Tiffani Bell, MD, is a child and adolescent psychiatrist in Winston-Salem, N.C. She also is the mother of three children under the age of 4, with another child on the way. Balancing work and home life was already a challenge for her, and the COVID-19 pandemic has only exacerbated that.

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“We're all juggling a lot of balls, some of them you can afford to drop, and there's some that we just can't,” Dr. Bell said. “Count the costs and figure out what you can let go for a little while.”

One thing to hold on to is time committed to your own well-being, she said. Whether it is a five-minute meditation, a brief yoga exercise or simply a walk, female physicians—as well as the general public—must pay attention to their own mental health.

“We're so busy that we put [mental health] to the back burner and just keep pushing through,” she said. “And I think the pandemic has really made it quite obvious that if you don't put yourself on the list of priorities, you won't have time. So, make yourself important.”

Dr. Bell shared that advice as part of a conversation on the mental health impact of COVID-19 on female physicians and patients. The discussion was part of the AMA’s daily COVID-19 update, and also featured Tracey Henry, MD, assistant health director in the Primary Care Center at the Grady Memorial Hospital in Atlanta, and Theresa Rohr-Kirchgraber, MD, professor of clinical medicine and pediatrics at the IU National Center of Excellence in Women's Health in Indianapolis.

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In the early months of the pandemic, Dr. Henry struggled with her dual roles as a physician and caregiver and the anxiety about potentially infecting her family. She developed her own decontamination routine to relieve that concern, but she still had other challenges to navigate, from worrying about not having enough personal protective equipment (PPE) to witnessing the impact the novel coronavirus was having on female colleagues throughout the health care industry.

“Women, in general, are often tasked with many of the service sort of roles in academics and in our institutions,” she said. “Those keep us really, really busy, but not productive in terms of benchmarks that we need for academic promotion. We are in position to take responsibilities for others, but not ourselves.”

To counteract that, Dr. Henry encouraged female physicians to take control—as best they can—of their own professional path and agenda. She also recommended that women practice saying “no” to certain tasks so that they are not filling their schedule with projects that prevent them from being, or at least feeling productive. 

“The same way you schedule time for everything else in your busy schedule, schedule time for yourself,” she said. “Know your limits and set boundaries.”

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Dr. Rohr-Kirchgraber said there is another concern female physicians and health care workers are currently dealing with, and that has to do with PPE. Women make up more than 75% of all health care workers, and yet based on a small study Dr. Rohr-Kirchgraber did at her local health care system, women were not getting as much protection from N95 masks as men. To fix this, she and her colleagues are investigating ways to have the N95 masks redesigned in order to provide more comfort and flexibility for different-sized faces. 

This was a problem Dr. Henry experienced as well.

“We certainly had an issue with having enough N95 masks of the smaller version,” Dr. Henry said. “And even those did not fit on many of our faces. We had to make special amendments to them to make sure that they fit. I think that’s part of the structural issue of making sure that our personal protective equipment works also for women.”

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