‘Not expected, but not surprising:’ Amid pandemic, many family physicians are lonely
The COVID-19 pandemic is “taking an emotional toll on family physicians,” according to researchers who created and implemented a small survey in Kansas.
“Loneliness has been deemed as a public health issue,” Samuel Ofei-Dodoo, PhD, MPA, MA, CPH, an assistant professor and director of residency research in the department of family and community medicine at the University of Kansas School of Medicine in Wichita, told Healio Primary Care.
He said a study in the Harvard Business Review found that physicians are among the professions with the highest rates of loneliness, but “little is known about the link between loneliness and other types of emotional distress (eg, burnout, depressive symptoms and fatigue) among family medicine physicians.”
Ofei-Dodoo and colleagues administered an online survey to 248 family physicians between May 22, 2020, and June 25, 2020. Among them, 113 responded to the survey, yielding a response rate of 45.6%.
The mean length of the respondents’ clinical experience was 16.7 years, 80.5% had provided care for presumptive or confirmed COVID-19 cases and about half of all respondents were men. All survey takers were asked questions about personal COVID-19 exposure, patient volume and, using the Maslach Burnout Inventory as guide, personal symptoms of burnout, depression, anxiety and stress.
The researchers wrote in the Journal of the American Board of Family Medicine that among all respondents, 50.4% met the Maslach Burnout Inventory’s criteria for burnout, with symptoms significantly higher in those who cared for presumptive or confirmed COVID-19 cases compared with those who did not.
“Finding that loneliness was associated with emotional distress (burnout, depressive symptoms, and fatigue) among family medicine physicians was not expected but not surprising to us,” Ofei-Dodoo said in the interview. “Another unexpected finding was that family medicine physicians with additional years of practice were less likely to consider themselves lonely.”
The latter finding may stem from the transition among younger physicians from training in groups to working in clinical settings that offer fewer opportunities to connect with colleagues, according to Ofei-Dodoo.
He encouraged family medicine physicians experiencing burnout to engage in various activities, including finding opportunities for “meaningful connections with other physicians” and “meaning in work,” like those offered by Balint groups. Other strategies to reduce burnout include exercise and mindfulness activities, healthy eating and “connecting meaningfully with family and friends,” Ofei-Dodoo said.
Other survey findings included:
- 66% of respondents reported seeing fewer patients as the pandemic progressed, 31% saw about the same number of patients and 3% saw more patients; and
- 83% expressed concern that some of their patients may be forgoing routine or acute medical care due to fears of COVID-19 exposure.
In addition, on a scale of 0 to 10 — with 10 indicating “very concerned” — the median level of concern among physicians about personally being exposed to COVID-19 was 5, while their median level of concern about exposing family members was 6.
“Data can help drive initiatives at local, state and national levels to help diminish the negative impact of the COVID-19 pandemic on physicians,” the researchers wrote.
Perspective
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The response rate to the survey Ofei-Dodoo and colleagues sent out is typical of online surveys. If it had been sent out to more people, the percentages might have been a bit lower. Even when many physicians are assembled, everyone is focused on managing their team, focusing on their screen and finishing out their notes, making the loneliness part of the Ofei-Dodoo paper quite interesting.
The use of scribes may help primary care clinicians reconnect with their work and their colleagues. Another thing that may also help doctors make social connections are social events and other gatherings (eg, book clubs, running teams). These types of events eroded with the COVID-19 pandemic, but it would be great to see these types of gatherings return.
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