As the U.S. continues to grapple with the health and economic toll of the COVID-19 pandemic, many of the nation’s doctors, nurses and other front-line health professionals are experiencing burnout amid the prolonged strain of caregiving during this time.
“The COVID pandemic has magnified the issues faced by our front-line workers and health care providers,” said UVA Physicians Group CEO Corey Feist during a webinar hosted by U.S. News & World Report Wednesday. Corey Feist is the brother-in-law of Dr. Lorna Breen, an emergency medicine physician who died by suicide in April at the height of the pandemic in New York City.
According to recent national survey data, “62% of our nurses and 42% of our doctors are feeling burnt out while battling COVID. Yet many of them continue to suffer in silence out of fear of professional stigma, out of fear of being ostracized by their families and friends, and don’t get the help they need,” Corey Feist said.
A crisis prior to COVID-19, burnout and other mental health problems among clinicians have soared during the pandemic, according to the panelists, often with devastating consequences. Breen’s tragic death occurred after weeks of working 12-hour shifts in the early stages of the outbreak – and following her own battle with COVID-19, including a return to work after just three days of being fever-free. She had no prior history of mental health problems.
“My sister was a front-line worker at ground zero in the height of an international pandemic,” said Jennifer Feist, Breen’s sister, “and when she finally couldn’t keep going, her primary concern was that her career that she had spent her entire life working for would be over.”
“We believe this entire culture needs to change,” Jennifer added. “And our expectation that the health care providers be superhuman with no needs, no fears, no family and no need for rest has to change as well. These are humans before heroes.”
Congress is considering bipartisan legislation – the Dr. Lorna Breen Health Care Provider Protection Act – aimed at addressing mental health problems among health care professionals. Sen. Tim Kaine, Democrat of Virginia, introduced the bill this summer along with several other senators (Indiana Republican Todd Young, Rhode Island Democrat Jack Reed and Louisiana Republican Bill Cassidy). Kaine is hoping lawmakers will closely consider such a bill as part of any upcoming legislation to address the pandemic.
“Because this is really directly related to the health care needs of those front-line health providers who are helping us through this pandemic, we’re trying to get it as part of any COVID-related legislation,” Kaine said during the U.S. News webinar. He noted that the bill could pass as a standalone piece of legislation in the lame-duck session after the election.
“The loss of Lorna was so tragic,” he said. After speaking with her family, he decided to take on the issue and introduce the bill in her honor.
Dr. Victor Dzau, president of the National Academy of Medicine, applauded the legislation and called on Kaine and his fellow members of Congress to establish funding to support the long-term needs of health care providers on the front lines of COVID-19, just as was done for first responders of the Sept. 11 terrorist attacks, many of whom still experience mental and physical illnesses stemming from that crisis today, nearly 20 years later.
According to a pre-pandemic 2020 Medscape survey of more than 15,000 physicians, 42% of physicians reported feeling burned out, with many reporting being wary of disclosing seeking mental health treatment.
Burnout not only impacts clinicians, but it can have devastating effects on patient care. “Patients depend on the clinicians to take care of them. If the clinicians are not well, they’re burned out, you can imagine that we’re putting the patients at risk,” Dzau said during the webinar. “There’s lots of data to show that the burnout effect on clinicians is causing more medical errors [and] COVID has made it worse.”
Many factors can contribute to the problem, from a culture of medicine that requires physicians to hide their emotions to the increasing demands of the health care system that keep medical professionals away from the bedside. For instance, Dzau cited one study that noted that doctors spend an average of 18 minutes in a half-hour clinical visit documenting work using electronic health records, for example, leaving only 12 minutes to examine and interact with the patient.
Among the possible remedies under consideration: an increase in the number of doctors, a greater emphasis on teamwork, the hiring of physician wellness professionals in the hospital C-suite and other efforts to change the culture in medicine.
The rate of suicide for physicians and nurses is twice that of the overall national average, said Corey Feist, a day ahead of National Physician Suicide Awareness Day.
“I continue to believe that if there were a different culture where she had felt comfortable saying, ‘I’m still sick,’ that (Lorna) might still be here,” said Jennifer Feist. “And she’s not the only one in that boat.”