Physician Wellness Beyond the Pandemic

Physician burnout has been a public health crisis long before COVID-19. Now, we are seeing the pandemic exacerbating this issue, resulting in an epidemic of burnout and declining professional fulfillment. According to The Physicians Foundation (2020), 58% of physicians have feelings of burnout and 50% have experienced inappropriate anger, tearfulness, or anxiety as a result of the pandemic’s effects.

The pandemic has also further highlighted the unique challenges facing women physicians and physicians of color.

Women Physicians

Burnout is documented to be higher in women physicians with several contributing factors that are aggravated by gender inequities, including having children at home, gender bias, and real or perceived lack of fairness in promotion and compensation.¹ Physician mothers experience unique stressors and have been found to be more dissatisfied with work-life balance compared to their male counterparts. These women are also juggling the daily responsibilities of being both a physician and a mother, taking on most of the household and familial roles, including childcare.² With higher workloads at home and at work, women physicians are at risk for increased burnout.

Physicians of Color

The weight of the COVID-19 pandemic has resulted in deteriorating mental health, even suicide, among physicians. Physicians of color, however, are carrying a second weight: racial disparities in health care. Battling a disease that has disproportionately harmed their community while dealing with entrenched racism and discrimination creates a heavy burden for physicians of color.⁴ Unless these types of issues are addressed, researchers warn, the ranks of Black physicians– already minuscule at just 5% of the profession and 7% of all medical school students– could shrink even further.⁴

As emerging physician leaders, chief residents are particularly well-positioned to lead a paradigm shift by encouraging equity, compassion, and self-care among themselves and their colleagues. As a result, CMA’s Terence Bostic, Ph.D. and Savannah Price, M.A. had the opportunity to work with the chief residents of one of the best U.S. hospitals to mitigate the deleterious effects of stress and the COVID-19 pandemic. Our main goals of this leadership development session were to enable the chief residents to process, recover, and learn from their experiences during the COVID-19 pandemic using Critical Incident Stress Debriefing (CISD) and the Physician Wellness Model (Bohman et al., 2017).

Before focusing on lessons learned and how emerging physician leaders can change the systems around them, we first found it important for the participants to process the impact of the pandemic. To accomplish this, we implemented a supportive, crisis-focused process similar to CISD (i.e., “psychological first aid”) where we allowed them to rumble with the burnout they experienced and its aftermath, as well as empowering them by emphasizing the strengths they leveraged to get through those difficult times.

According to Bohman et al. (2017), the many drivers of both physician burnout and high professional fulfillment fall into the three domains of the Physician Wellness Model: efficiency of practice, a culture of wellness, and personal resilience. In order to recover and learn from the pandemic as emerging physician leaders, it was crucial for the chief residents to explore how they can impact all three domains and change the healthcare system while keeping self-care at the forefront.

Physicians are experiencing a historical shift in the way they practice and deliver care to patients. This presented an opportunity for CMA to empower emerging physician leaders in one of the best U.S. hospitals to rebuild a system with health care workers and patients in mind.

References

1. Collateral Damage: How COVID-19 Is Adversely Impacting Women Physicians
2. Survey reveals impact of COVID-19 pandemic on physician mothers
3. AMA’s Prioritizing Equity video series: The Experience of Physicians of Color and COVID-19
4. The ‘Black Tax’ and COVID-19: Amid Pandemic, Black Doctors Carry Double Load
5. The Physicians Foundation 2020 Physician Survey
6. Bohman et al. (2017). Physician well-being: the reciprocity of practice efficiency, culture of wellness, and personal resilience. NEJM Catalyst, 3(4).