Kidney specialists face increasing work demands, high rates of burnout, and declining interest in nephrology as a career. A group of articles publishing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN) sheds light on how that these factors threaten to reduce job satisfaction and impair the delivery of high-quality care to patients with kidney diseases.
In an introductory article, Ian de Boer, MD, MS (University of Washington, Seattle) notes that there are no quick or easy solutions, but there are certain fundamental issues and specific steps that the nephrology community should consider. "Stimulating job satisfaction and attracting the best physicians to nephrology require change at many levels, including health systems, practice implementation, personal approaches to work-life balance, and fellowship training," he said.
In the first article, Amy Williams, MD (Mayo Clinic of Medicine) notes that half of surveyed nephrologists experience burnout. Dr. Williams stresses that individual physicians cannot tackle burnout alone: healthcare systems, academic institutions and organizations, including dialysis organizations, must improve work environments, influence policy and support physicians' wellbeing at all career stages.
A second article by John Roberts MD, MS, MEd (Duke University Medical Center) states that nephrology training is at a crossroads, and it is critical to move away from overwork, emotional exhaustion, and depersonalization for residents and physicians and to instead consider constructing the practice of nephrology in a healthier way that considers how each individual is motivated to make the best career decision not only for personal interests but also for their health and family responsibilities.
In the third article by Mitchell Rosner, MD (University of Virginia Health System) and Jeffrey Berns, MD (Perelman School of Medicine at the University of Pennsylvania), experts propose a series of measures that can lead to meaningful improvement in the professional lives of nephrologists. These measures can be divided into those that focus on fellowship training, practice transformation, creating a stronger community of nephrologists, stimulating the cognitive aspects of practice, and enhancing the clinical scope of practice of nephrology.
"Our hope at CJASN is that these insightful articles will provide a constructive platform to discuss the issues facing nephrology today and the concrete steps we can take as a field to improve careers in nephrology," said Dr. de Boer.
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"Introduction: Nephrology at a Crossroads," "Transforming Nephrology," "Addressing Physician Burnout in Nephrology," Clinical Journal of the American Society of Nephrology (2018).