N. Droz2, P. Parikh2, M. Whitmill2, K. M. Hendershot1 1University Of Alabama at Birmingham,Acute Care Surgery,Birmingham, Alabama, USA 2Wright State University,Trauma And Acute Care Surgery,Dayton, OH, USA
Introduction:
Providing 24/7 care for our patients and supervision for our residents/fellows is a cornerstone in the Trauma/Acute Care Surgeons (T/ACS) work-life. Our previous work defined what the T/ACS current practice pattern is (majority in a group practice with shared responsibilities; majority take in-house call in 24 hour shifts and 3-7 calls per month; majority staying part or all of post-call day).
The purpose of our current study is to look at the T/ACS attitudes regarding their practice patterns, specifically related to their call schedule and post-call day. Issues such as post-call fatigue and burnout related to their work schedule are also explored.
Methods:
An IRB-approved electronic survey was distributed nationally to Eastern Association for the Surgery of Trauma members. Participants were asked about attitudes related to their call schedule and coverage they provide while on call. They were also asked about fatigue and burnout related to their work schedule.
Results:
A total of 274 participants were analyzed (response rate 20%). The majority like their call schedule structure and length of their call shifts (62% and 66%, respectively). The scope of practice was liked by 77% with 14% not liking the elective surgery aspect of the practice. The majority (86%) covers all trauma, emergency general surgery (EGS), and surgical critical care while on call and 75% feel this is an adequate amount of work to cover while on call. The majority (83%) think they should get paid for trauma/EGS call.
Although 75% state they are able to get some rest while on call, 56% are “very tired” post-call and 29% have fallen asleep while driving post-call. The majority (71%) is concerned about fatigue post-call; 67% are concerned about being over-worked, and 72% are concerned about burnout. A change in their practice pattern could help with fatigue and feelings of being overworked according to 72% of participants.
Conclusion:
Despite the majority of T/ACS expressing concern about post-call fatigue, being overworked, and feelings of burnout, less than 20% have developed or implemented any innovative strategies to change the call structure and post-call day. Change is often difficult, so trying to think outside the box and develop novel approaches to attendings’ practice patterns should be encouraged and shared with the larger trauma community.