There’s a particular conversation I’ve had with fellow hospitalist colleagues. I’ve had it so many times it’s almost like a tape recorder. Here’s how it goes:

Them: Angie, I’m done. I’ve had it. I want to quit

Me: Oh?

Them: Yea. I’m going to look for another job.

Me: Ok , I understand and  I support you.

Them: What? Aren’t you going to try and get me to stay?

Me: No. You’re free. Go find yourself.

Them: Go find myself?

Me: Yes. And then call me when you figure out what makes you happy.

I’ve encountered this conversation with most of the new grads that go into hospital medicine. I had a colleague once text me literally in the middle of her first job interview after she told me she wanted to quit. In so many words, her text read: Never mind. You were right. I’m coming back.

Within a few minutes of that interview, she had realized she wasn’t going to get the leadership support that she had at US Acute Care Solutions. It’s always something.

There is no doubt that hospitalists, like many other specialties, are facing a crisis of burnout. There are a range of factors, which every hospitalist can list in their sleep: the seven on, seven off schedule and the ever-increasing documentation requirements probably top the list.

For some, they go to other hospitals or other practice settings and realize, like my colleague did, that they are not getting the leadership support they want. It’s not uncommon for hospitalist leadership to stop working clinically, which makes it challenging for those leaders to relate to the everyday challenges a hospitalist faces. It’s as if they’ve lost their finger on the pulse of the everyday issues a hospitalist has to go through.

Other hospitalists get out of residency after years and years of training, and the reality of the job they’ve been trained to do doesn’t meet their expectations. They’ve never hit the pause button to figure out what it is they want out of their careers – or their lives.

So, they go in search of more money, figuring that if they can’t have job satisfaction at least they’ll cash in. Unfortunately, they soon realize that the vesting schedule of the group they are looking at is x, and the incentive pay is actually y, and they too come back to me. They realize that the benefits at USACS actually made their overall financial picture more secure with us.

Meanwhile, several female hospitalists who I’ve talked to go out in search of a better job but realize that none of the other groups offer the strong parental leave benefit that we do or are as committed to having women in leadership roles. As USACS’ National Senior Director of Quality and Education for Hospitalists, I’m a walking example of that. And regarding that other colleague who texted me from the job interview? A few months after she decided to stay with USACS, she was promoted to an Assistant Hospitalist Medical Director role.

Other times it’s the culture that brings them back to USACS. They miss our sense of teamwork, our collegiality, the sense that we are all in this together. They miss the willingness of our leadership to listen and work together with them to solve problems.

Our model of integrating hospitalists with the emergency medicine providers – placing both groups under one umbrella with the same leadership and making them all owners – may not seem all that important to a new hospitalist. However, they quickly realize how valuable the model is as soon as they try to solve a problem, and they see that instead of a long drawn out process of adversarial groups with different motives, they can come together with fellow colleagues and actually figure out a solution that works for everyone.

Hospitalists are an analytical bunch to be sure. But few of them having just graduated residency have truly figured out what makes them happy, in work or in life. It is tempting, when their work lives run up against the realities of hospitalist medicine, to go in search of greener pastures. But the grass isn’t always greener.

I will continue to give the same three-worded advice that I have given in the past to any hospitalist who is confused: go find yourself. It sounds cliché, but it’s true. And then, when they’ve figured out what they actually need to be happy, they always give me a call.