University of Wisconsin–Madison Medical College of Wisconsin

Mitigating Burnout Imperative for Retention of Hospitalists

Amarilis A. Martin, MD; Adaira Landry, MD, MEd; Meridith Englander, MD; Jessica M. Allan, MD

WMJ. 2024;123(2):67

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Dear Editor:

We were interested to read the article by Vazirnia et al, “Perception of Burnout and Its Impact on Academic Hospitalists During COVID-19 and Institutional Strategies to Combat Burnout and Improve Wellness.”1 The authors surveyed academic hospitalists on their perceived contributions to burnout, strategies to mitigate burnout in academic medicine, and the impact of COVID-19. Some of the perceived contributions to burnout for hospitalists included high workload, bureaucratic hurdles, extensive documentation, and lack of control over administrative decisions. Suggestions to mitigate burnout included improving open communication between leaders and clinicians and providing opportunities for social gatherings within and outside of work. One of the most important strategies was “to increase social interactions to foster a sense of community.”1

Survey participants’ focus on community building highlights their need for belonging. Belonging has been defined as, “everyone is treated and feels like a full member of the larger community and can thrive.”2 In medicine, belonging has been associated with increased physician retention.2 In one study, women clinicians who reported a higher sense of belonging were less likely to leave their institution within 2 years.2 Retention is critical for the sustainability of the physician workforce and the financial health of the institution. Attrition is costly; the direct and indirect costs have been estimated to range from $250,000 to $1 million, where the variability is dependent on specialty and other factors.2 If creating a work environment that fosters belonging increases physician retention, then hospitals and other health care organizations have a compelling reason to invest in efforts that improve physician belonging.

Solutions are imperative – especially given the high levels of burnout in hospital medicine and the current inpatient workforce shortages1 –  and should focus on mitigating burnout, enhancing community, and facilitating communication. Previous suggestions to foster workplace belonging include empowering professional thriving.2 For academic hospitalists, this may include streamlined clinical care, support for career advancement, and promoting open, effective, and safe communication.3 These strategies are aligned with the initiatives suggested by Vazirnia et al, which may not only decrease burnout but also promote belonging and retention. As we continue to evaluate burnout, we should consider the topic of belonging and its potential benefits on physician burnout and hospital retention.

  1. Vazirnia P, Luebke M, Abdelrahim MT, et al. Perception of burnout and its impact on academic hospitalists during COVID-19 and institutional strategies to combat burnout and improve wellness. WMJ. 2023;122(5):394-398. PMID:38180932.
  2. Schaechter JD, Goldstein R, Zafonte RD, Silver JK. Workplace belonging of women healthcare professionals relates to likelihood of leaving. J Healthc Leadersh. 2023;15:273-284. doi:10.2147/JHL.S431157.
  3. Silver JK, Allan JM, Martin AA, Overholser B, Spector ND. Enhancing belonging and other stay factors to improve physician retention. J Hosp Med. Published online March 25, 2024. doi:10.1002/jhm.13340

Author Affiliations: Renaissance School of Medicine at Stony Brook University, Stony Brook, New York (Martin); Stony Brook Children’s Hospital, Stony Brook, New York (Martin); Brigham and Women’s Hospital, Boston, Massachusetts (Landry); Albany Medical College, Albany, New York (Englander); Palo Alto Medical Foundation, Palo Alto, California (Allan); Stanford University School of Medicine, Palo Alto, California (Allan).
Corresponding Author: Amarilis A. Martin, MD, Department of Pediatrics, Renaissance School of Medicine at Stony Brook University, 101 Nicolls Rd, Stony Brook, NY 11794, email, phone 631.444.2710; ORCID ID 0000-0002-4634-7347
Funding/Support: None declared.
Financial Disclosures: None declared.
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