Physician wellness is associated with career satisfaction.1 Compared to other specialties, emergency physicians suffer from high rates of burnout.2–6 In addition to personal career satisfaction, wellness and resilience are important to maintaining patient safety and quality of care. We demonstrate some important principles of wellness and quality through five case scenarios.
Case 1: No Duty Hours for Attendings
You are recovering from a painful divorce. Although suffering from some depression and sleep deprivation, your financial needs necessitate moonlighting to pay for your kids’ college tuition, and you are working 60–70 hours per week. Colleagues have remarked you are becoming forgetful. On a few occasions, you have forgotten to hand off patients properly to floor providers and lost track of treatments in progress for your ED patients. Who should monitor wellness and quality?
The Accreditation Council for Graduate Medical Education duty hour restrictions were set in place in 2003 and updated in 2011. These guidelines were instituted to enhance patient safety and improve the working conditions and education of resident physicians.1,2 Unfortunately, there are no restrictions on attending physician duty hours. The lack of regulatory oversight makes it imperative for individual physicians, colleagues, and departments to monitor workload and fatigue.