Embracing the Future of Nocturnist Work: Telemedicine as a Sustainable Solution for Hospitalist Burnout

Hospital medicine is constantly evolving, propelled by the escalating complexity of patient care and the ever-growing demand for 24/7 coverage. Amid the COVID-19 pandemic, nocturnists emerged as vital players, ensuring uninterrupted care for patients. Unfortunately, their heightened responsibility also intensified burnout issues, especially for those juggling locum work.

Now, as the critical need for nocturnist work in hospital medicine continues to expand, we also have the chance to transform how we address that need.

The all-hands pandemic emergency

The COVID-19 pandemic had a profound impact on healthcare systems and healthcare professionals throughout the United States. As frontline providers, hospitalists faced a significant and rapid influx of critically ill patients, the need for nimble adaptation to new clinical protocols, and the high risk of exposure to COVID.

The pandemic also highlighted the critical role of hospitalists in managing acute care, coordinating resources, and ensuring continuity of care for patients, especially for nocturnists. Hospitalists who provided nighttime coverage were indispensable in addressing the increased patient load, managing nighttime emergencies, and reducing the burden on their daytime counterparts.

Over the last three years, in-person nocturnists have been vital in providing around-the-clock care, monitoring patients’ progress, updating treatment plans, and ensuring smooth handoffs between shifts. This coordination between nocturnists and daytime hospitalists was crucial for hospitals to improve patient outcomes during the pandemic.

Burnout in hospital medicine

And yet, this all-hands emergency only accelerated pre-existing trends toward hospitalist burnout.

“When we were in the middle of the pandemic, it was an absolute emergency,” said Access TeleCare’s Hospitalist Service Line Chief Dr. Paulgun Sulur. “When the dust cleared, I think what we started seeing is a need for longevity, a need to avoid burnout.”

High patient volumes, complex medical cases, and the necessity for rapid decision-making have taken their physical and emotional toll. Additionally, hospitalists often worked long hours and faced high expectations for performance and efficiency. Furthermore, burnout can often lead to high turnover rates among hospitalists, disrupting patient care and putting additional strain on both patients and the healthcare system.

As surges in volume and acuity struck different parts of the country at different times, many many hospitalists took on locums work, plugging holes and filling gaps in care when and where needed. These roles placed even greater stress on hospitalists, requiring them to travel away from family, live out of hotels, and drop into unfamiliar hospital environments on short notice. The lack of consistent support systems can be taxing, while unfamiliarity with hospital protocols and staff only increases feelings of isolation.

The critical need for nocturnists

Yet demand for nocturnists remains a critical need in hospital medicine.

“We’ve had a great effect on communities,” said Dr. Sulur. “There’s a great appreciativeness from the patients and families when they can get that continuity of care overnight.”

Hospitals recognize the value of dedicated nocturnist teams in improving patient outcomes and overall efficiency. However, the surge in nocturnist opportunities through locum tenens companies may not provide the ideal working conditions for long-term sustainability, whether for the physicians filling those needs or for the hospitals.

Telemedicine offers a sustainable solution for nocturnists seeking to meet the critical need for overnight care while mitigating the risk of burnout.

“If you’re going to do nocturnist work, doing it from a home office environment is far more sustainable in the long run,” notes Dr. Sulur.

By providing remote care, telemedicine allows nocturnists to support hospitals and patients from a stable work environment, often in their own homes, without the need for constant travel and adaptation to new settings. This can lead to a more balanced lifestyle and improved job satisfaction, as well as less turnover for the hospital.

“It’s helpful to the hospital to have familiar faces everywhere, so the daytime hospitalists are much happier,” said Dr. Sulur. “If the daytime hospitalists also had to do nighttime call, we’d be dealing with so much more turnover. I can guarantee, hospitalists who get nighttime coverage from nocturnists at Access TeleCare never want to go back to the way it was before.”

An acute care telemedicine career

Practicing acute care telemedicine at Access TeleCare presents an opportunity for hospitalists seeking nocturnist roles without the drawbacks of locum work.

Access TeleCare offers a supportive, collaborative, and flexible work environment with a strong emphasis on physician well-being. Telemedicine enables nocturnists to provide high-quality care remotely, thus allowing them to support hospitals still in critical need of nighttime coverage.