Physician Burnout: The End or a New Beginning

Will the Covid Pandemic which started in December 2019 burn itself out in the end and assuming it does, will healthcare revert to where it was prior to what has turned out to be one of the most disruptive periods in healthcare ? 

There are various factors which point to the fact that the changes we have seen will be enduring and, in many respects, we are seeing many of them accelerate.    Considering the main factors which together with COVID could well make change irreversible :

·       A significant upsurge in activity.  Not only are we having to play “catch up” with activity which was simply not managed (like cold surgical procedures) but we are also having to cope with the effect of lack of management of existing non communicable disease as well as delays to diagnosis because of late presentations for cancer and cardiovascular diseases to name a few conditions.

·       Health Security. This was certainly not a priority pre covid but has now taken on increasing importance both in terms of developing robust surveillance on a regional , national, and supra national dimension.  We all know we will have to face more pandemics in the future and the connectivity of our modern way of life practically guarantees spread accelerating faster than our capacity to contain – hence the increased focus and resources 

·       Ageing .  this is obviously accelerating both in the population and particularly in the health and care workforce and with ageing comes multimorbidity and complexity 

·       Finance    Covid denuded the treasuries of every nation on earth and the pressure on health and care systems has increased as a result with resources now even more difficult to identify

·       The age of precision   this has two dimensions both precision medicine which puts extra pressures on an unreformed system to personalise care and precision health which is now acknowledged to be an essential constituent of the lifelong care which is applicable for people living with, or having risk factors for developing non communicable diseases

·       Workforce   Not only is this ageing but rates of burn out, early retirement and increased part time working have limited the ability of systems to react to increased demand and in some cases are already seriously restricting availability of care  

·       Sustainability. Climate change is here and here to stay, and health systems are increasingly being asked to contribute their fair share to manage unnecessary journeys and activity.  This approach is likely to accelerate and become more pressing

·       Artificial intelligence deployments which have the potential to transform care.  We merely saw the first glimmers of this during covid but are now seeing a whole multitude of these new approaches emerging and we are seeing them deployed and becoming mainstream.  There is no one who believes this trend will do anything but accelerate 

So how are we to cope with all of this change ?  What are health systems and clinicians to do in this maelstrom of change ? 

Actually, there is much that can be done and should be done now.  From better managing burnout, to deploying digital solutions which are more in line with the clinical workflows to adopting more blended approaches to managing care and prevention.   Here too we are still in the foothills, but we will address what our options are in a subsequent blog