A rapid response for burnout among inpatient physiatrists: A survey of leaders of inpatient rehabilitation facilities

Background: Symptoms of burnout are highly prevalent among physiatrists, and prior studies have helped identify key contributors to this epidemic of burnout. Little is known about the physician stressors unique to those providing care in inpatient rehabilitation facilities (IRFs) and what strategies such facilities have used to help mitigate burnout among inpatient physiatrists. Objective: To identify what IRF leaders perceive as stress points contributing to burnout among inpatient rehabilitation physicians and what, if any, interventions their programs have implemented to help mitigate physician burnout. Design: 10 item cross-sectional survey study of IRF physician and nonphysician leaders in the United States. Participants: 104 physicians serving in the roles of IRF medical director, director of rehabilitation, and/or executive leadership and 19 nonphysician IRF leaders. Results: Regulatory demands, late admissions, understaffing, and on-call responsibilities were the major stress points most identified as contributing to physician burnout among both the physician and nonphysician respondents. The use of advanced practice providers and hospitalists were the most common system changes reportedly used to help mitigate physician burnout. Although 57.8% of physician leaders felt late admissions were a major stress point for physicians, only 18.2% of those responding reported having implemented admission cutoff times. Conclusions: There are stressors unique to the practice of inpatient rehabilitation that are likely contributing to physiatrist burnout, including late admissions and on-call responsibilities. Many IRFs have begun to implement system changes to help mitigate burnout among inpatient physiatrists. The use of nonphysiatrist providers is a commonly reported strategy. Future studies are needed to determine the effectiveness of such a strategy on reducing symptoms of burnout among IRF physicians as well as its effect on IRF patient outcomes.