Literature Review

How physician CEOs are reenergizing later-career cliniciansBecker's Hospital Review; by Kristin Kuchno; 4/9/25 While much attention has been paid to recruiting top talent amid workforce shortages, retaining physicians later in their careers is also a key focus for health systems. Mentorship, flexible scheduling and leadership development opportunities can help energize experienced physicians and reduce burnout in the years leading up to their retirement, health system CEOs told Becker’s. Physician CEOs are uniquely positioned to understand the challenges around burnout and retention. Sunny Eappen, MD, president and CEO of The University of Vermont Health Network in Burlington [described], “Having experience being in front of a patient and having to either have difficult conversations or make difficult decisions is at the core of what we do,” Dr. Eappen said. “People understand that I can really speak from the heart and truly be in their shoes.”

Why good palliative care clinicians get fired JAMA Network - Viewpoint; by Abby R. Rosenberg, MD, MS, MA; Elliot Rabinowitz, MD; and Robert M. Arnold; 4/14/25 Even the most seasoned palliative care clinician gets fired. In the past year, one of us was fired after asking whether a patient endorsing suicidal ideation had access to a gun; the patient requested not to see the palliative care team because we asked intrusive questions and documented the encounter. One of us was fired after supporting a family’s decision to discontinue life-sustaining therapies for their loved one with multisystem organ failure; the primary intensivist suggested palliative care overstepped in discussing options for which the family (and clinical teams) was not ready. And one of us was fired after sharing the impression that a patient with cancer was dying; the family suggested they preferred the oncologist’s version of a more hopeful future.

The modern health care professional: How to combine skills from different fields to redefine your career MedPage Today's KevinMD.com; by Jalene Jacob, MD, MBA; 4/11/25 Gone are the days when careers followed linear paths and job titles neatly fit into predefined boxes. Today’s health care industry celebrates versatility, and hybrid professionals are redefining what it means to succeed. A hybrid health care professional combines skills and expertise from different fields, blending knowledge to create unique value in the health care space. Whether you’re a nurse with coding skills, a doctor with a passion for data analysis and research, or a biomedical engineer with a talent for design and business, hybridization is becoming the new competitive advantage. This article explores how early professionals can harness their diverse interests and talents to shape their careers and stand out in a rapidly evolving job market.

Rural US loses 43% of independent physicians: 5 things to know Becker's Hospital Review; by Kelly Gooch; 4/7/25 The number of independent physicians in U.S. rural areas declined 43% over five years — from 21,956 in January 2019 to 12,467 in January 2024 — according to an Avalere study sponsored by the Physicians Advocacy Institute. ... Five things to know:

The cost of nurse turnover in 24 numbers | 2025 Becker's Hospital Review; by Molly Gamble; 4/7/25 Nurse shortages and mounting labor costs are among health system CEOs’ top concerns, and a new survey puts numbers to the financial risks hospitals face from nurse vacancies and churn. The 2025 NSI National Health Care Retention & RN Staffing Report features input from 450 hospitals in 37 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies.  It found the average cost of turnover for one staff RN grew from January through December 2024 to $61,110, among other dollar figures and statistics that are helpful to understand the financial implications of one of healthcare’s most persistent labor disruptions. Here are 24 numbers that illustrate the cost of nurse turnover, according to the most recent edition of the report, which is available in full here. [Continue reading ...]

What role do immigrants play in the direct long-term care workforce? KFF; by Priya Chidambaram and Drishti Pillai; 4/2/25 President Trump has made a slew of immigration policy changes focused on restricting entry at the border and increasing interior enforcement efforts to support mass deportation. While these actions are focused on undocumented immigrants, they likely will have ripple effects across immigrants of all statuses and millions more people living in immigrant families. Mass deportations could negatively impact the U.S. economy and workforce, given the role immigrants play, particularly in certain industries. ...

Most people pursue a toxic type of purpose in life—but if you do this instead, ‘there is no way to fail’ CNBC Make It; by Dr. Joran Grumet, contributor/hospice medical director; 4/4/25 It took me many years and quite a bit of emotional heartache to realize a life-changing fact: When it comes to purpose, bigger is not better. Most of our anxiety stems from what I call “big P” Purpose, which is overly focused on the outcome or destination. ... [Dr. Grumet describes what he calls "big P" Purpose vs. "little P" Purpose.] I’ve found that most people end up pursuing the former, toxic type of purpose. It’s the easiest kind to choose, because it means meeting society’s expectations and following in the footsteps of the herd. The harder decision by far is to do the internal work to discover what really lights you up — and find a way to pursue it in the world. This all takes effort, but it’s worth it. ... Little P purpose embraces an abundance mentality. There is room for everyone — I mean everyone — to pursue that which brings them inner joy and happiness. This pursuit will never rely on whether someone else is succeeding or failing. ... [Continue reading ...]

Higher sedentary time linked to more chronic conditions, study shows McKnights Long-Term Care News; by Kristen Fischer; 4/2/25 A new study showed a progressive increase in multimorbidity, or multiple chronic conditions, in people who spent more time sedentary (or not moving). When people limited their time being sedentary to under four hours a day, it was linked with a lower chance of multimorbidity. Findings were published Tuesday in Archives of Public Health. ... On average, 46.1% of participants were sedentary for one to three hours a day, while 9.4% of people were still for more than seven hours each day. When scientists put the data together, they noticed a clear trend: The longer time people spent sedentary, the more likely they were to have more health ailments. ... Systemic arterial hypertension, chronic spine problems and high cholesterol were the most common chronic conditions among participants. [Continue reading ...]  Editor's note: What health/wellness support do you provide for your employees who spend hours upon hours at a computer? Do you provide innovative breaks? Walking groups? A roomwith exercise machines? Employee discounts for local gyms? Email me with your supportive solutions. 

Managing oncology nurse burnout through peer support, emotional intelligence Oncology Nursing News; by Pattie Jackel, MN, RN, AOCN; 3/28/25 Debriefing after patient loss, supporting patients at the end of life, and finding outlets outside of work can help oncology nurses avoid burnout. ... Pattie Jakel, MN, RN, AOCN, spoke with Oncology Nursing News® about burnout in oncology nursing and ways to avoid it while providing palliative care to patients. ... You have to have a strong network and support. And my husband is…an architect, so medicine is not his thing, and in the beginning, he’d be like, “Pattie, I can only hear one sad story a week because I can’t hear all your sad stories.” ... "Working in acute care, I saw some horrific death and dying that occurred for our patients. We would definitely debrief afterwards, bring the group together 5 minutes. Sometimes we did longer ones." [Continue reading ...]

From heroes to burnout: How we failed our frontline health workers MedPage Today's KevinMD.com, and excerpt from Health Care Nation; by Tom Lawry; 3/15/25 Of all the lessons learned from fighting a pandemic, none was more frightening or important than discovering how dependent the system is on how we treat our doctors, nurses, and frontline caregivers.  They were already in short supply, with burnout on the rise, when the pandemic hit. As multiple waves of COVID-19 variants washed over us, frontline health workers stepped in at great risk and personal sacrifice to care for highly infectious patients. ... Some witnessed more deaths on a double shift than they did in a normal year. They delivered the bad news to families and managed end-of-life care. They were often the last face and warm voice a COVID-19 victim saw and heard. In the end, they not only saved lives but saved the system from total collapse. ... We called them heroes. And we promised to do better in how we treated them once the COVID-19 crisis passed. Promises made should be promises kept. While we continue to talk about workforce burnout using polite terms with concern in our voices, let us be clear: A system with a mission of healing continues to harm in record numbers the very people in short supply who are there to take care of the rest of us. ... [Click on the title's link for more.]

MedPAC recommends Congress tie physician pay to inflation for 2026 Healthcare Dive; by Susanna Vogel; 3/17/25 Dive Brief:

Spiritual well being at Kaiser HMG - Hews Media Group, Los Cerritos Community News, Los Angeles, CA; 3/13/25 At Kaiser Permanente Downey Medical Center, the hospital and staff are committed not only caring for the patient’s physical, emotional and mental wellness, but just as importantly to their spiritual well-being. ... Chaplains at Downey Medical Center are called upon when a patient and/or family is: