COVID-19: Managing Physician Burnout Today and Tomorrow

Physicians are working in unprecedented conditions as they try to support their communities amid current challenges. We hear stories of physicians sleeping in hospitals or vehicles after long shifts and going weeks without seeing their families. We see physicians as leaders stepping up to be the first to examine, test and treat suspected COVID-19 patients, inspiring their team members to have the courage to do the same. Furthermore, as many physicians are exposed to COVID-19 patients on a regular basis, some have become ill.

While physician burnout isn’t new, today’s pandemic is taking a significant toll on physicians’ mental, emotional and physical well-being. Healthcare organizations must recognize the need for effective strategies to reduce and manage physician burnout today while, at the same time, helping to support and prepare physicians for the eventual recovery phase and the future.

Physicians are under pressure to perform at a very high level under the extraordinary circumstances of COVID-19. Helping them manage burnout today means understanding and addressing both the organizational and personal factors weighing on physicians in these uncertain times. These factors will differ by organization, which is why physician and administrative leaders must be more in tune to the needs of their front-line physicians than ever before.

Operational Factors

• Ensure physicians have the resources they need. Physicians must have the supplies and teams they need to manage changes, such as the increased need for personal protective equipment (PPE). Though shortages of PPE are hard to control in the current environment, healthcare organizations should consider letting physicians wear their own PPE when supplies are low. Additionally, healthcare organizations can provide greater ease of practice by ensuring administrative support is set up to remotely manage patient access and intake, follow-up appointments, and testing, as well as providing adequate technical support for the increase in telehealth and virtual services.
• Practice regular, concise and transparent communication. For the betterment of all clinicians, leadership must be visible, transparent and consistent in communicating their operational and clinical expectations. In addition to saving time in decision making and increasing adherence to process changes, clear direction from above makes physicians feel supported. Leaders can show physicians that they are not in this alone by regularly rounding on physicians and having daily leadership safety huddles.

Personal Factors

• Understand the emotional toll of the situation. Recent research shows that physicians are suffering from eight distinct sources of anxiety amid the pandemic: decreased access to personal protective equipment; the fear of exposing their families and coworkers to the virus; not knowing if the organization will take care of them if they get sick; needing more child care to compensate for working longer hours; not being able to acquire basic needs such as food, hydration, transportation and lodging; being able to perform if they are transferred to a new functional area; and a lack of information from the organization. To support physicians during this tumultuous time, check in with physicians regularly to understand the unique personal factors impacting their emotional health. Ask meaningful questions such as, “Is there something you need that you’re not getting?” and “What is weighing on you most today? How can I help?”
• Strongly encourage physicians to take their own mental and physical health seriously. Because physicians are accustomed to working long hours and understand the urgency of the moment, they may be reticent to take breaks. They may forget to drink water or eat. They may feel guilty for wanting to go home and spend time with their families, so they forgo critical personal connection. We suggest intentionally initiating conversations with physicians to help them recognize whether they’ve been neglecting their own needs while caring for others. Ask them what they’ve done lately for their own wellness; if they can’t answer that question, remind them that their needs matter, that they cannot be at their best if they don’t take care of themselves and that the organization supports them in accomplishing this.
• Determine what the organization can do to make physicians’ lives easier today. Leaders are familiar with creating ease of practice, but what about ease of life? The less physicians have to worry about their lives outside the hospital, the more they can focus on their role within the hospital. For example, CommonSpirit Health realized its clinicians didn’t have time to shop for groceries, so leadership transformed the cafeteria into a grocery store. We recommend asking physicians what your organization can do to make life easier for them today. Little things that demonstrate appreciation can go a long way toward easing burnout.

The pandemic’s effects on the healthcare industry are not static. As the situation changes, so too will physicians’ needs. Healthcare organizations must have a plan in place for how they will transition from the current state to one of recovery and reinvention. Even if volumes allow, extended physician leaves or vacations are not long-term fixes to burnout. Instead, we must fundamentally change personal behaviors and organizational infrastructure to align with a positive working environment. Here are some ways to manage burnout in the future:

• Rethink physician compensation plans.The pandemic may have alerted physicians to services and special considerations that help to make their jobs and lives easier such as child care, flexible hours and mental health resources. Consider augmenting compensation plans to account for benefits that physicians might be drawn to that go beyond traditional financial compensation models.
• Set realistic productivity targets. Review your productivity models, keeping the impact of the pandemic in mind. What is and isn’t urgent? What is and isn’t possible under the current circumstances? How is volume expected to change in a week, a month or a quarter? Gather what you know about your services and your service area and create a productivity model rooted in fairness and reality.
• Abandon the idea of “normal.” The message used to move forward from the crisis should not focus on returning to the past. By making flexibility and innovation normal, physicians and their teams can appreciate that their collective experience is valuable in making and creating a better future.
• Foster physician engagement. Create opportunities for physicians to interact with each other and staff, focusing on connection, rebuilding relationships and enjoying their time at work. Depending on future conditions regarding COVID-19, virtual happy hours or catered lunches with no agenda provide a time for everyone to relax and communicate outside the context of the fast-paced COVID-19 environment.

The conditions physicians are facing in the battle against COVID-19 are amplifying existing sources of burnout and creating new stressors. To create a healthy physician workforce of the future, healthcare organizations must find ways to help physicians manage and reduce the effects of burnout today while putting in place the infrastructure to help them recover and build a better tomorrow.