As our world confronts an impossible crisis, my greatest fear has been that the COVID-19 pandemic is compounding another, less heralded epidemic — physician burnout.
The truth is, we health care workers were tired before COVID-19. We were overworked and stressed before a nationwide shortage of face masks, other personal protective equipment, and hand sanitizer.
Back in the halcyon days of 2019, 40% of physicians surveyed by Medscape reported that they felt burned out, and 24% admitted that they had had suicidal ideation. While this might be a shock to members of the general public, the news was coldly comforting to me, because it proved in objective statistics that I was not alone.
There are countless reasons for physicians to be dissatisfied, starting with the corporatization of health care and ending with constant battles with insurers to gain access to the treatments our patients need. To paraphrase Tolstoy: All happy doctors are alike; each unhappy doctor is unhappy in their own way.
For many doctors, though, the simplest explanation for their burnout is that they are just too darn busy. Urologists, in particular, are in high demand, with 72% of counties in the US having only one or no urologists. Wait times in my office can be longer than an hour, and that’s after patients wait months for a new patient visit.
Friends tell me to be happy that business is good, but in medicine, there’s such a thing as business being too good. There was a time when I felt like no matter how hard I tried, I was disappointing someone every day. When doctors work too much it can affect their marriages, and their relationships with their children. Perhaps most importantly, when doctors are too busy, they don’t spend as much time listening to their patients. Crucial labs or imaging results can fall through the cracks. Patient care is affected, and medical errors rise.
Hospitals have realized that their most precious commodity — their human resources — are at risk, and they’ve created committees to address burnout. Mindfulness programs help. Hiring advanced practice providers is essential. However, there is no quick fix.
I, like so many of my colleagues, have had to turn inward to regain my sense of joy.
A few years ago, after I cried in front of a patient, not because she was berating me about wait times, but because she simply asked me how I was doing, I sought out the help of mental health professionals.
I also started writing again. More than anything, finding a passion outside of medicine has, paradoxically, given me the balance that allows me to stay in medicine. Having a creative outlet allowed me to process my own struggle with depression (I like to pitch my next novel, This is My Brain in Love, as a happy book about mental illness), while also giving me a voice — which is its own antidote to the sense of powerlessness that I often feel as a physician.
I fear that in the coming months there will be few opportunities for me and my colleagues to enjoy life outside of the clinic. Stress is climbing over the delay in COVID-19 testing and the shortfall in supplies. As my colleagues and I are exposed, the workforce will be stretched impossibly thin when we have to enter quarantine, are hospitalized, or ultimately succumb to the virus.
So what can we all do to combat this insidious epidemic within a pandemic? I can’t help but think back to the patient who moved me to tears, to her keen insight into the fact that even though she was the one with the illness, I was suffering too.
The coronavirus can’t defeat these moments of grace.
In the coming months, we will feel powerless and hopeless. We will make mistakes. But we are not alone in our fight. Don’t be afraid to ask your fellow soldiers how they are doing. And remember that both compassion for others and self-compassion are vital if we are to survive this crisis.