Weeks ago, I had burnout on the brain. You know, the kind that physicians and other healthcare workers deal with on a constant basis thanks to constant changes in administrative and legislative requirements. You all know this: we can’t just practice medicine anymore. We can’t just treat patients.
Now we have to do it a certain way. And always keep in mind our RVUs. And meet all the benchmarks. We need to ensure we’re meeting our patients’ needs but also working more “efficiently” (i.e. harder and longer with fewer resources and less actual face time with patients).
And then there’s the paperwork. You can’t be in medicine right now without spending half your waking hours on the phone with insurance companies, but battling with insurance companies doesn’t generate RVUs, so we’re doing that on our own time.
Burnout tends to find you easily when you’re working extra hours for free.
So I had all this on my mind and was working on some feasible solutions, but then: the COVID-19 pandemic. Originally, I had been thinking that yoga at work and free chai lattes were not going to do anything to solve the deeper systemic issues affecting the healthcare industry. I had thoughts about eliminating red tape and bringing back empathy. Perhaps focusing on the living breathing human beings under the white coats would be a prudent first step toward reducing burnout.
But now? Well, maybe this COVID-19 healthcare crisis will turn out to be an inflection point we didn’t know we needed.
Medical professionals are the frontline of this war and if they thought they felt burned out before, they had no idea what burnout really is. So many of us are working nonstop right now without the proper protective equipment, in makeshift facilities, without enough tests, without any kind of safety net at all.
We are weeks if not months from being through this crisis, and none of us can predict the lasting effects it will have. Everything from the global economy to the education system to social relationships are likely to undergo seismic shifts. It’s hard to imagine there won’t also be massive changes to healthcare.
Currently, rapid legislative changes are being pushed in medicine without the input of physicians. Are these temporary? Permanent? I cannot begin to imagine the fall out. I understand that things need to happen quickly in a pandemic and there may be time to sort it all out later, but it is definitely adding to the anxiety we are feeling.
So I am worried about the future of medicine while I worry about the safety of healthcare workers and their families. Wearing a bandana does such a poor job at protecting us from infectious diseases, I am AGHAST it is included in a CDC statement. I am aghast that hospitals are advising health care workers NOT to wear PPE (personal protective equipment) because it may scare the patients. Given that this virus can present in a variety of symptoms, including gastrointestinal complaints, we need to protect ourselves.
I learned in my military training that a sick soldier is a liability, which is why so much emphasis is placed on preventative medicine and care. The military takes care in providing soldiers, airmen, sailors, and marines with access to primary care, immunizations, and also equipment to protect themselves during combat.
Who would enter battle riding a horse, wearing a bandana, slinging a sword, when facing an armored tank? The answer is: no one. We enter battle dressed appropriately so we can protect ourselves; so we are not the next casualty. When doctors and healthcare workers become patients, it’s a double whammy. You have more patients and you have fewer caregivers. Your army becomes smaller but the enemy force is unchanged.
As of right now, 23 physicians in Italy are dead from COVID-19. This is a staggering number. Many more are ill, too ill to work.
Some of their family members are also ill. Some are dying.
Meanwhile, I’m sitting here trying to write a letter to an insurance company so that I can fix a broken bone in a patient’s back. I’m trying to explain to them that the new requirement of having a neurologist see every fracture is not realistic, especially in a rural setting. Our neurologists book six months out and this is an urgent procedure. I’m trying to figure out what kind of wording will get this procedure approved so this patient’s pain can be relieved. I’m frustrated because the insurance companies are the only ones who are unfazed and prospering right now. Premiums are being paid but elective procedures are being cancelled (and rightly so).
Why don’t Aetna and Blue Cross contribute in a positive way in this pandemic? I’m sure all the execs are going to get their quarterly bonus while regular people, most businesses, and nearly all healthcare providers are struggling, and will continue to struggle long after the curve is flattened.
Case in point: some physicians and healthcare workers are having their shifts reduced and are being offered pay cuts. RVUs aren’t that great when elective procedures are being cut. I understand that healthcare is a business, but it’s important to remember that these people are your safety net in a pandemic. There may come a time, like in Italy, when you will run out of us.
In other places, which have been hit harder, healthcare workers are being asked to perform roles outside of their primary training. We are happy to help in any reasonable way we can. We are a team. But are there safeguards to make sure the new roles are safe for us and for the patients?
It is safe to say that things will never be the same after this pandemic in a way that things were never the same after 9/11.Let’s just hope that the healthcare changes resulting from this rapid shift are positive, and permanent.
Recent Comments