, the accomplishments mean more than the everyday frustrations?

A group of hospitalists recently surveyed a large number of their colleagues in an effort to gain some perspective on this issue. The Hospital Medicine Physician Worklife Survey asked more than 3,000 U.S. hospitalists about many domains of work, from their compensation and personal time off to relationships with colleagues and quality of care for patients.

Courtesy of Dr Hinami
Courtesy of Dr. Hinami.

The results, which revealed that 62% of hospitalists are highly satisfied with their jobs, were published in the Journal of General Internal Medicine and the Journal of Hospital Medicine in January. Lead author Keiki Hinami, MD, ACP Member, recently spoke with ACP Hospitalist about some of the survey's other findings, and how they should be understood by hospitalists and their employers.

Q: Were there any surprises in your results?

A: In 2009-2010, when we administered our national survey, hospitalist jobs and hospitalist work patterns were highly variable. Additionally, there were important differences in the priorities of individual hospitalists for selecting their jobs. Despite these differences in the characteristics of individuals and their jobs, job satisfaction among practicing hospitalists was not different.

Q: Are there lessons in this for hospitalists and their employers?

A: The important lesson for employers is that not all hospitalists are the same. Similarly, an important lesson for hospitalists is that not all hospitalist jobs are the same. If you are an individual hospitalist looking for a job, make sure that the requirements and responsibilities of that job align with your priorities and abilities.

Q: Organizational climate stood out as an issue in your results. Could you talk about that?

A: In the JGIM paper, we ranked the satisfaction domains from highest to lowest. And organizational climate came down at the very bottom of that list. The fact that hospitalists are finding their organizational climate to be among the least satisfying part of their jobs suggests something is amiss. This is particularly true for employers, I think, who may have a few things they can do to improve morale among their workforce.

Q: Your study found an association between higher workload and greater satisfaction. How do you interpret that?

A: The association between perceived workload and job satisfaction makes sense to me, in that hospitalists like what they do. They are trained to do this work, so it makes sense that the most satisfied hospitalists are also the most productive. We're seeing an example of job engagement, I think.

Q: The study also found some significant differences in hospitalist compensation. What does that indicate?

A: We found significant differences in the compensation rate across hospitalist practice models. We also found that despite differences in total earnings across practice models, the average job satisfaction across these practice models was not different. This suggests that pay isn't everything for everyone. Hospitalists have different priorities in selecting their jobs. For some hospitalists, pay is the most important feature. Other hospitalists are willing to sacrifice some of their pay for other opportunities that a job might offer them. Academic hospitalist jobs, for example, are not highly remunerative but they offer educational and research opportunities that can't be found in other practice models.

Q: Is the incidence of burnout that you found reason for concern?

A: The burnout rate of about 30% that we found in our survey is similar to burnout rates among hospitalists seen in other studies. There is some concern that maybe that rate is a little bit higher than back in 1999, the last time a national survey of hospitalists was administered, but we can't say for sure because we used different survey instruments to assess burnout symptoms.

Q: Are there specific areas of this survey that you think require further research?

A: Hospital medicine as a specialty has grown remarkably over the last 15 years. And it has grown into a lot of niches. The specialty has become big enough to accommodate different hospitalists with different priorities. I think it will be interesting to learn how individual hospitalists find their right job and how they grow with their jobs.