The Deep Impact of COVID-19 on Physicians
The USA is heading up the curve of the "third wave" of COVID-19. While much of the current impact is on more rural areas, we have become a bit fatigued by the constant reminders of the disease, and a significant portion of the population denying its significance.
Still clinicians are caring for patients in intense high-risk environments, despite many those not on the front lines not understanding the current and future impact of this pandemic on our clinical workforce. This is driving burnout and its harmful sequelae to levels further above what we have experienced to date.
Last week KevinMD featured a blog post by Kaci McCleary, a neurology resident at the University of Minnesota. Dr. McCleary does an excellent job of identifying the myriad of ways that COVID-19 has heightened the drivers of burnout, providing an up-close and personal view into the challenges our clinicians face, particularly those who are in training.
Dr. McCleary's review of the drivers of burnout includes:
Work overload - the increased number and acuity of patients while the number of available physicians has decreased due to quarantines following positive tests
Lack of control - clinical care is suffering with delayed tests and surgeries, restrictions on direct patient care, and unexpected requests to cover additional shifts due to colleagues out sick, impacting people's lives in multiple ways
Insufficient reward - early on the public showed great appreciation to clinicians, but as time goes on the public recognition is waning. Some systems have done well with internal recognition programs, others have not.
Breakdown of community - social distancing and decreased available time leave physicians unable to come together as they used to for mutual support at a time when they need it the most. Camaraderie and collegiality are just not the same over Zoom.
Absence of fairness - the lack of adequate PPE, ACGME requirement violations, and the potential risk of malpractice despite doing one's best add to the underlying strain
Conflicting values - whether at the institutional or national level, the lack of commitment to do what physicians view as the right thing for patients and the clinical workforce drive understandable resentment
Healthcare leaders, at the local and national level, must place a high priority on clinician safety and well-being and implement processes to address the drivers of burnout, increasing efforts to identify and support their clinicians experiencing burnout and its multiple sequelae.
Many of the personal impacts of COVID-19 will remain with clinicians for years to come. There is much we can do to reduce these impacts, particularly if we understand the connections between the current situation and the drivers of burnout, and act decisively to improve the conditions in the workplace.
If you would like to learn more about this, you are welcome to reach out to me at firstname.lastname@example.org