Physicians and other health professionals on the front lines face a fear of COVID-19 and are concerned about carrying the novel coronavirus home to loved ones. Some doctors, working amid shortages of protective gear, have chosen to limit-in person contact even with members of their households, which limits the valuable source of solace and support that loved ones provide.
While slow but essential progress has been made in the last few years to fight physician burnout broadly speaking, the COVID-19 pandemic has added layers of stress and financial anxiety to doctors’ working lives.
“We're seeing unprecedented challenges ... due to the COVID-19 pandemic, raising heightened concerns and awareness of physician burnout and well-being,” Marie Brown, MD, the AMA’s director of practice redesign, said in a webinar hosted by the AMA Organized Medical Staff Section. “We have chosen a calling that invites people who are worried and suffering to allow us to help, which is quite an honor.
“This work should give us joy, meaning and purpose, not burnout to rule the day, but sadly it does not,” said Dr. Brown, an internist and professor of internal medicine at Rush University Medical Center in Chicago. “We know that prior to COVID-19, almost 50% of our colleagues were experiencing some level of burnout.”
In the webinar, Dr. Brown shared ways to address the added stress on physicians and other health professionals.
Measure caregiver stress
“We were able to pivot and provide a COVID-19 Caring for the Caregivers survey to monitor professional well-being during this critical time,” said Dr. Brown, adding that it is important for health systems to deploy a survey to measure stress because it shows “that you care and are committed to supporting your workforce.”
“Knowing that you’re paying attention to their stress level is impactful,” she said. “It allows you to track the trends and see where you might apply some of your limited resources and identify the specific intervention that your workforce may need”
The AMA is offering two free surveys to help health care organizations monitor the impact of the pandemic: Coping with COVID-19 for Caregivers and the Pulse survey. The Coping with COVID-19 survey includes 20 questions and is used to measure baseline while the PULSE survey is a two-question follow-up to continue to assess change over time. As of July 2020, nearly 30,000 people from over 50 health care organizations have responded to the survey.
How to support the workforce
The AMA has “a lot of resources to support the workforce during COVID-19,” said Dr. Brown, adding that the strategies include workload redistribution, institutional policies, access to personal protective equipment, meeting basic needs, building a resilient organization, social support, and emotional and mental well-being.
Here are seven solutions that health systems have implemented during the pandemic and beyond.
- Jo Shapiro, MD, an associate professor of otolaryngology-head and neck surgery at Harvard Medical School, developed and shared her peer-to-peer support program for physicians, said Dr. Brown. A peer-support program can positively affect and shape the culture of medicine during the COVID-19 pandemic and moving forward.
- “Implementing team-based care is clearly something that we want to revisit because the silver lining that we've seen happen during COVID-19 is teams coalescing and crossing those barriers out of necessity,” said Dr. Brown. “We can keep that kind of team-based care going.”
- From basic needs like child care and food to mental health and supportive counseling, Mount Sinai Health System in New York City maintains an up-to-date list of resources for all health professionals and employees, keeping their well-being at the center of focus.
- “In New York, they couldn’t have physicians and nurses coming through the subway system into the hospital, so they paid for private ways to get to the hospital,” said Dr. Brown, adding that they also paid “attention to family care, daycare and eldercare.”
- A unique resource at Henry Ford Health System is their well-being resources for leadership across the organization to help not only themselves but their teams too.
- “Training for leaders at Henry Ford was noted to be critical,” said Dr. Brown. “They wanted to be sure the leaders had talking points, so that there was a consistent message.”
- “At Johns Hopkins, they developed moral resilience rounds once a week for an hour beginning with some music and then dialogue on challenging experiences —just to share with colleagues what they were experiencing, not necessarily to fix the problem,” said Dr. Brown.
- “We know that physicians are less likely, for a variety of reasons, to seek out formal mental health programs. So we need to be there and almost push them rather than wait for the physician to ask for help.” A reactive approach, she said, can have “tragic consequences.”
- The University of Washington School of Medicine “developed online town hall meetings in response to COVID-19,” said Dr. Brown, adding that “synthesizing the overwhelming information, transparency and communication are vital.”
- AMA member Heather Farley, MD, chief wellness officer at ChristianaCare in Wilmington, Delaware, “was updating their COVID-19 dashboard every six hours,” said Dr. Brown. Additionally, they also “provided hotel accommodations for staff who were either exposed or fearful of bringing COVID-19 home to a high-risk person in the house.”
“We must turn short-term stress into growth and thriving, not PTSD [post-traumatic stress disorder],” said Dr. Brown. “Now more than ever, it is important for health systems and health system leadership to implement and ensure infrastructure and resources are available to support clinicians during this time.”
The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic. The AMA also provides resources for health care leaders on caring for our caregivers during COVID-19.