Since the pandemic began, focus has shifted to accommodate the unique needs of physicians and health professionals experiencing heightened stress. By understanding the top concerns contributing to increased stress right now, health systems and organizations can adopt changes to meet those evolving wellness needs.
During a recent episode of the AMA COVID-19 Video Update, well-being experts from three health systems shared how they are supporting physician wellness during the COVID-19 pandemic. They were:
- Nigel Girgrah, MD, PhD, chief wellness officer at Ochsner Health, an AMA Health System Program Partner.
- Amy Locke, MD, co-director of the Resiliency Center at the University of Utah Health in Salt Lake City.
- Bryant Adibe, MD, system vice president and chief wellness officer at Rush University System for Health in Chicago.
Here are factors contributing to physician stress during the COVID-19 pandemic.
“Back in March, New Orleans was a real hotspot with COVID. Then, it was perceived as an acute threat, like a hurricane, and we're pretty good at managing acute threats,” said Dr. Girgrah. “People were worried about things like vents, PPE, having enough critical care staff, day care for their children.”
“One weekend in March, in 72 hours, we put together—with collaboration with other services—day care for all our employees that needed child day care,” he said. “Those things were just absolutely essential.”
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“It's been a busy summer here in Chicago, and a busy year,” said Dr. Adibe. “Here at Rush, at least, we were really impacted pretty heavy, pretty early on.”
“A statistic that puts it in context is at one point, at the max of the surge, one out of every four, so 25% of all critically ill COVID-19 patients in the entire state, were being seen here at Rush,” he said. “We were obviously kind of leading the charge, relative to that early push.
“That comes with a cost, long-term. And so, there's certainly that fatigue,” said Dr. Adibe. “The other piece that we're certainly seeing is that anticipatory anxiety—as we head into this fall flu season—of a potential second wave, and we're certainly beginning to prepare for that.”
Learn about Rush’s five wellness task force tactics designed to prioritize physician health.
Now “that surge capacity of adrenaline has dissipated a little bit, and there's a bit of crisis fatigue now,” said Dr. Girgah. “We have this situation where it's both business as unusual, and business as usual. …That's a little hard for us to grasp.”
“We're seeing the just extreme fatigue of month after month of thinking about how to do things slightly differently, combined with worries about our families, and quite a lot of stress around politics and racial violence,” said Dr. Locke. “All of those things combining are just creating a really tremendous level of stress.”
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When COVID-19 hit, two things became clear at Ochsner: They needed to broaden their scope and move down the Maslow’s Hierarchy of Needs.
The focus transitioned to “developing a sense of self-actualization in the workplace—a sense of belonging,” said Dr. Girgrah. “We have to really think about physiological safety in the workplace.”
“People can't do a good job if they're worried about their own safety in the workplace,” he said. It’s about “whether their compensation is going to be safe,” and “whether their colleagues are going to be furloughed.”
“In the spring with COVID really looming, it was an opportunity to pull together a COVID resiliency work group,” said Dr. Locke. This allowed them “to really think about how to support people.”
It was not only “about the day-to-day of being a physician in terms of self-actualization, but also, really tangibly, how are we doing with personal protective equipment?” she said. “How are we going to cover for each other when people are not available?”
“If you look at our numbers of providing either one-on-one or group support, we've more than doubled usage in the last six months,” said Dr. Locke. “So just really being able to have conversations and get out the word about how to support teams and each other.”
The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.
Additionally, the AMA is offering two free surveys to help health care organizations monitor the impact COVID-19 has on their workforce during this pandemic.