Hiking hospitalists
A hiking competition brought hospitalists together outside of work.
Background
Hospitalist John Botkin, MD, ACP Member, understands the problem of physician burnout, having gone through it himself in 2018. That experience led him to become a “people pillar” for his hospitalist group, working to improve physician connection, retention, and experience. But just as he started that role, the pandemic came along. “We couldn't meet face-to-face. We were all very clinically busy and drowning in the work that we were doing,” he said.
Around the same time, he came across an ACP Internist article about a residency program's hiking group and the concept clicked. “As I was recovering from burnout, I had found getting out in nature and spending time in physical activity helpful,” he said. “We'd been struggling to figure out how to connect with our colleagues, especially in the midst of recovery from COVID and still having some restrictions on being physically in the same place, and adding an outdoor activity was a lightbulb moment for me.”
How it works
To get his colleagues moving around outside together, Dr. Botkin started a Facebook group called “The Hiking Hospitalists.” He also created a point system to incentivize participation.
“If you're walking around your neighborhood, that gives you a point for an urban hike. A nature hike where you're actually in the wilderness gives you two points. And then you get an additional point if you hike with another hospitalist and another additional point if you hike with more than one hospitalist,” he explained.
The point collection ran from May 1 to Aug. 31, 2022, after which participants gathered for an awards ceremony, which also included some hiking, of course. “I'm a woodworker as a hobby, so I made cutting boards and posters and I gave those out as prizes for the top three performers,” Dr. Botkin said. Group members also have T-shirts and mugs, which they paid for, keeping the cost of this intervention to nearly zero, he noted.
Results
Dr. Botkin and colleagues presented data on the hiking club's first year as an abstract at the Society of Hospital Medicine's CONVERGE. They found that half of the 120 hospitalists who were invited joined the Facebook group and 29 of them participated in hikes. The participants reported a total of 117 hikes, 25 of which were taken with at least one other team member.
A number of hospitalists have joined the Facebook group and not gone hiking, Dr. Botkin noted. “Even for those people, when I talk to them, they like it because they get to know their colleagues better and they get to see us being humans outside of the hospital. It builds that camaraderie and that partnership,” he said.
Their abstract reported many positive comments from participants, such as “Although I have worked with some of my peers for years, this platform offered the opportunity to connect with them outside of work” and “This was so much fun! Can we do it again next year?” Some participants didn't even want to wait for hiking weather, posting in the winter to ask if anyone else owned snowshoes, Dr. Botkin said.
Next steps
For the 2023 summer hiking season, the project has grown in both size and concept. “We've actually expanded it to our whole service line, so it includes our suburban hospitals. As of this morning, I think 89 people are in our Facebook group,” Dr. Botkin said in early May.
He also hopes to increase in-person camaraderie in the group. “This season, we're trying to start some sanctioned hikes … ‘This is the date and we're going to go on a hike and everybody who can come, please come,’ so that we can have more time when we are together.”
Challenges
Although Dr. Botkin has tried to make the program inclusive of those who aren't on Facebook, it has been challenging to involve them. “I have struggled to find another platform that is as functional as Facebook groups are for this,” he said. “We use [Microsoft] Teams at our hospital and I've created a Teams page so that people who aren't on social media can give me their data. I've even told people to write it on a napkin and then just take a picture of it and send it to me. But in general, those who weren't engaged in the Facebook group have not been engaged in the hiking.”
He's continuing to work on that technical issue, he said.
Lessons learned
Hiking hospitalists from other institutions are welcome to join (the Facebook group is public), but this group's existence also proves that it's not hard to start it on your own, according to Dr. Botkin. “It doesn't take a big investment from your institution to make change. It doesn't take a wellness committee to improve the well-being of your team. It really just takes a little bit of elbow grease and some creativity, and you can put together a program where people can get together,” he said.
Words of wisdom
Hiking will not be the solution for everyone, but finding any recreational activity that brings hospitalists together is a big help in recovering from the challenges of the pandemic, Dr. Botkin said.
“There are people who started at my institution during COVID, worked here for two years, left and did a fellowship, and I'm sorry to say I never even met them,” he said. “That was heartbreaking for me. … I think having areas like this where we can find people who have an interest and connect with them outside of work not only gives them a popoff valve for the stress they're under but it allows them to have a friend at work, which helps you thrive in your job.”
