The impact of home-based call on sleep patterns and wellness in genetics and metabolism physicians compared with subspecialists

With increases in precision medicine initiatives and genetically defined rare diseases, the genetics and metabolism workforce is necessary to provide around-the-clock care for patients. Here, we describe the impact that home-based call has on the geneticist and metabolist workforce. Physicians from 3 populations were self-identified (pediatric subspecialist, geneticist, metabolist) and completed a survey regarding the impact of home-based call service on their sleep and wellness. Estimated sleep while serving on home-based call was reduced from 7.5 to 5.4 hours per night. Safety concerns were noted by geneticists and metabolists for themselves (55%) and their families (28%), similar to other subspecialists. Geneticists and metabolists were more likely than other pediatric subspecialists to be worried about their patient’s safety while on home-based call (48% vs 9%). Themes from open-ended questions regarding the impact of home-call included positive responses, decreased access to wellness activities, sleep exhaustion, impact on life responsibility, and impact on mood. Reported coping mechanisms included work-based initiatives, off-loading personal responsibility, and creating personal accommodations. Institutional-based supports for home-based call were endorsed by only 29% of respondents; thus, interventions at the institutional level would be expected to have a large effect on overall provider wellness. [Display omitted]