Physicians report reduced income, increased burnout, and heightened mental health concerns over past year of the pandemic.
ANALYSIS | BY CHRISTOPHER CHENEY
The coronavirus pandemic is taking a heavy toll on the wellbeing of physicians, says a new survey by The Physician's Foundation.
The coronavirus pandemic is one of the most significant public health crises in more than a century. Physicians have been on the frontline of the struggle, working long hours and enduring the emotional toll of losing hundreds of thousands of patients to the virus.
The new survey report, which was published this week by The Physicians Foundation, is based on data collected from 2,500 physicians. The survey was conducted from May 26 to June 9, 2021.
The survey report features eight key findings.
- About 80% of physicians have been significantly impacted by the pandemic, with 49% reporting reduced income, 32% reporting reduced staff, and 18% switching to a primary telemedicine practice.
- In consideration of the long-term effects of the pandemic, most physicians anticipate continuing telehealth in their practices, seeing an increase in serious health conditions, and experiencing a significant decrease in independent physician practices.
- There has been a significant increase in physician burnout during the pandemic, with 61% of physicians reporting having feelings of burnout often, which is a 20% increase compared to the physician burnout level that The Physicians Foundation reported in 2018.
- The pandemic has had a negative impact on physician mental health, with 57% of survey respondents reporting inappropriate feelings of anger, sadness, or anxiety because of COVID-19. Nearly half of physicians (46%) report withdrawing or isolating themselves from others, and 34% report feeling hopeless or without a purpose. Despite the high level of mental health concerns, only 14% of physicians reported seeking medical attention.
- Physicians reported that family (89%), friends (82%), and colleagues (71%) have been most helpful in addressing their mental health and wellbeing during the pandemic.
- Most physicians (70%) reported that a multifaceted approach is necessary to address their mental health conditions, burnout, and suicide prevention. Suggested approaches included confidential therapy, counseling, or support lines as well as evidence-based professional training.
- Over the past year, about 20% of physicians reported knowing a physician who had either considered, attempted, or died by suicide. Throughout their career, 55% of physicians reported knowing a physician who had either considered, attempted, or died by suicide.
- A positive element of the pandemic has been widespread adoption of telehealth. Among physicians who are 45 or younger, 75% reported they anticipate continuing to use telehealth in the practices. Among female physicians, 74% reported they anticipate continuing to use telehealth in the practices.
INTERPRETING THE DATA
Physicians need help to address the negative impacts of the pandemic, the report says. "Given the high levels of stress, burnout, and physical and mental harm caused to physicians by COVID-19, it is clear that more must be done to foster and promote physician wellbeing, for the good of the public and for physicians."
The survey report highlights two public health concerns that have impacted physicians for decades.
1. Linkage between physician wellbeing and healthcare outcomes: "A decline in physician wellbeing and an increase in physician burnout levels have consistently been linked to poor healthcare outcomes. It is in the public's interest to help maintain physician wellbeing and lower levels of physician burnout because healthy, engaged physicians generally provide better care than unhealthy, disengaged physicians," the report says.
2. Physician suicide: The finding that about 20% of physicians reported knowing a physician who had either considered, attempted, or died by suicide during the pandemic indicates physician suicide remains a top concern for the profession. "Left untreated, burnout can cause more cases of depression, anxiety, PTSD, substance use and suicidal thoughts for physicians. It is estimated that approximately 1 million Americans lose their physician to suicide each year," the report says.
The survey report shows that physicians want systematic change to improve how their field addresses burnout and mental health conditions, Gary Price, MD, president of The Physicians Foundation, said in a prepared statement.
"We know evidence-based solutions exist; they now need to be scaled. For example, through the Foundation's collaboration with the American Medical Association in the Practice Transformation Initiative, Washington Permanente Medical Group in Washington state implemented pre-visit laboratory testing, which gave their physicians the opportunity to discuss results directly with patients at their appointment. This streamlined administrative tasks and contributed to a reduction in the number of hours spent on indirect patient care by three hours," he said.