Clinicians and Professional Societies COVID-19 Impact Assessment: Lessons Learned and Compelling Needs

Madara, James L.; Miyamoto, Suzanne; Farley, Jason E.; Gong, Michelle N.; Gorham, Millicent; Humphrey, Holly J.; Irons, Mira; Mehrotra, Ateev; Resneck, Jack S.; Rushton, Cynda Hylton; Shanafelt, Tait D.

doi:10.31478/202105b

Cited by 18 publications

(22 citation statements)

References 74 publications

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“…[68][69][70][71][72][73] Other pandemics will come in the future, and it is critical beforehand to establish programs that support staff and a culture of organizational justice, particularly in listening to staff and giving importance to their needs related to work, work-life balance, and mental health. 15,61,62,74 Limitations This study's 44.3% response rate is typical for clinician surveys 75,76 but can invite response bias. The pandemic experiences of NHSC participants in these 20 states may not reflect experiences in all states.…”

Section: Discussionmentioning

confidence: 91%

“…We cannot know if these work changes differed in magnitude or duration from those of outpatient clinicians generally, because available data for other clinician groups are available only for specific weeks or months during the pandemic, and measures have lacked standard definitions and instruments. 15,40,42,[51][52][53] The employment situations of this study's NHSC participants in primary care and behavioral health disciplines were Abbreviation: NHSC, National Health Service Corps. a Clinicians serving in the NHSC as of July 1, 2020, in 20 states were surveyed by the authors in late 2020. b Determined by second-order Rao-Scott adjusted χ 2 test.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…However, like all clinicians, NHSC participants have risked infection through their work, have had to negotiate a shift to virtual care and many other changes in care processes, and have sometimes faced disruptive job changes, such as reduced hours, furloughs, and practice closures. [15][16][17][18][19][20][21] NHSC clinicians are contractually obligated to practice only in approved sites and for a specified minimum number of hours each week, with restrictions on taking leave from their jobs. 22 NHSC service contracts were not designed for the exigencies of a pandemic.…”

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confidence: 99%

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confidence: 99%

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Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic

et al. 2021

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Objectives The impact of the COVID-19 pandemic has been particularly harsh for low-income and racial and ethnic minority communities. It is not known how the pandemic has affected clinicians who provide care to these communities through safety-net practices, including clinicians participating in the National Health Service Corps (NHSC). Methods In late 2020, we surveyed clinicians who were serving in the NHSC as of July 1, 2020, in 20 states. Clinicians reported on work and job changes and their current well-being, among other measures. Analyses adjusted for differences in subgroup response rates and clustering of clinicians within practices. Results Of 4263 surveyed clinicians, 1890 (44.3%) responded. Work for most NHSC clinicians was affected by the pandemic, including 64.5% whose office visit numbers fell by half and 62.5% for whom most visits occurred virtually. Fewer experienced changes in their jobs; for example, only 14.9% had been furloughed. Three-quarters (76.6%) of these NHSC clinicians scored in at-risk levels for their well-being. Compared with primary care and behavioral health clinicians, dental clinicians much more often had been furloughed and had their practices close temporarily. Conclusions The pandemic has disrupted the work, jobs, and mental health of NHSC clinicians in ways similar to its reported effects on outpatient clinicians generally. Because clinicians’ mental health worsens after a pandemic, which leads to patient disengagement and job turnover, national programs and policies should help safety-net practices build cultures that support and give greater priority to clinicians’ work, job, and mental health needs now and before the next pandemic.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic

et al. 2021

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Physician Coaching by Professionally Trained Peers for Burnout and Well-Being

Kiser,

Sterns,

Lai

et al. 2024

JAMA Netw Open

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ImportancePhysician burnout is problematic despite existing interventions. More evidence-based approaches are needed.ObjectiveTo explore the effect of individualized coaching by professionally trained peers on burnout and well-being in physicians.Design, Setting, and ParticipantsThis randomized clinical trial involved Mass General Physician Organization physicians who volunteered for coaching from August 5 through December 1, 2021. The data analysis was performed from February through October 2022.InterventionsParticipants were randomized to 6 coaching sessions facilitated by a peer coach over 3 months or a control condition using standard institutional resources for burnout and wellness.Main Outcomes and MeasuresThe primary outcome was burnout as measured by the Stanford Professional Fulfillment Index. Secondary outcomes included professional fulfillment, effect of work on personal relationships, quality of life, work engagement, and self-valuation. Analysis was performed on a modified intention-to-treat basis.ResultsOf 138 physicians enrolled, 67 were randomly allocated to the coaching intervention and 71 to the control group. Most participants were aged 31 to 60 years (128 [93.0%]), women (109 [79.0%]), married (108 [78.3%]), and in their early to mid career (mean [SD], 12.0 [9.7] years in practice); 39 (28.3%) were Asian, 3 (&lt;0.1%) were Black, 9 (&lt;0.1%) were Hispanic, 93 were (67.4%) White, and 6 (&lt;0.1%) were of other race or ethnicity. In the intervention group, 52 participants underwent coaching and were included in the analysis. Statistically significant improvements in burnout, interpersonal disengagement, professional fulfillment, and work engagement were observed after 3 months of coaching compared with no intervention. Mean scores for interpersonal disengagement decreased by 30.1% in the intervention group and increased by 4.1% in the control group (absolute difference, −0.94 poimys [95% CI, −1.48 to −0.41 points; P = .001), while mean scores for overall burnout decreased by 21.6% in the intervention group and increased by 2.5% in the control group (absolute difference, −0.79 points; 95% CI, −1.27 to −0.32 points; P = .001). Professional fulfillment increased by 10.7% in the intervention group compared with no change in the control group (absolute difference, 0.59 points; 95% CI, 0.01-1.16 points; P = .046). Work engagement increased by 6.3% in the intervention group and decreased by 2.2% in the control group (absolute difference, 0.33 points; 95% CI, 0.02-0.65 points; P = .04). Self-valuation increased in both groups, but not significantly.Conclusions and RelevanceThe findings of this hospital-sponsored program show that individualized coaching by professionally trained peers is an effective strategy for reducing physician burnout and interpersonal disengagement while improving their professional fulfillment and work engagement.Trial RegistrationClinicalTrials.gov Identifier: NCT05036993

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Understanding the non‐professional needs of early career doctors: An interview‐based study

Gurney

O’Sullivan

McGrail

et al. 2022

Health Planning & Management

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BackgroundSpecialty colleges and health services play a key role in supporting doctors in their early careers, fostering a highly skilled workforce to respond to the community's healthcare needs. In doing so, they are often well attuned to professional factors, such as long or uncontrolled work hours, but non-professional factors are less acknowledged. This is partly because there is limited research about the non-professional needs of early career doctors, impeding the capacity to tailor a response through structured policy and programs. This study aims to describe the non-professional needs of doctors in their early postgraduate career, including how they intersect with career and training experiences. MethodsSemi-structured interviews were conducted with 32 male and female medical graduates working across all Australian states and territories, spanning a variety of specialty areas and early career stages (up to their 17 th postgraduate year). Participants were asked about their career journey to date including nonprofessional factors related to their experiences. ResultsThe results identi ed important non-professional needs, that strongly interplayed with career and training experiences, including: children's education; partner's career needs; family stability; major life stages; proximity to the extended family; and spending time with immediate family. Results also suggested clear gender differences, with female doctor's needs orientated to partner work and carer responsibilities, while male doctor's needs were oriented to spending time with family and meeting the family's needs. ConclusionsThis study highlights a range of important non-professional needs which should be routinely considered as legitimate needs within health service employment and specialty training arrangements. The nonprofessional needs appear to vary by gender, location and eld of work, and whether doctors have partners, children or encounter major life events in their early career. In exible postgraduate training and employment, by both specialty colleges and the employing health service, are likely to create tension for early career doctors in their non-professional lives. Whereas accommodating these needs ensures early career doctors can realise their full potential, fostering participation, satisfaction and completion of various early career work and training stages, with positive consequences for community access.

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Clinicians and Professional Societies COVID-19 Impact Assessment: Lessons Learned and Compelling Needs

Cited by 18 publications

References 74 publications

Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic

Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic

Physician Coaching by Professionally Trained Peers for Burnout and Well-Being

Understanding the non‐professional needs of early career doctors: An interview‐based study

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