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Impact of Burnout on Self-Reported Patient Care Among Emergency Physicians

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

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Provider Workforce

Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

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

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Provider Workforce

Staff Perceptions of an On-site Clinical Pharmacist Program in an Academic Emergency Department after One Year

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.

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Provider Workforce

Implementation of a Successful Incentive-Based Ultrasound Credentialing Program for Emergency Physicians

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.

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Provider Workforce

A Survey of Graduating Emergency Medicine Residents’ Experience with Cricothyrotomy

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.

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Provider Workforce

Board-Certified Emergency Physicians Comprise a Minority of the Emergency Department Workforce in Iowa

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.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.