Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.
Featured topic and speakers
AMA Chief Experience Officer Todd Unger speaks with AMA President Patrice Harris, MD, AMA Vice President, Professional Satisfaction, Christine Sinsky, MD, and Chief Wellness Office, Icahn School of Medicine at Mt. Sinai Jonathan A. Ripp, MD, MPH, on updates regarding COVID-19 including how to care for health care workers during the COVID-19 pandemic.
Learn more at the AMA COVID-19 resource center.
Transcript
Unger: Hello. This is the American Medical Associations' COVID-19 update. Today, we're discussing how to care for healthcare workers during COVID-19. I'm joined today by Dr. Patrice Harris, AMA's president and a psychiatrist in Atlanta, Dr. Christine Sinsky, AMA's vice president of professional satisfaction in Madison, Wisconsin, and Dr. Jonathan Ripp, chief wellness officer at the Icahn School of Medicine at Mount Sinai in New York. I'm Todd Unger, AMA's chief experience officer in Chicago.
Dr Ripp, thank you for being here today. I understand you've been up all night. Appreciate you being here. As a wellness leader in a health system at the epicenter of the pandemic, tell us what the situation has been like for you and your team.
Dr. Ripp: Sure, and thank you. It's really a pleasure to have some time with you today. It's been quite a month, a little more than a month. Actually yesterday, I was reminded that it's 40 days, I guess, since things really kicked into high gear and our incident response really began.
In many ways, it's what you hear about on the news. We are clearly experiencing something that none of us have ever experienced before. You know, I think there was a period of uncertainty in those early days, which I think a lot of our colleagues across the country are currently experiencing, sort of waiting to see what will come their way. And certainly we had that in the beginning, a lot of projections around the number of cases and obviously the acuity of illness, the need for a large number of beds in ICUs and ventilators and so forth.
And in many ways, all those predictions have come to be. We, as a hospital system that has eight hospitals and 40 plus thousand employees, have really been singularly focused in having a unity of mission to address this crisis which we're facing. And thankfully, I think that effort has really paid off in terms of our capacity to handle what has come to be the number of patients, the acuity of illness. That is very much what is happening right now.
Unger: How is the stress taking a toll on the front line workers at your system and how are you helping them?
Dr. Ripp: Yeah, thanks for asking. I think, clearly, there are so many stressors coming from so many angles, that it's definitely taking its toll on our workforce.
Obviously there are all the issues around the pandemic itself and how it's really disrupted society. So when you think about kind of just the basic daily needs one has to get to and from work and through the day, all of that has been turned upside down.
How are you going to, if you have children, how are you going to manage your children? If you are taking care of an elderly loved one, how are you going to manage that? How do you get to work? How do you find the next meal? How do you ensure that you're safe when you're taking care of patients? So many things related to the pandemic, just the day to day.
And of course then, layer on top of that how many of our workforce have had to be moved from one place that they typically work in, to another place to address the needs and the stresses that that place is on, someone who perhaps is a pediatrician and now is involved in the care of an adult patient or any variety of sort of redeployments as you might think of. That too, creates an enormous amount of stress.
And then on top of that, we're dealing with far more sickness, disease and death than we do in a typical setting, and so it's incredibly tragic and sad to deal with that.
Unger: When you think about the strategies that you're using in your system right now, what's proven to be most effective given that broad range of the kind of stress that physicians are under right now?
Dr. Ripp: Yeah. I'd hesitate to say that we've proven anything just because this is our first pandemic obviously, and there's much discussion around how there's not really a roadmap or a guidebook.
The approach that we took was really trying to understand in a very rapid fashion what the needs are and the stressors are, and then direct what seemed to be appropriate resources at those needs. We've categorized them as meeting the basic daily needs, such as what I just mentioned; all of those day to day activities. To address those stressors, the institution, the system has leveraged all of its resources to provide a variety of additional means for those issues; childcare and transportation and food and so forth. And we've made all that available.
In addition, a lot of the uncertainty is what's driving the stress, right? Not only uncertainty about the pandemic that's unfolding, but uncertainty around just information and where am I going next and how is the hospital going to face things next? We've also focused on a lot of communications, making sure that our communications are steady, reliable, heartfelt, and addressing the needs.
And then of course, really building up a robust psychosocial support and mental health support, building on existing infrastructure, but advancing considerably based on what we believe are the needs now. And quite frankly, what we think is going to be a growing a need for those types of resources as there's sort of this weariness phase that we've entered into 40 days of dealing with the growth of patients and the acuity of patients. And so we anticipate that those needs will grow and we are ready to provide those services in a variety of ways.
Unger: Dr. Harris, Dr. Sinsky, physician wellness has been a focus of the AMA for quite some time. Obviously it takes on a new level of importance and a different filter in the pandemic. What is the AMA doing to help physicians in this way right now?
Dr. Harris: Well Todd, first of all, let me say a big thank you to Dr. Ripp. First of all, as you noted, you worked last night, and you're here with us today to give us this up close and personal view of what we have been hearing about since the beginning of this epidemic. So again, thank you, thank all of your colleagues, and then also thanks to your system.
Todd mentioned that the AMA, and Chris will say more about this, but has been addressing the issue of physician burnout and physician wellness for some time.
And so, here, we have sort of this COVID-19 pandemic and all of the issues around stress and exhaustion and burnout on top of what was already a significant problem. So we really appreciate the system view that you all took because certainly physicians should do their best to sleep and eat and get their rest, but this is really about systems supporting physicians. So thank you for that and thank you for bringing us some of these systemic solutions.
I'll turn it over to Chris to talk a little bit more about what we have been doing at the AMA because, of course, she's been leading that very important work.
Dr. Sinsky: Well thanks, Patrice, and happy to share some of the work we've been doing. And some of it we've done in partnership with leaders such as Dr. Ripp and others.
And so one of the things we have developed very quickly is a coping with COVID survey. And it's a brief, very light touch survey that can be done in about three seconds, with another companion survey that can be done in less than three minutes, that practices and institutions can deploy to keep a finger on the pulse of the stress level within their organization. It gives leaders a dashboard of what the stress level is, what some of the drivers are, and what meaning and purpose the workforce is also finding.
We just launched that last week to a small number of systems. We've had over 1500 responses so far. And today, we've opened it up to all practices and health systems. Clinician.health—that's the website where one can go and register. The next day you'll get a link and can deploy that out.
So that's one of the things. And the other I wanted to mention is one that, Dr. Ripp, you helped write with Dr. Shanafelt—Dr. Tait Shanafelt, who's the chief wellness officer at Stanford—and that's a toolkit, a how to playbook that's online that was launched today online, and it is a play by play of how to care for the healthcare workforce during a crisis. Much of it comes out of our experience from COVID, but we've written it so that it will be applicable to future crises. Hopefully we won't have the need for those, but of course we know realistically there will be other things that will come up. So those are two of the many things that we've put together so far.
Dr. Harris: And Chris, if I could, and that is so very important that we are opening it up to all practices because we, as we should, have a diversity of practice settings in this country and physicians practice in different large systems, small systems, employed, solo private practice, and so it is important as the AMA always does is keep its finger, keep our finger on the pulse of the many practice settings out there. And the stressors will be different. There will be some similarities, but some differences. And so that's critical.
I know some of the small practices for instance in rural areas are worried about their viability now, but particularly post-COVID. So I think that's very important to make sure we get the data now. And I know and I've said this in many settings that AMA will continue to get this data.
As a psychiatrist, of course, I'm worried about post-traumatic stress disorder in many of our colleagues. Actually, in everyone across the nation. I know that we will at the AMA, and I'm sure Dr. Ripp and system at Mount Sinai, will continue these efforts because they won't go away once we get through this acute phase of the pandemic.
Unger: Well thank you very much, Dr Harris. That's it for today's COVID-19 update. I want to thank our guests, Dr. Harris, Dr. Jonathan Ripp and Dr. Christine Sinsky for being here and for their important contributions to physician wellbeing during this time.
We'll be back tomorrow with another update. In the meantime, for more resources on COVID-19, use the AMA COVID-19 resource center at ama-assn.org/COVID-19.
Thanks for joining us.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
