(Photo courtesy of “The Hill”)
The devotion to their work that we have seen from our clinicians, doctors, nurses, nurse practitioners, physician assistants and EMT’s, in the face of such huge adversity, says everything about why they are the nation’s heroes. It also speaks volumes about why we need significant changes in our U.S. healthcare system. These health professionals, who are on the front lines of the Covid-19 epidemic, deserve better treatment than they are getting. They are sent in every day to battle Covid-19 without the proper equipment and with a lack of processes or protocols that have been drilled into them since their training days. They have received no preparation to help them help their patients in this fight. In spite of the deficiencies in our system, our clinicians continue to show devotion and caring for their patients above and beyond. They have stepped up and taken on responsibilities that, in many situations are not in their sphere of specialty. They handle whatever they have to without question or complaint, regardless of what this might mean to their own personal safety and that of their families.
All of this is taking place in an environment where we have routinely taken for granted the untenable position and personal needs that our doctors, nurses, physician assistants and nurse practitioners experience daily. We have universally failed to appreciate the burdens that our society and the healthcare industry put upon them. From the massive loans that doctors have accumulated coming out of medical school, to their struggles, in many cases, to pay their bills, as they work for less pay and longer hours than their counterparts in other industries with similar education and background. Hospital systems and consumers of healthcare have failed to treat our front-line medical personnel with the respect and rewards they deserve. Orders and regulations that emanate from our profit-driven hospitals and payers are forcing clinicians to see too many patients, perform too many procedures and surgeries and complete massive amounts of paperwork, all crushed into too short a time. This creates an environment of concern about the standards that enable safe, high quality care.
A from the National Academy of Medicine, “Taking Action Against Physician Burnout: A Systems Approach to Professional Well-Being,” indicates that clinician burnout – a workplace syndrome resulting from chronic job stress – is a major problem across the nation. Substantial stress and burnout symptoms are present in 35-54 percent of nurses and physicians and 45-60 percent of medical students and residents. That burnout is a growing public health concern. The results showed that nurses and physicians feel substantial symptoms of exhaustion, depression and emotional numbness. For medical students and residents, the prevalence of burnout ranges from 45 to 60 percent. Contributing factors include: increased demand for health services, increased workloads, administrative burdens resulting from implementation of electronic health records, lack of resources that stem from organization culture and policies, leadership expectations, excessive documentation and reporting requirements that detract from patient care, and the stigma that prevents clinicians from seeking help and support. The study reported that emotional exhaustion, and a loss of sense of professional efficacy are barriers to professional well-being. Addtessing burnout requires improving the environments in which clinicians train and work.
Jessica Gold, M.D. , an assistant professor of psychiatry at Washington University in St Louis wrote that “mental health cannot be an afterthought but must be considered now in copig with the pandemic, particularly for healthcare workers. “Our mental health system is deeply flawed and understaffed, she said, “and is in no way prepared to manage the onslaught of issues in healthcare providers and the citizenry in general after such a mass tragedy. We must think about way to prevent mental health from deteriorating while also coming up with innovative ways to target at risk groups, particularly healthcare workers”
Covid-19 has put a new perspective on so many failings in our dysfunctional healthcare system. We now understand that once we are done with this initial crisis, we have a long way to go toward implementing changes to our system that fails all of us. Clinicians need to be able to treat all patients, at all times, in a safe environment with the proper support and equipment. We are going to need a radical re-engineering of the healthcare system, including interventions that protect both the physican and mental health of our front-line workers, whom today we salute!