5 November 2015

How to Build a Stable Emergency Medicine Department

Evidence indicates that emergency medicine will be an “undersupplied” specialty in the U.S. for at least 20 more years. The number of physicians who are board-certified in emergency medicine is unlikely to meet the staffing needs of U.S. hospital emergency departments – staffing needs which, if requiring at least one physician present in the ED 24 hours a day, demand 40,000 physicians with such training. In 2005, there were only 22,000 EM board-certified physicians, meaning that only 55 percent of the need was filled. Supply is not estimated to meet demand until 2038 at the earliest.

These data highlight the dire need for hospitals to retain the board-certified physicians that they already employ and the new ones they hope to hire. Easier said than done, as emergency medicine physicians experience the highest rate of burnout among all specialties. While this is not necessarily surprising, what is surprising is that hospitals do not always dedicate the right resources to recruiting the best physicians and prioritizing their physicians’ job satisfaction and retention.

Recruiting is the first piece of the puzzle — and that often means finding people or agencies with a comprehensive knowledge of the local physician market in order to attract top tier talent. Then, a key step in quality recruiting efforts is defining the job requirements. Not only does this help an organization find the right physician to fulfill its needs, but it also helps set the expectation of the physician for what will be required of him or her in this new role.

Retaining these physicians, on the other hand, can be a bit tougher, largely due to the ambiguity surrounding “burnout” among physicians and how it can be counteracted. According to the 2015 Medscape Physician Lifestyle Report, 46 percent of physicians said they experienced feelings of burnout. This represents a significant jump up from the 39.8 percent that reported feeling burned out just two years prior. As previously mentioned, the rate of burnout is highest among emergency medicine physicians.

For healthcare providers, reducing physician burnout is crucial for several reasons. Physicians facing high levels of burnout or stress may be more likely to change jobs or quit. Additionally, a disengaged, tired physician is more likely to make mistakes and less likely to act empathetically towards patients. As one article in Hospitals & Health Networks put it, “the secret to caring for patients is caring for our caregivers.” At a time when patient quality outcomes and satisfaction scores directly impact reimbursement, hospitals have a massive added incentive to start to take better care of their doctors.

By attracting the right type of talent and instituting processes that help doctors in emergency medicine cope with the high levels of stress, hospitals can build stable emergency department units that better serve patients and staff. One of the best ways to do this is to build a culture that gives physicians a voice in their departments, allowing them to regularly give input on day-to-day processes and independently design strategies to improve them. At Sheridan, we accomplish this using Kaizen, a continuous improvement methodology pioneered by Toyota. Kaizen empowers all participants in a process by giving them regular opportunities to give constructive feedback and improve their workplace.

If you'd like to learn more about how Kaizen builds more stable departments by empowering physicians, check out our “The Role of Kaizen in Hospital Performance Improvement” video, featuring the President/CEO of Jupiter Medical Center in Jupiter, FL.