Outside of EM, the most successful interventions focus on changes to systems rather than to individual physicians. Within EM, the number of well-structured interventions that have been studied is limited. Future work to achieve the desired culture of wellness within EM requires establishment of a consistent endpoint that serves as a surrogate for clinical significance, addressing contributors to burnout at all levels, and integrating successful interventions into the fabric of EM.
Gender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians’ experiences with workplace gender discrimination and sexual harassment.
Burned-out physicians are unlikely to seek professional treatment and may attempt to deal with substance abuse, depression and suicidal thoughts alone. This paper reviews the scope of burnout, contributors, and consequences both for medicine in general and for EM in particular.
We thank Mr. Wu, PA-C, MHS (President, the Society of Emergency Medicine Physician Assistants [SEMPA]) for his insightful letter in response to our paper, “Emergency Medicine Physician Assistant (EMPA) Postgraduate Training Programs: Program Characteristics and Curricula.”
This two-article series provides a review of relevant tools and offers guidance to clinical mentors and researchers in choosing the appropriate instrument to suit their needs, whether assessing mentees or testing interventions in the research setting.
We appreciate the authors conducting research describing EMPA postgraduate training program characteristics and agree that more research is needed in this field. As the largest national organization representing EMPAs, we would like to expand on a few points regarding these programs and overall EMPA practice.
The objective of this study was to provide an overview of the current state of EMPA postgraduate training and to describe program characteristics and curriculum components. We conducted a cross-sectional study of EMPA postgraduate training programs using data from websites and contacting individual programs to provide program characteristics and curriculum components.
Increasing attention has been focused on parental leave, but little is known about early leave and parental experiences for male and female attending physicians. Our goal was to describe and quantify the parental leave experiences of a nationally representative sample of emergency physicians (EP).
Volume 16, Issue 7, December 2015.
Dave W. Lu, MD, MBE
Introduction: Burnout is a syndrome of depersonalization, emotional exhaustion and sense of low
personal accomplishment. Emergency physicians (EPs) experience the highest levels of burnout among
all physicians. Burnout is associated with greater rates of self-reported suboptimal care among surgeons
and internists. The association between burnout and suboptimal care among EPs is unknown. The
objective of the study was to evaluate burnout rates among attending and resident EPs and examine their
relationship with self-reported patient care practices.
Methods: In this cross-sectional study burnout was measured at two university-based emergency
medicine residency programs with the Maslach Burnout Inventory. We also measured depression, quality
of life (QOL) and career satisfaction using validated questionnaires. Six items assessed suboptimal care
and the frequency with which they were performed.
Results: We included 77 out of 155 (49.7%) responses. The EP burnout rate was 57.1%, with no
difference between attending and resident physicians. Residents were more likely to screen positive
for depression (47.8% vs 18.5%, p=0.012) and report lower QOL scores (6.7 vs 7.4 out of 10, p=0.036)
than attendings. Attendings and residents reported similar rates of career satisfaction (85.2% vs 87.0%,
p=0.744). Burnout was associated with a positive screen for depression (38.6% vs 12.1%, p=0.011) and
lower career satisfaction (77.3% vs 97.0%, p=0.02). EPs with high burnout were significantly more likely
to report performing all six acts of suboptimal care.
Conclusion: A majority of EPs demonstrated high burnout. EP burnout was significantly associated
with higher frequencies of self-reported suboptimal care. Future efforts to determine if provider burnout
is associated with negative changes in actual patient care are necessary
Volume 15, Issue 4, July 2014
Teresita M. Hogan, MD et al.
The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients
Volume 15, Issue 2, March 2014
Zlatan Coralic, PharmD, BCPS et al.
Emergency department clinical pharmacists (EPh) serve a relatively new clinical role in emergency medicine. New EPh may still face barriers prior to working in the emergency department (ED), including staff acceptance. We aimed to assess staff perceptions of a university hospital EPh program 1 year after implementation.
With the rapid expansion of emergency ultrasound, resident education in ultrasound has become more clearly developed and broadly integrated. However, there still exists a lack of guidance in the training of physicians already in practice to become competent in this valuable skill. We sought to employ a step-wise, goal-directed, incentive-based credentialing program to educate emergency physicians in the use of emergency ultrasound. Successful completion of this program was the primary outcome.
The Emergency Medicine (EM) Residency Review Committee stipulates that residents perform 3 cricothyrotomies in training but does not distinguish between those done on patients or via other training methods. This study was designed to determine how many cricothyrotomies residents have performed on living patients, the breadth and prevalence of alternative methods of instruction, and residents’ degree of comfort with performing the procedure unassisted.
Introduction: The objective of our study is to better understand the current staffing practices of Iowa emergency departments (EDs).
Conclusion: Many EDs in Iowa remain staffed by family medicine-trained physicians and are being increasingly staffed by APPs. Without the contribution of family physicians, large areas of the state would be unable to provide adequate emergency care. Board-certified emergency physicians remain concentrated in urban areas of the state, where patient volumes and acuity support their hiring.