Physicians’ Occupational Health During COVID-19: A Qualitative Analysis of Systems Factors

Details

• Personal Author:
  Buchbinder MH
• Description:
  Physicians are at risk for high rates of depression, substance abuse, suicide, and burnout, an occupational phenomenon resulting from chronic workplace stress. Burnout is characterized by 1) fatigue or exhaustion, 2) feelings of negativity toward one-s job, and 3) reduced professional efficacy. The COVID-19 pandemic exacerbated this occupational burden at a time when baseline levels of stress, burnout, and poor mental health were already overwhelmingly high. This study sought to (1) understand the relationship between pandemic workplace conditions and adverse health outcomes (e.g. fatigue, stress, burnout, mental illness) and (2) identify work practices and organizational characteristics that promote physicians' health and well-being and reduce the risk of such outcomes. We conducted interviews with physicians in Los Angeles (n=35) and Miami (n=31) who worked on the front lines of COVID-19 care (i.e. from emergency medicine, hospital medicine, pulmonary critical care, and palliative care). Our findings highlight the importance of factors beyond the immediate workplace environment shaping physicians' stress, health, and well-being. Stressors in the social, political, and economic environment included dealing with the politicization of COVID-19, including vaccine hesitancy; state and federal governmental COVID-19 policies and messaging; and shifting CDC guidance. Employment and labor pattern stressors included the national nursing shortage, different policies for paid time off, furloughs, reduced pay, and layoffs. Organizational-level stressors included institutional policies, staffing constraints and high patient volume (i.e., increased number of cases and longer lengths of stay), and perceived poor leadership. At the individual level, stressors included concerns about viral transmission to family, strained personal relationships, and work-life fit, particularly for those with young children. Respondents identified protective factors at multiple levels, including responsive state leadership, job security, concrete opportunities to provide input into institutional policy, strong leadership and communication, and feeling cared for by one's institution. Taken together, these findings support a multi-level strategy that acknowledges internal organizational and external factors shaping physicians' occupational well-being. Hospitals and health systems may improve clinicians' work-related well-being by targeting elements of organizational culture such as communication, leadership, and expressions of appreciation for employees. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Fatigue Health Personnel Mental Health Nervous System Occupational Health Safety Stress, Psychological
• Keywords:
  COVID-19 Job Stress Mental Health Physicians Well-being Work-family Balance Work Organization Work Practices
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  California ; Florida ; North Carolina ; OSHA Region 4 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-15
• NIOSHTIC Number:
  nn:20069613
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R21-OH-012175, 2024 Jan; :1-15
• Email:
  mara_buchbinder@med.unc.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of North Carolina Chapel Hill
• Peer Reviewed:
  False
• Start Date:
  20210901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8d0619584085bf0201ef28b17545246355fc94a3f33e293ae3b9386b1887a4a7f2b379da2c8a76d0b31fbebb51e03c042aced462afd56be20a9d41346782aaf7
• Download URL:
  https://stacks.cdc.gov/view/cdc/219246/cdc_219246_DS1.pdf
• File Type:
  [PDF - 1.12 MB ]