How are patients and providers coping during COVID?
Routines have absolutely been disrupted — graduations, the ability to celebrate birthdays, or gather for cookouts. All of that is disrupted. So the first thing I would say is, everybody take a deep breath, all right. And give yourselves the grace and the space to feel whatever you're feeling — angry, frustrated, lonely, all of those things.
Then, I would tell parents to develop new routines. So 10 o’clock, we’re going to all get up and go outside if the weather permits, or inside, we’re going to do play a game and make learning fun. Or make masks together with cartoon characters so they are fun and not scary. I think we sometimes focus on the deficit, and what we don’t have. And that’s okay for a couple of weeks, but after that we should start getting creative. And I think we’ve seen all sorts of creative ideas like learning pods and drive-by graduations or birthday parties.
For the teenagers it’s tough, because they miss their friends. And that's a very important part of their lives. But they do have technology — go ahead and rely on technology to keep them texting, to keep them connected. And focus on letting the teenagers and the kids drive, have them come up with some ideas of what we can do.
We will get through this. Until it’s over, let’s focus on what we can do. We can go outside. We can wear our masks and stay six feet apart, and wash our hands, and work really hard, so community spread is low. So let’s focus on what we can do. We are not hopeless or helpless in this situation. And so sometimes just doing something makes you feel less hopeless.
Burnout is certainly more evident now, as we see doctors and nurses running toward a problem rather than away. We’ve seen health professionals actually risking their lives, but staying committed to the work. The unrelenting nature of this epidemic, the lack of a national plan and strategy, lack of basic safety equipment, has really worsened symptoms of burnout, distress, anxiety, worry, despair. Physicians are human.
But, as you know, we at the AMA, and others, were thinking about burnout before this pandemic, right. One of our strategic arcs has been to understand burnout. And we made a point, early on, to make sure — we’re talking about choices and blaming and shaming, because the original conversation around physician burnout was, get more sleep. Eat better. Meditate. You’ll be okay.
Our position is that this is a system issue. We started out talking about the need to make the system healthy. That’s what we need to do. And so that’s been our focus at the AMA— you’ve got to figure out the system, what you're going to do to support, physicians and everyone else throughout this.
Physicians probably have a challenge asking for help — we’re the helpers, we don’t always ask for help. And there’s stigma in the community. So we have to, again, make sure we are making the systems healthy, that physicians can talk about acute issues and symptoms or signs regarding burnout. But also, even go deeper, in that there’s openness and a willingness to not only say it, but act in a manner that allows physicians to seek the help they need.
Then you should look at what about your system is causing burnout. AMA has done surveys and it looks like the two biggies are prior authorizations and electronic health records. Our studies show that for every hour of patient care, physicians spend two hours on administrative burdensome tasks.
Look at your technology and look at who’s around the decision-making table when you are considering changes to it. Make sure physicians are there, and telling you how this tiny change that’s perceived as tiny by leadership ends up wreaking havoc on the frontlines. I think, if you get the suggestions from the frontlines, you will probably get a solution that won't even add to burnout.
Click here to read more of Dr. Harris’ insights on the state of healthcare equity.