More than 1 in 3 cardiology professionals reported burnout during COVID-19 pandemic
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The COVID-19 pandemic has increased burnout among CV professionals, with many surveyed citing their basic, emotional and safety needs were not well supported by health care organizations, which, for some, led to a desire to change careers.
The prevalence of burnout among all CV professionals nearly doubled after the start of the COVID-19 pandemic, from 20% in 2019 to 38% during the pandemic, according to data from the American College of Cardiology 2020 Well Being Study, a survey sent to ACC members in fall 2020.
Looking closer at the overall respondents, among U.S. cardiologists, peak COVID-19 burnout rates increased to 40% from a pre-pandemic rate of 27% and among international cardiologists, burnout doubled to 21% from a pre-pandemic rate of 10%. Burnout rates rose to 43%, from 21% in 2019, among U.S. fellows in training. The largest increase was reported by U.S. CV team members — a 139% increase, from 23% in 2019 to 55% during the pandemic.
“The issue of burnout has been simmering for years and was brought to a boil by mounting changes in the health care system — most predominantly, the widespread institution of electronic health records and performance metrics,” Cardiology Today Editorial Board Member Laxmi Mehta, MD, noninvasive cardiologist, Sarah Ross Soter Endowed Chair in Women’s Cardiovascular Health and professor of medicine in the division of cardiovascular medicine at The Ohio State University, said during a presentation. “COVID-19 has had a devastating health, social and economic effect worldwide. The impact of COVID-19 on the well-being of CV professionals has not been reported. The potential long-term psychological effects are real and concerning.”
Leadership, professional contentment, emotional burden
The survey was sent to 10,019 ACC members in October and November 2020. Of those, 1,288 completed the survey, answering questions on symptoms of burnout and stress, including physical and/or emotional exhaustion, personal sense of lack of accomplishment, and cynicism and detachment; safety; and leadership at their local peak time of COVID-19. Burnout was assessed using the Mini Z survey.
CV professionals who reported burnout were:
- more likely to report experiencing disruptive economic consequences during the pandemic, reduction in salary, and lack of personal protective equipment (PPE)/providing direct in-person care without adequate PPE;
- less likely to report that their health care organization leadership provided support for health care workers’ basic needs, child care needs and emotional needs, or honored dedication and sacrifices in a meaningful way;
- less likely to report that their organizational leadership took appropriate steps to protect health care workers, provided timely information to keep them informed, prepared them to effectively perform duties, and listened and understood health care workers’ needs and concerns; and
- less likely to agree with statements that their work is meaningful to them, that they feel worthwhile or happy while at work or feel in control when dealing with difficult problems at work.
Moreover, those who reported burnout also felt less connected and less empathetic with colleagues, and less connected and less interesting in talking with patients.
‘Improving the work environment is essential’
The current stressors experienced by survey respondents also highlighted negative consequences to the cardiology workforce.
CV professionals who reported burnout were far less likely to recommend a career in medicine to students seeking their advice than those who were not burned out.
Those who reported burnout were more likely to report plans to leave their current practice setting (20% vs. 10%), reduce clinical work hours (31% vs. 19%) or retire early (22% vs. 9%) than those who did not report burnout. The COVID-19 pandemic influenced the decision to leave practice for 12% of respondents, reduce clinical work hours for 17% and retire early for 11%.
“The impact of clinicians leaving practice or the profession is profound and is a concern given the current shortages of caregivers, the increased demands in care of acute patients, and the added burden of taking care of child and elder care, and then the rapid aging of our society and having a lower age workforce,” Mehta said.
Mehta noted several limitations of the current study, including its response rate of 13%. The researchers also acknowledged potential for bias to completing the survey in those who were burned out or stressed, compared with those who were not. Also, burnout was self-reported and may vary over time.
These new results come on the heels of 2019 survey data from the ACC, which found that the prevalence of burnout in cardiology increased by 32% since 2015, especially among women and mid-career cardiologists, despite efforts to alleviate job-related pressures. The increase in the prevalence of burnout was 90% from 2019 to 2020.
“Improving the work environment is essential to promote well-being and in turn preserve the cardiovascular workforce,” Mehta said.
More information can be found on the ACC’s Clinician Well-Being Portal: www.acc.org/ClinicianWellBeing.
- Reference:
- Mehta L, et al. Featured Clinical Research II.
Perspective
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Doreen DeFaria Yeh, MD
This was a survey of ACC members highlighting there has been an increase in perceived rates of burnout among cardiologists, fellows and members of the CV team compared with before the peak of the COVID-19 pandemic. The study spotlights areas of frustration and burnout in the workforce that were particularly heightened during the pandemic. These include concerns about disruptive economic sequelae, PPE and the lack of in-person connection. These sentiments were more prevalent in those concerned about burnout than in others.
This is an important study that highlights what many of us know: 2020 was a very hard year, and it is hard to ignore how the pandemic impacted how people in the workforce feel, and how they are handling the challenges emotionally. This is not a topic that has been at the forefront of our scientific sessions, but it certainly deserves conversation and recognition.
If a cardiologist, fellow or member of the CV team is feeling frustrated or burned out, that should initiate a conversation among their group and among leadership. Consideration should be given to how things in the microenvironment could be changed and addressed, but it should also prompt reflection on how we can change the macroenvironment. Starting the conversation at a national meeting is a great step, but it may not go anywhere if it is not continued in our local institutions and communities and among smaller groups.
A number of resources have become available through ACC, including the clinician well-being portal on the colleges website. During the pandemic, many institutions have recognized that providing resources around mental health support and support for other challenging circumstances, such as child care, that can make work life more difficult is important.
Some people may not come to their leaders if they feel burned out, so recognizing the signs is also crucial. Someone who is burned out may be withdrawn, may not participate in community activities or working groups, may not help create new ideas and may not help make changes in an organization. These are signs people may be feeling frustrated or just tired and overwhelmed. Leaders need to be actively vigilant in screening for or being aware that members of their team may be experiencing symptoms of burnout.
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