Featured case: The Impact of COVID on the Mental Health of
Health Care Providers

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The case

bedWho – the protagonist

Isabelle Davis, Dean of the School of Nursing at Mountain View University (MVU) Health.

What?

MVU Health is an academic medical centre in a rural town in the mid-Atlantic region with annual revenues of $2.5 billion.

Why?

Davis had spent the last three years working on a focus group at the National Academy of Medicine on clinician well-being and burnout, and she was a member of its task force dedicated to this issue.

The COVID-19 pandemic added a new stressor to the lives of clinicians, including doctors and nurses, so Davis had been charged by MVU Health leadership to develop a plan for the health system

When?

Davis had been in her position since the fall of 2019, putting a real focus on efforts to support clinician well-being at MVU.

COVID-19 placed this further under the spotlight, as clinicians were burdened by feelings of inadequacy and hopelessness while they risked their own lives and the lives of their families to stem the effects of the pandemic.

Where?

MVU Health is situated in a rural town in the mid-Atlantic region in the US.

Key quote

“We already know they are stressed, but COVID hasn’t really hit us that hard. Why do we need to ask them in a survey?” – one MVU Health executive mused.

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What next?

Davis knew it was vital to participate in the United States Medical Association (USMA) survey. A national USMA survey had already shown a national average of 68% burnout, but to gain access to local data she needed to convince the MVU Health leadership that it was worthwhile to participate in the local survey.

 
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The impact of COVID on the Mental Health of Health Care Providers
Ref UVA-E-0457

The author

author

J. Corey Feist

Corey discusses the need to address burn out suffered by health care professionals, and his students’ interest in the subject.

Suffering in silence

Corey said: “Physicians and health care providers suffer from a critically high degree of burnout and stress. Currently, more than one physician in the United States dies by suicide every day. The COVID-19 pandemic of 2020 has magnified the issues faced by frontline health care providers, yet many continue to suffer in silence out of fear of the professional stigma of seeking help.

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“In the majority of states, this fear is exacerbated by required disclosures of mental health assistance, regardless of scale or severity, to licensing boards and health care institutions. These disclosures have resulted in censure by licensing boards, termination of employment, and have had a widespread negative professional impact for many – reinforcing a culture of suffering in silence.

“In order to avoid professional repercussions, overly stressed and burnt out physicians and providers often feel trapped, taking care of patients with little to no relief. It is not surprising that the quality of patient care suffers in parallel. Without immediate action, the added stress from the pandemic crisis will put more pressure on our caregivers, resulting in more loss of life and a further decline in patient care. This will no longer be a health care industry problem: It will affect all of us.”

Finding the solutions

Corey explained: “While the health care industry has known about this issue for quite some time and has been making progress to address it, the problems have multiple layers of complexity and the solutions are not totally clear.”

Looking after health care professionals

He added: “The key issue from this case is that there is a pandemic within the pandemic – our health care workforce is burnt out and needs to be taken care of so they can take care of their patients. Approximately 80% of the issues creating burn out are organisational in nature so it is incumbent upon the health care industry to modify their own operations to prevent that, as well as putting the appropriate supporting structures in place to support providers when they are burnt out.”

A big issue

Corey commented: “Students were generally surprised at the extent of the problem. Those with health care backgrounds or with friends/family in the industry clearly recognised and supported that this is a big issue. Students were also highly supportive of a need for change in the industry and developing solutions which can be sustained over the long term.”

burn out

Understanding the impact of provider burn out

He concluded: “The issue of provider burn out was here before the pandemic. In fact, this year, the public health community called out provider burn out as the next public health crisis. Obviously, COVID took over that spot. COVID also magnified the issue for the world to see and highlighted how fragile the health care infrastructure is. Given that COVID has not gone away, leaders need to understand the short and long-term impact on their businesses and how they can support their workforce.”

About the author

J. Corey Feist is Chief Executive Officer of the University of Virginia Physicians Group and adjunct faculty at the University of Virginia Darden School of Business.

Corey is also the Co-Founder of the Dr. Lorna Breen Heroes’ Foundation. The Foundation’s mission is to reduce burnout of health care professionals and safeguard their well-being and job satisfaction.

e FeistC@darden.virginia.edu
tw @CEOCoreyUPG

 

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