From Hopeless to Hopeful: Helping Physicians Manage Mounting Burdens from the Pandemic

We have come a long way since the days of communities clapping and ringing bells in cities to support health workers on the front lines of COVID-19. Now, we have an array of vaccines and a plan to make all Americans eligible to receive the vaccine starting May 1, according to the Biden administration. Still, as practicing physicians, much of the hope being felt by the general public and our patients is simply not enough to ease the burden of the atrocities we as frontline healthcare workers have experienced in the last year.

As an emergency medicine physician and a family practice clinician, we see two very different types of patients. Nonetheless, the issues we are experiencing ourselves and among our clinician colleagues are remarkably the same. From anxiety and depression to substance abuse and suicidal ideation, the issues facing physicians today — on the tail end (hopefully) of the pandemic — are stark.

Navigating a path to normalcy post-pandemic isn’t something many physicians are able to do on their own. We too need a wealth of support from friends, family, colleagues, and the organizations that employ us. And, well, we need it now.

With data showing that one-in-five COVID-affected health workers is now weighing quitting the practice of medicine and that worry and stress related to COVID-19 has led to adverse health impacts for frontline health workers, healthcare provider organizations are unsure of how best to support physicians while also dealing with the day-to-day demands of patient care.

In order for provider organizations and payers to succeed, they need physicians practicing at the top of their game. More so, patients need physicians who are bringing their whole selves to work each day so that they can acutely focus on their care needs. It is simply not possible to do so when you are reliving the immense professional and personal losses from the last year.

Still, we believe there is a smarter path forward, one that balances the mental health and well-being needs of physicians while also prioritizing patient care and outcomes. In order to help physicians get back to practicing medicine and caring for patients, instead of reliving the horrors of the past year, we recommend that providers, industry, and also patients consider and prioritize the following:

• Treat Physicians Like Humans. While seemingly basic, we each have had encounters with patients and with colleagues where basic human civility was lost. The fastest way to demotivate anyone — including physicians — is to show distrust and disrespect. While we have all been stretched to the extreme emotionally over the last year, nearly all physicians still want and are doing everything they can to care for their patients and for the teams around them. Basic respect and trust can go a long way toward improving the well-being of clinicians today and is a fast, easy, and free fix.
• Create a Culture Where Mental Health is Discussed, Prioritized, and Supported. As physicians, there is no place for mental health issues of your own in the workplace. It is frowned upon, and the repercussions of sharing one’s own mental health challenges can lead to forced leave and no pay. While many large employers have adopted more innovative approaches to employee mental health during the pandemic, the same cannot be said about healthcare providers. It is a disservice to not invest time and resources in building a culture where physician mental health is a top priority. The more we pretend that physicians shouldn’t speak up about mental health, the greater these issues will become. Provider organizations and their payer partners that invest in building transparency and authenticity in discussions regarding mental health, while also providing access to services and support for physician mental health, will be best suited to optimize long-term performance, reduce clinical mistakes, and improve patient outcomes.
• Reduce Unnecessary Administrative Burdens. Mounting administrative burdens were a massive issue before the pandemic. Today, that hasn’t changed. The same issues remain: frustrations with electronic health records, annoyances with incomplete clinical documentation to align with risk-based contracts, and day-to-day paperwork that seems to just pile up despite our greatest efforts. The time for complaints has passed. Addressing unnecessary administrative burdens, such as clinician documentation improvement, isn’t a tough fix. It takes an investment in education, technology, and personnel, but it’s not rocket science by any means. While providers and payers are more focused on the bottom line on the heels of financial losses brought on by the pandemic, it is not fair to continue to place the burden of issues like a lackluster investment in a bargain electronic health record on physicians. Take the time to listen and collaborate with physicians now and these administrative burdens will move from massive, demotivating roadblocks to minor issues in due time.
• Embrace Emerging, More Flexible Ways To Practice Good Medicine. One of the blessings from the pandemic was the broad adoption of new modes of care, including telehealth, that allow patients and physicians to win. Patients get care when they need it from the comfort of their home, and physicians can provide virtual care anytime, anywhere. Virtual care has opened up a host of new opportunities for physicians — allowing them to take a more entrepreneurial approach to medicine — and an approach that allows them to better balance life and work at times. Provider organizations need to embrace these emerging models of virtual and in-home care and allow clinicians to practice in ways that allow them to operate at the top of their license without burning out in traditional models of in-person patient care.

Lastly, please stop incenting physicians with volume over value. It’s not good for us or for the patients we serve, and it’s an antiquated approach as well. As an industry and as physicians, we are due for a massive reset in the year ahead. As provider organizations and payers consider the path forward post-pandemic, it is critical that they prioritize and address the four areas mentioned above. Doing so will improve the practice of medicine for physicians, patients, and the industry at large.

Anthony Healy, M.D., is a physician with AdventHealth Shawnee Mission and Matt Lambert, M.D. is the chief medical officer at Curation Health