New Lifestyle Report Finds Residents Ready to Use Telehealth

Neil Chesanow

Disclosures

July 28, 2015

In This Article

Intriguing Insights Into Residents' Lifestyles

Practicing physicians have been slow to embrace telehealth as a means of seeing patients remotely, despite growing demand. However, the majority of today's medical residents would have no problem consulting with at least some patients by video, telephone, or email, a new Medscape report found.

The readiness of a majority of residents to adopt telehealth media in the service of patient care was one of many intriguing insights revealed in Medscape's 2015 Residents Salary & Debt Report, which was issued in two parts. While the first part of the report looked at residents' compensation and related money matters, part 2 focused on lifestyle issues.

In addition to their willingness to participate in virtual patient consultations, the report queried residents on their biggest challenges faced in residency; emotional aspects of resident life; their doubts about becoming a good doctor; whether their first post-resident salary would be a trigger to overspend after years of receiving, in most cases, very modest compensation; whether they saw themselves as future practice partners or owners or preferred working for someone else; and whether they paid enough attention to their health and wellness during residency.

Over 1700 residents in 24 specialties offered insights as part of an online survey conducted by Medscape from May 14 through June 22, 2015. All participants were required to be enrolled in a US medical residency program. Here are the highlights.

Key Challenges During the Residency Years

Among the brightest and most intellectually accomplished graduate students, residents typically begin their working lives earning modest pay by most professional standards, putting in long hours, working night shifts at least several times a month, and spending a good part of their free time poring through the clinical literature for their specialties to hone their knowledge and skills. Given this, what do they find most challenging about the resident lifestyle?

For nearly one third (32%) of our respondents in the first 1-4 years of residency and 37% in years 5-8, finding a harmonious work-life balance was a challenge. Yet only about 1 in 5 residents (21%) reported that they had difficulties dealing with the time pressures of their jobs in the first 4 years of residency, and even fewer (19%) had problems in years 5-8.

Once they leave the hospital environment as residents, however, this may change. In Medscape's 2015 Physician Lifestyle Report, one of the top causes of burnout among practicing physicians was spending too many hours at work.

Residents, by and large, are confident that they know what they are doing. Only 14% of those in the first 4 years of residency, and only 10% of those in years 5-8, reported that they had problems developing the clinical skills required for their specialties.

Residents' relationships with attending physicians, nurses, and physician assistants (PAs) were generally unproblematic. Only 2% of respondents noted them as challenging, although their comments were instructive.

For example, "Many nurses consider residents as temporary trainees, not colleagues," one resident observed.

There were about 100 comments along these lines, vs over 1700 that simply rated relationships with nurses and PAs as "good," "very good," or "excellent," without further elaboration.

Residents' relationships with attending physicians, about which criticism has sometimes been expressed in the media, received scant critique in our 2015 report. Only 2% of residents found relationships with attendings to be a problem.

"Some attendings belittle us, curse at us, yell at us, don't teach, are unreasonable, and promote a negative work culture," one resident wrote by way of example, one of slightly more than 100 critical comments out of over 1700 assessments received, the vast majority of which ranged from "good" to "excellent." But this commenter also added, "Others are fantastic to work with—patient, great teachers, and knowledgeable."

Only 2% of residents said they felt challenged by the death of a patient or by having to treat chronically or terminally ill patients. This is no longer surprising, not after family physician Pamela L. Wible's poignant and disturbing Medscape article, "Physician Bullying: 'Not Allowed to Cry,'" blew the lid off residents' often shocking acculturation into a profession where emotional displays, even in the most heartbreakingly tragic human circumstances, traditionally aren't tolerated.

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