Providing clinician support in times of calm and chaos

Before the world was crippled by the spread of COVID-19, physician burnout was already taking an alarming toll on our health care system. Physicians were working more hours, more days, in high-pressure circumstances with excessive charting requirements and administrative burdens, on too little rest with too few healthy stress-relief outlets.

Flash forward to the last four months: unfathomable circumstances of inadequate PPE, short-staffed hospitals, overloaded emergency rooms, and very sick patients with a disease whose diagnosis and treatment changed, at times, on a daily and weekly basis. Tragically, a few physicians took their own life, and the impact took a toll on health care workers across the nation.

We should have seen this coming. Before coronavirus became a household word, I came across a Wall Street Journal story on widespread physician burnout, based on January’s Medscape National Physician Burnout & Suicide Report 2020. About half of physicians in my age range – “Generation X,” between 40 and 54 years of age – reported being burned out. This was true among both younger and older cohorts, with four in ten feeling the same as their Gen X counterparts. Since then, emergency rooms were overwhelmed with exhausted clinicians doing their best to treat patients and protect themselves, often with scarce medical equipment and limited resources.

The problem is not limited to ERs and ICUs. Specialties, including obstetrics, are well-acquainted with marathon office hours and the need to be available evenings, holidays, or in the midst of a public health crisis. In the Medscape survey, 46 percent of OB/GYNs surveyed reported burnout – the 7th highest of the medical specialties surveyed. This percentage is about the same as the previous year (45 percent). So, while several other specialties are on a slight downward trajectory for burnout, OB/GYNs are not.

I’ve had firsthand experience with burnout, which disproportionately manifests in female physicians. Organizations are often ill-prepared, or sometimes unwilling, to address the issue. And I know that when COVID-19’s immediacy passes, burnout will likely be at even higher levels.

Some organizations, including my employer, offer health care workers resources to address physician burnout. The best ones offer these resources not only for periods of chaos, but to help clinicians navigate the complexities associated with the practice of medicine. And the Centers for Disease Control and Prevention (CDC) list of resources to help responders, parents, and patients deal with the stress and anxiety that naturally comes in uncertain times offers tangible tips that are applicable at any time, including during the pandemic.

When I speak with colleagues experiencing burnout, I encourage them to consider changes that don’t involve leaving the medical field, but instead, to change the way they work within the health system. For me, this meant switching from private practice to an OB hospitalist role, where I am now working with a network of hospitals in the labor and delivery unit. The switch gave me significantly more flexibility, more time with my children, and the opportunity for greater life balance, where I have more control over my schedule and generally work an average of five to eight hospital shifts a month. Remarkably, while the Medscape survey found 49 percent of physicians would accept less money in exchange for more free time, I didn’t have to accept a pay cut.

Burnout is a complex and critical workforce problem requiring collaboration between multiple stakeholders for progress. I salute my dedicated peers, who are practicing self-care. The obligations and expectations of physicians are nearly superhuman. Physicians, and indeed, all medical personnel, should feel empowered to help protect their own mental and physical well-being, as well as the patients entrusted to their care — both in times of chaos and in our everyday practice.

Jane van Dis is an obstetrics-gynecology hospitalist.

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