It’s not an overstatement that many physicians who worked on the front lines of the COVID-19 pandemic are now experiencing something akin to post-traumatic stress disorder. It changed them as people, and it continues to affect how they feel about their work.
So says Gerard Clancy, MD, senior associate dean for external affairs at the Roy J. and Lucille A. Carver College of Medicine at the University of Iowa, in an episode of “AMA Update” about being proactive in heading off physician burnout stemming from the pandemic. Dr. Clancy also is a psychiatrist at the University of Iowa Hospitals and Clinics, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.
Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.
Care teams aren’t the same anymore
In his role as the consult psychiatrist for the University of Iowa Hospitals & Clinics, Dr. Clancy walks some seven miles a day through his 1,000-bed academic medical center. But besides checking on patients, lately he has also been looking in on the health of the hospital’s staff.
“ICD-11 lists the criteria for burnout being cynicism, exhaustion, lack of joy in the job and, at times, a loss of effectiveness at work,” Dr. Clancy said. “But with the pandemic, we've seen so much more added to it.”
He refers to this phenomenon as pandemic-informed burnout. It emanates from the perceived dangers at work and at home, constantly bearing witness to unprecedented suffering and death, and even the growing incidence of patients’ becoming violent.
“The pandemic threw new stresses at us, and so we needed to actually have new strategies as well,” he said.
Seeing the effects the pandemic was having on the workforce—including in the area of retention—the University of Iowa set up a plan to address these new stressors. The reaction from physicians was immediate.
“I remember talking to the entire department of obstetrics and gynecology, and I finished up my workshop part of the program and we were ready to go into discussion,” Dr. Clancy said. “The chief resident stood up and said, ‘Finally, we're talking about this.’”
When challenges shift, so do plans
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Just as the experience of pandemic-informed burnout isn’t static, the University of Iowa’s plan for addressing it isn’t either.
“Maybe you had a strategy for 2020 that didn't fit for 2021 or didn't fit for 2023. The pandemic is changing, society is changing, and unfortunately, the impact on our clinicians is changing as well,” Dr. Clancy said.
Later this year, the University of Iowa will implement the AMA's Organizational Biopsy®, a comprehensive well-being assessment that includes the validated Mini-Z burnout tool.
“What the Mini-Z allows us is to give regular updates on how our clinicians are doing,” Dr. Clancy said. “I remember well in medical school learning that if I didn't have a diagnosis, I couldn't put together an accurate treatment plan. This is all about putting together an accurate diagnosis about where our clinicians are so we can put programming in place that meets their needs.”
Dr. Clancy likes to say that when you help a physician, you also help 1,000 patients.
“One of the few silver linings in this pandemic,” he said, “has been the recognition that mental health, mental strain, mental distress can happen to anyone.”
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