Those who practice emergency medicine work hard, sacrifice sleep, and masterfully multi-task to care for patients who often do not, or cannot, thank us. Some clinicians concurrently serve as educators, administrators, and staff supporters, going above and beyond to attempt to better the lives of others. Members of our profession rarely get a break from the constant assault to our psyche and morale from our work environment, whether it be from patient care, social factors, or administrative burdens. It is true that we may not receive much thanks from our patients. However, we could probably do a better job of recognizing each other’s hard work and accomplishments. We often take it for granted as if what we’re doing is just “part of the job.” Some emergency departments probably do practice some form of recognition and “thanks” for their staff, but are we doing enough as a profession to recognize and appreciate the hard, important, sacrificial work of our peers?

Years ago, a friend said to me, “Compliments are free, so why not give them?” It was the response he gave me after I seemed surprised when he paid me a compliment. This simple sentiment seemed mind-blowing at the time and has stuck with me ever since. This is such a simple concept, and its lack of implementation both inside and outside our workplaces is unfortunate.

Validation can be a simple but powerful tool in the fight against burnout. In 2017, the Institute for Healthcare Improvement (IHI) released a white paper that identified these nine critical components of a system for ensuring a joyful, engaged workforce:

• Rewards and recognition
• Camaraderie and teamwork
• Meaning and purpose
• Choice and autonomy
• Physical and psychological safety
• Wellness and resilience
• Real-time measurement
• Daily improvement (building opportunities to learn from mistakes and make science-based improvements into daily practice)

While all these components together are needed to make a joyful and engaged workplace, creating programs that encourage rewards, recognition, and validation is a simple step every department should take. A statement of validation can be extremely gratifying for an employee and help reestablish passion for emergency medicine.

In 2018, the ACEP Wellbeing Committee launched the Gratification in Emergency Medicine (GEM) Project under the leadership of Diann Krywko, MD, in an effort to tackle the first facet of the IHI report, rewards and recognition. The goal was to ask a critical question: “What matters to us?” A voluntary and confidential study was conducted in spring 2018 via an email survey to members of the ACEP Wellness Section (n=760) and Wellbeing Subcommittee (n=45).

Although the survey response rate was low at 6.6 percent, it was reassuring to know that 95 percent of those responding were proud to be an emergency physician. When asked what matters most, 45 percent reported human interactions and 23 percent personal accomplishments. Almost 90 percent reported that external recognition matters, and 43 percent preferred words of affirmation.

Respondents ranked being recognized for clinical service as most important at 35 percent, but only 8 percent felt they were recognized for it, with written recognition being the most common method of recognition. This begs the questions, “Why don’t we give a compliment when someone’s clinical service deserves commendation?” “Why do we hesitate to give thanks to a clinician who goes above and beyond to help their colleagues?” “Why don’t we recognize a nurse who provides extraordinary comfort to an ailing patient?”

This data gives us a starting point. External reward is important and valued. EM leaders need to understand that their teams do not feel they are being heard. Emergency physicians like what they do, but they want to be appreciated. Interventions to create a community of appreciation and camaraderie include:

• Team recognition awards to motivate staff members and remind them that they are indeed appreciated
• Team debriefs after critical patients to serve as a check-in process, providing a moment to give thanks

Incorporating a daily huddle that includes a moment for recognition is a wonderful and low stress way of starting the recognition process. Taking a few minutes at the beginning or end of a shift to recognize those who have gone above and beyond can serve as an opportunity to formally recognize our team members.

We will kick off this spirit of thanks virtually. To the emergency physicians reading this, thank you for performing this often-thankless job so willingly. Thank you for emotionally absorbing the medical tragedies of humanity and taking on this trauma day in and day out. We humbly request you pay it forward.

Dr. Shah is assistant professor and associate chief medical informatics officer at Rush University Medical Center in Chicago. Dr. Nordenholz is associate professor of emergency medicine at the University of Colorado School of Medicine in Aurora.