The elephant in the doctors’ lounge

With roughly 156 million Americans Fully vaccinated against COVID-19, doctors see signs of relief on the horizon. This relief cannot come soon enough. The initial energy and adrenaline that drove doctors to treat critically ill patients during the first few months of the pandemic has been replaced by fatigue, burnout and post-traumatic stress disorder (PTSD). It’s time to speak up – and take action – so that these struggling feelings don’t lead more of our co-workers to a mental health emergency.

Physician suicide was a public health crisis long before the COVID-19 pandemic. Almost one in four doctors know of a doctor who committed suicide. Now, they have been in a nonstop crisis for over a year, with COVID-19 inflicting severe psychological injuries on them. Some doctors have had to deal with more trauma and patient deaths during this time than they had seen before in their entire careers.

Harsh working conditions – such as a lack of personal protective equipment (PPE), caring for patients who can be seriously ill for weeks on end – as well as heavy administrative tasks, long hours and the heartache of losing jobs. patients have become the norm. Burnout can be like the death of a thousand strokes. In our 2020 physician survey, nearly 60% of physicians reported experiencing feelings of burnout, but only 13% reported seeing a physician for a mental health issue caused by the effects of COVID-19 on their practice or job.

If left untreated, burnout could cause more cases of depression, anxiety, PTSD, substance abuse, and suicidal thoughts in our profession. It is these people, our colleagues – perhaps even ourselves – who are more likely to quit medicine, or worse, to die from preventable suicide. Poor mental health among physicians can have devastating effects on the access, quality and cost of health care in our country. It is estimated that approximately 1 million Americans lose their doctors to suicide every year.

We need to take care of the elephant in the room – in our practices, clinics and hospitals. We must unite and break the culture of silence surrounding physician mental health.

It is important to give ourselves permission to talk about our own mental health. We need to change the paradigm from a system where doctors think burnout, depression, or suicidal thoughts are something we can or must overcome on our own, to a system where we have a plan in place to access our own mental health care. Having a plan for getting mental health care should not only be accepted, but also normalized. Access to mental health care should become a fundamental and permanent element of the medical profession.

A personal crisis management plan can help identify coping strategies and resources that may work best for each of us individually to successfully overcome stress, feelings of burnout, or other challenges. In fact, in a health care system, almost a third of participating residents used a personal crisis plan within the first 3 months of submitting this resource.

This is a staggering number, especially considering that he is one of the most recent physicians to join our profession. And while this might just be one data point of many on burnout and stress in physicians, it shows how many of us can be suffering right now – or worse, suffer in silence or alone – all because of the stigma associated with doctors seeking to take care of their mental health.

Encouraging the use of mental health resources and evidence-based burnout improvement programs can provide physicians with that much-needed open door to seeking care and alleviating these feelings of stigma and shame.

For example, a Washington state firm designed several workflow redesign interventions to address physician burnout. One example they explored was a pre-visit lab ordering checklist to reduce administrative burden for the physician and provide an opportunity to discuss the results with patients during their visit. The intervention group eventually saw a decrease of 3 hours in the total number of self-reported hours per week spent on indirect patient care and administrative tasks, and reported an increase in both overall job satisfaction and job satisfaction. alignment of values ​​with clinical leaders.

This is just one type of real solution to tackling physician burnout and helping physicians deal with stressors that put their emotional and physical health at risk.

You may never know when the feather that breaks the proverbial camel’s back will come. But in our business, it is more than likely that a day will come. It is simply the nature of the work that we are privileged to do. Doctors, like everyone else, should feel comfortable asking for help when it’s needed most.

Gary Price, MD, MBA, is a member of the board of directors and current president of the Physicians Foundation. He is also an attending surgeon and clinical assistant professor of surgery at Yale-New Haven Hospital in Connecticut.

If you or someone you know is considering suicide, call the National Suicide Prevention Hotline at 1-800-273-8255.

About Hector Hedgepeth

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