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Urgent message: For several years, JUCM has reported on the national crisis of “provider burnout.” New data related to the COVID-19 pandemic indicate a need to revisit the topic.

Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine.

No part of the world has been left untouched by the COVID-19 pandemic. Currently, many urgent care centers are in crisis mode as new—and continually evolving—challenges put a great deal of strain on both businesses and owners. The pandemic has caused significant decline in revenue from visits related to injuries and other illnesses while, for many centers, visits for COVID-19 testing have skyrocketed.

Urgent care companies who embraced COVID-19 testing early are likely less concerned about their finances as many are seeing record volumes. However, businesses that didn’t adopt COVID-19 testing—or who got on board late—are suffering from financial pressure caused by decreased visits and revenue.

For physicians who work in an urgent care setting, these stressors are a major contributor to burnout. This isn’t a new problem for the healthcare industry. Providers have been reporting high levels of burnout for years.1 The COVID-19 pandemic is only making a bad problem worse.

Recent numbers from a survey of physicians conducted by Medical Economics show just how serious of an issue burnout is becoming.2 More than 70% of physicians reported feeling burned out. That’s a staggering number that needs to be addressed—both in the urgent care world and in the wider healthcare industry.

Burnout by the Numbers

Physicians are under many different pressures at any given time. Things like finances, safety, long hours, and trying to find a reasonable work-life balance create a lot of stress. Perhaps that’s why 91% of physicians in the Medical Economics study reported having felt burned out at some point in their career. To be clear, 91% doesn’t happen by accident and it isn’t a fluke. It is a sign that there is a serious problem in the way the U.S. healthcare system is structured.2

The current pandemic has certainly had a negative impact. Of the physicians surveyed, 65% said that COVID-19 has made them feel more burned out than they already were. That increase can be attributed to a number of different causes.2

Finances

One of the most commonly cited stressors related to the pandemic is financial concerns. Half of all respondents said that financial worries have added to their feelings of burnout. Although many people believe that being a doctor is a lucrative profession, that isn’t always true—especially for physicians who run their own practice. As such, the COVID-19 pandemic is causing heightened financial stress for physicians both on a personal level and for their businesses.2

Health

Some 47% of physicians surveyed said that concern for their health or the health of their loved ones is also adding to their stress. Perhaps that is related to the fact that 30% cited a lack of adequate PPE as a contributing factor. These two issues are directly tied to the pandemic and contribute to the fact that 71% of physicians are currently experiencing burnout.2

Workload

A final contributing factor is the number of hours that physicians are currently working. The survey found that 79% of physicians are working more than 40 hours per week while 23% work more than 60 hours per week.

Despite a decrease in non-COVID patients, many physicians—especially in the urgent care setting—have been asked to increase their exam quota. A busy urgent care doctor may be performing as many as 8 to 10 COVID-19 evaluations per hour. When factoring in the time of the visit itself, the time it takes to change PPE, and charting time, that is an exhausting workload. When it is prolonged over days, weeks, and even months, it becomes a major contributor to provider burnout.2

Coping Struggles

Sadly, it doesn’t appear that a solution for provider burnout is anywhere on the horizon. The COVID-19 pandemic shows no signs of letting up, meaning that long hours and increased stress will likely be normal for at least a few more months.3

That’s a problem, considering that up to 12% of physicians report not feeling like they are coping with their stress in a healthy manner. Only 14% of those experiencing burnout have sought professional counseling. Others turn to exercise, time with family or friends, and their own hobbies as ways to cope.2

Bob Piccinini, DO, from Sterling Heights, MI says, “Physicians often suffer in silence. We got away from showing that we are human. Talking about burnout can be a great way of helping deal with it.”

While talking to others can be a great way to negate some of the effects of burnout, it isn’t enough on its own. Doing something about the problem is even better.4 Taking time for healthy activities, getting enough sleep, drinking water, and unplugging from the news are all good steps for physicians feeling the effects of burnout.

For urgent care owners, it’s important to be cognizant of this problem as the COVID-19 pandemic wears on. Checking in with the physicians on your staff in an open, nonjudgmental way can be a great first step.5

Although the pandemic isn’t ending yet, and neither is burnout, effective coping strategies will be a vital part of making it through the next few months safely and sanely. Accepting that burnout is a problem and launching a discussion about it is an ideal starting place.6

References

  1. Hartzband P, Groopman J. Physician burnout, interrupted. N Engl Med. 2020;382:2485-2487.
  2. Medical Economics Staff. 2020 burnout survey results: physicians facing unprecedented crisis. Medical Economics. September 20, 2020. Available at: https://www.medicaleconomics.com/view/2020-burnout-survey-results-physicians-facing-unprecedented-crisis. Accessed October 22, 2020.
  3. Robeznieks A. How the pandemic cases physician burnout in a new light. American Medical Association. Available at: https://www.ama-assn.org/practice-management/physician-health/how-pandemic-casts-physician-burnout-new-light. Accessed October 22, 2020.
  4. Ayers A. Strategies for managing employee burnout. J Urgent Care Med. Available at: https://www.jucm.com/strategies-managing-employee-burnout/. Accessed October 20, 2020.
  5. Ayers A. Recognizing and preventing provider burnout in urgent care. J Urgent Care Med. Available at: https://www.jucm.com/recognizing-preventing-provider-burnout-urgent-care/. Accessed October 22, 2020.
  6. Ayers A. Provider burnout is real; show compassion for yourself. J Urgent Care Med. Available at: https://www.jucm.com/provider-burnout-is-real-show-compassion-for-yourself/. Accessed October 22, 2020.
The COVID-19 Pandemic Is Making Burnout Worse for Physicians Already in Crisis

Alan A. Ayers, MBA, MAcc

President of Experity Consulting and is Practice Management Editor of The Journal of Urgent Care Medicine