The Pediatric Hospitalist: A Survey of How We Are Doing

Physician well-being has important implications for clinicians, patients, and health care organizations. Burnout not only takes a human toll but is also associated with reduction in work hours, attrition, and medical errors.1 Conversely, career satisfaction is linked to improved retention and patient outcomes.2 Prior work has suggested an inverse relationship between burnout and career satisfaction, with one meta-analysis demonstrating that physician burnout was associated with a nearly 4-fold decrease in job satisfaction.3Burnout has previously been reported in approximately 18.6% of pediatric hospitalists,4 while career satisfaction was reported at 77.4%.2 Recent changes in the field of pediatric hospital medicine (PHM), including the end of the practice pathway for board eligibility and new pediatric residency training requirements, could affect burnout and satisfaction.5,6We hypothesized that some pediatric hospitalists are experiencing burnout, and that correlates with plans to decrease clinical time. We also hypothesized that career satisfaction is high but may be influenced by various factors. This study aimed to 1) assess burnout among pediatric hospitalists and determine whether level of burnout correlates with plans to decrease clinical time, and 2) evaluate overall career satisfaction among pediatric hospitalists and determine whether satisfaction varies by full-time work, work-life integration, gender identity, or board certification status.In 2024, the American Academy of Pediatrics Section on Hospital Medicine Workforce Taskforce conducted a cross-sectional survey of pediatric hospitalists that was distributed through multiple electronic and in-person channels.7 Additional study details are described in Jackson et al.7 This report focuses on survey items related to burnout, career satisfaction, and future plans. Burnout was evaluated by a previously validated single-item burnout measure.8 Satisfaction data were transitioned from a 5-point Likert scale (strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, and strongly disagree) to 3 categories (agree, neither agree nor disagree, and disagree) for some analyses. Cochran-Armitage trend tests were performed to evaluate the relationship between level of burnout and plan to decrease clinical time and night shifts. Univariable ordinal logistic regression and Fisher exact tests examined differences in satisfaction among various groups.Respondents reported varying levels of burnout, with 37.3% reporting at least 1 symptom of burnout (Figure 1). As level of burnout increased, a greater proportion of respondents reported plans to decrease clinical time or night shifts (trend test P < .001 for both, Figure 2). Women had higher odds of reporting burnout (odds ratio [OR], 1.83; 95% CI, 1.36–2.48).Most respondents strongly or somewhat agreed that they are satisfied with their career choice (89.8%) and would choose PHM if they started their career over again (78.2%). Respondents with full-time work had increased odds of reporting career satisfaction (OR, 2.16; 95% CI, 1.25–3.73), as did those who reported an appropriate balance between personal and professional commitments (OR, 13.88; 95% CI, 7.78–24.75). There was no difference in career satisfaction based on PHM subboard certification (overall P = .278) or gender identity (P = .987).We found high career satisfaction in PHM but, also, that significant burnout exists. Importantly, increased burnout correlated with plans to decrease clinical time.Career satisfaction among pediatric hospitalists was high (89.8%) relative to recent pediatric residency graduates (85.9%)9 and Pediatric Emergency Medicine physicians (77.8%).10 Prior work has shown that diversity of clinical and nonclinical responsibilities positively influences hospitalists’ career satisfaction.11 Our companion study demonstrated a wide range of clinical and nonclinical activities across respondents, which may contribute to the high satisfaction presented here.Despite high career satisfaction, more than one-third of respondents reported some degree of burnout, which was associated with plans to decrease future clinical time and night work. These findings suggest that burnout may have serious implications for our workforce capacity, even among physicians who remain satisfied with their careers. Women also had higher odds of burnout in our study, which warrants particular attention because our workforce is predominantly female and faces gender discrepancies in work-life integration.12,13Study limitations include our modest response rate and uncertainty regarding how representative our respondents were of the field. Future work should evaluate institutional strategies to reduce burnout, including novel approaches that address work-life integration. As PHM continues its ever-constant growth and evolution, ongoing monitoring of burnout and career satisfaction will be crucial to ensuring the workforce’s health and well-being.We wish to acknowledge the work of the American Academy of Pediatrics Section on Hospital Medicine Workforce Task Force who helped with the creation and distribution of the survey.