THE EXHAUSTED Many of my colleagues were feeling overburdened long before COVID-19 emerged, and the pandemic has only amplified their feelings. According to a Medscape survey last fall, nearly a quarter of physicians in the United States were considering early retirement. Another study earlier this year suggested that, while overall rates of burnout have remained steady during the pandemic, the specialties most affected have changed, with rheumatologists and infectious disease specialists now topping the list. However, with 42% of physicians across all specialities reporting symptoms of burnout, we will still have serious issues to reckon with long after the pandemic subsides.
THE INSPIRED Some of my colleagues have experienced a burst of energy and a renewed sense of calling — feeling more connected, inspired, and motivated than ever before. My genetics colleagues have said they can’t recall a time when the entire scientific community was focused on solving the genome of a single problem at once. On smaller levels, I’ve heard dozens of inspiring stories. One of my favorites is about a colleague who commandeered an old school bus to make a “temperature check and pre-vaccination station on wheels.” Almost all of my peers felt that their hospitals rose to the challenge and pulled together in amazing ways.
THE RELIEVED Quite a few of my colleagues, particularly those in elective procedure-based specialties, were initially worried about the falloff in patient visits near the beginning of the pandemic. While there’s been a gradual return of patient encounters, the reality is that many practices are still 10% below their volumes early last year. Meanwhile, their expenses have increased with the need for additional PPE and technology, on top of the staffing and workflow changes required to deliver care during a pandemic. Fortunately, preventive and routine care is beginning to normalize again, and we can begin to contemplate focusing on “whole patient” health, not just SARS-CoV2.
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THE EXASPERATED Fellow physicians in many parts of the country grew exasperated by the misinformation being spread online and via social media over the course of the past year. Many found it challenging to treat patients who downplayed or even denied the existence of the virus — some even after they became seriously ill or had family members die as a result of COVID-related complications. Closer to home, a good friend from residency who now oversees a fellowship training program decided not to require her fellows to see patients during a PPE shortage, but was overruled by a supervisor who enforced the redundant additional visit. My friend was brought to tears recounting the experience and the obvious danger to which her trainees were exposed. Feeling her rage and frustration and not knowing what else to do, I sent extra N95 masks from our hospital to hers, located in a different state. I couldn’t help but think to myself, “how is this happening in our country?” She was expected to round on COVID patients every day without a medical-grade mask. It still boggles my mind to this day.
THE DIGITALLY DIVIDED One common thread for most of us is that virtual visits really saved the day. It made routine care possible again, saving many organizations from a total loss of access to their patients for an extended period. That said, I’ve heard friends and colleagues muse about virtual care both positively and negatively. A common challenge is that the logistics around these visits can really tax the administrative support staff, especially if the patient has limited technical capabilities. Some liked it because they saw the patient in their “home environment” and could often get a more complete picture of what was actually going on in their recovery. But others felt it merely accentuated the divide and the health disparities between the “haves” and the “have-nots.” Nearly all of my colleagues are grateful that the technology was there to bridge the gap, but most everyone missed actually touching the patient. That essential element of touch is what makes us physicians — both literally and figuratively.
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