Published On May 20, 2021
It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic.
The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndrome characterized by depersonalization, emotional exhaustion and a low sense of personal accomplishment. It’s extremely common, afflicting about one in two physicians in the United States. Burnout can compromise physicians’ altruism, professionalism and the quality and safety of the care they provide. For individual physicians, burnout has been associated with cardiovascular disease, alcohol use, depression, suicide and a shorter life expectancy.
Prior to the pandemic, our efforts through the Massachusetts General Physicians Organization (MGPO) to mitigate burnout focused on three main areas—creating a culture of wellness, encouraging personal resilience and improving practice efficiency. In particular, our work attempted to home in on the systems issues that drive burnout, rather than focusing solely on the impact on individual physicians.
But COVID-19 changed everything. Not only were we suddenly facing incredible systemic challenges, but we also had to find ways to support a population of clinicians who were being stretched in ways they had never encountered before. Suddenly everyone was working long hours, often in unfamiliar clinical areas, on a disease no one had ever managed. Clinicians had to juggle work and home life more than ever, while also contending with a loss of personal connection on the job and the fear of becoming infected or transmitting COVID-19 to their families.
The MGPO’s efforts centered on transparent communication, providing a leadership presence in clinical units, ensuring adequate supplies of personal protective equipment and facilitating active listening to identify needs. In practice, that meant several daily, organization-wide communications with the latest information about the hospital’s evolving COVID-19 response. To support personal resilience, we helped make sure clinicians’ basic needs—for food, shelter, safety, child care, transportation—were met while also providing up-to-date education on the virus, training and guidance on using PPE, instruction on how to protect yourself and your family, and strategies for connecting to others. We offered space for reflection and processing as well as mindfulness and stress-reduction programs and expanded access to mental health services. Virtual care platforms helped enhance practice efficiencies as we also supported new COVID-related workflows and clinician training to provide care outside usual practice spaces.
The impact of the COVID-19 pandemic on clinician burnout will continue to be felt for years to come, and we’ll have to do even more to understand and meet needs that existed pre-pandemic, have arisen because of it and are yet be identified. But we have learned how important it is to focus on burnout not only among physicians but also to include clinicians of all kinds. The challenges have been undeniable, and defeating burnout won’t come easily. Yet the innovations we have witnessed—efforts that transcend ordinary divisions among generations and kinds of providers—offer hope for the future.
Marcela Del Carmen // interim president of the Massachusetts General Physicians Organization. Kerri Palamara McGrath // leads the Center for Physician Well-Being for the Department of Medicine at MGH.
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