{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:20:00Z","timestamp":1747196400483,"version":"3.40.5"},"reference-count":17,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T00:00:00Z","timestamp":1690934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"Background<\/jats:title>Morale and burnout were concerns for hospitalists prior to the COVID-19 pandemic; these concerns were amplified as COVID-19 spread and hospitals experienced unprecedented stress. In contrast to prior literature, our study assesses both satisfaction and the importance of various factors. This study examines morale of hospitalists early in the COVID-19 pandemic in two settings: conventional hospitals and a COVID-19 Alternate Care site (ACS) in the same geographic region in Maryland. Multiple studies published early in the pandemic show low morale in COVID-19 hospitals.<\/jats:p><\/jats:sec>Methods<\/jats:title>In a cross-sectional survey study, we analyze data from the Hospitalist Morale Index (HMI) administered between September 2020 and March 2021 to determine the pandemic\u2019s impact on hospitalist morale.<\/jats:p><\/jats:sec>Results<\/jats:title>Surprisingly, our study found morale in the ACS was better than morale at the conventional hospitals. ACS hospitalists and conventional hospitalists were demographically similar. Our results show that a significantly higher proportion of conventional hospitalists reported burnout compared to the ACS hospitalists. General quality of life was rated significantly higher in the ACS group than the conventional group. Significantly more ACS hospitalists were invested in making their group outstanding. Five main HMI domains were examined with questions on a 5-point rating scale: Clinical Factors, Workload, Material Rewards, Leadership, and Appreciation\/Acknowledgement. ACS hospitalists rated most measures higher than conventional hospitalists; largest differences were observed in Clinical Factors and Appreciation\/Acknowledgement domains. Narrative comments from ACS hospitalists revealed strong identification with the mission of the ACS and pride in contributing during a crisis. One key difference between the two groups explains these findings: provider autonomy. The ACS staff chose the position and the assignment, while conventional hospitalists caring for COVID-19 patients could not readily opt out of this work.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Our data suggest that autonomy in assignments with risk has implications for morale and burnout.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0288981","type":"journal-article","created":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T17:37:05Z","timestamp":1690997825000},"page":"e0288981","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of hospitalist morale in a COVID-19 alternate care site (ACS) to hospitalist morale in conventional hospitals in Maryland"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2703-3243","authenticated-orcid":true,"given":"Catherine","family":"Washburn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinda E.","family":"Kantsiper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2567-2121","authenticated-orcid":true,"given":"Rogette","family":"Esteve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ishaan","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulzeb","family":"Memon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry J.","family":"Michtalik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Bayview Educational and Academic Research (BEAR) Core Consortium","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"issue":"12","key":"pone.0288981.ref001","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/j.mayocp.2015.08.023","article-title":"Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014","volume":"90","author":"TD Shanafelt","year":"2015","journal-title":"Mayo Clin Proc"},{"key":"pone.0288981.ref002","doi-asserted-by":"crossref","unstructured":"French G, Hulse M, Nguyen D, Sobotka K, Webster K, Corman J, et al. (Morbidity and Mortality Weekly Report). Impact of hospital strain on excess deaths during the COVID-19 pandemic-United States, July 2020-July 2021 [Internet]. Atlanta [GA]: Centers for Disease Control and Prevention: Nov 2021 [cited Jan 2022].1686 p. Report.: 70. Contract.: 46. https:\/\/www.cdc.gov\/mmwr\/volumes\/70\/wr\/mm7046a5.htm","DOI":"10.15585\/mmwr.mm7046a5"},{"key":"pone.0288981.ref003","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s11606-020-06529-z","article-title":"Impact of the early phase of the COVID-19 pandemic on US healthcare workers: results from the HERO registry","volume":"36","author":"the members of the HERO Registry Research Group","year":"2021","journal-title":"J Gen Intern Med"},{"key":"pone.0288981.ref004","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1007\/s11606-022-07487-4","article-title":"Patterns of potential moral injury in post-9\/11 combat veterans and COVID-19 healthcare workers","volume":"37","author":"VISN 6 MIRECC Workgroup & HERO Research Program","year":"2022","journal-title":"J Gen Intern Med"},{"issue":"21","key":"pone.0288981.ref005","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1001\/jama.2020.5893","article-title":"Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic","volume":"323","author":"T Shanafelt","year":"2020","journal-title":"JAMA"},{"key":"pone.0288981.ref006","first-page":"e102","article-title":"Recruitment, readiness, and retention of providers at a field hospital during the pandemic","volume":"17","author":"members of CONQUER COVID Consortium","year":"2022","journal-title":"Disaster Med Public Health Prep"},{"issue":"4","key":"pone.0288981.ref007","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1136\/bmjmilitary-2020-001642","article-title":"Coping with COVID-19 in United Nations peacekeeping field hospitals: increased workload and mental stress for military healthcare providers","volume":"167","author":"Y Zhang","year":"2021","journal-title":"BMJ Mil Health"},{"issue":"9S","key":"pone.0288981.ref008","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1016\/j.mayocp.2020.05.038","article-title":"Precautions, utilization of personal protective 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