Residents and other physicians fighting on the front lines for weeks or months during the worst public health crisis in a lifetime are highly susceptible to psychological stress. A recent presentation at the AMA GME Innovations Summit—"Moving from Post-Traumatic Stress to Post-Traumatic Growth”—offered some insight on how prevalent and far-reaching the mental health effects could be for those physicians.
Data on the topic and a list of potential interventions was presented by Christine Sinsky, MD, the AMA’s vice president of professional satisfaction.
Early in her presentation, Dr. Sinsky offered evidence from multiple international studies—from China and Italy—showing that the front-line health professionals were at significant risk of stress events during the pandemic.
Results from the AMA’s Coping with COVID-19 for Caregivers Survey reflect similar trends.
Key findings from data collected from more than 40,000 respondents across 70-plus organizations included that a majority were afraid of exposure to themselves or their family and more than one-third experienced anxiety or depression due to the COVID-19 pandemic.
“Stresses are inherent in this crisis,” Dr. Sinsky said. “They will naturally lead to stress injury.”
The Coping with COVID-19 for Caregivers Survey is one of two free surveys the AMA is offering to help health care organizations monitor the impact COVID-19. The surveys can be used to track trends in stress levels, identify specific drivers of stress, and develop supportive infrastructures based on these drivers. Organizations that use the surveys will receive free support from the AMA in launching the surveys and access to data through an easy-to-use reporting dashboard.
Learn about seven ways to address physicians’ pandemic stress.
Avoiding chronic stress reaction
Chronic stress reactions, Dr. Sinsky said, are not an inevitability. To combat stresses caused during the fight against COVID-19, Dr. Sinsky cited a framework formed at the outset of the pandemic by Stanford Medicine.
The result of listening sessions with staff, the framework—described in a JAMA Viewpoint, “Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic,” breaks down into five domains.
Hear me: This domain calls on institutions to listen and transparently address staff concerns by sharing what is known at the time. Events such as weekly town halls and Zoom calls offer caregivers a chance to be heard.
Protect me: Work to reduce the risk of health care workers developing infection.
Prepare me: Train staff to provide high quality care to patients, particularly for those facing new areas of responsibility.
Support me: Offer support and acknowledge the human limitations brought on by the critically ill patients and intense work hours required during the pandemic.
In terms of how support can be created during a pandemic, Dr. Sinsky pointed to feedback she had been given by residency program directors about keeping resident teams together for cohesion. She also cited the website , which offers physicians a buddy to support them during a crisis.
Care for me: Offer holistic support for the physicians and their families. This can manifest itself in helping caregivers meet their obligations outside the clinical setting. Dr. Sinsky cited one organization that paid up to $100 per day for any employee who needed help with child care during the first three months of the pandemic.
Responding to the needs of physicians during crisis and offering tangible sources of support gives physicians an opportunity to find fulfillment down the road, Dr. Sinsky said.
“We all have this collective opportunity to create resilient organizations where the individuals within it are less likely to experience stress and go down a path toward dysfunctional chronic stress reactions, and in a few cases tragic outcomes,” Dr. Sinsky said. “And more people have the opportunity to step up to the need of the crisis, experience some of the stress but then go on to be stronger for it—to go on to be able to reflect on it, draw meaning from it, and have greater professional fulfillment and thrive in the long run.”