Year 2020 has been remarkable for our frontline workers in the medical fraternity. As the pandemic continues to rise, our doctors, nurses, carers and paramedics around the world are facing an unprecedented workload in overstretched health facilities, and with no end in sight.

The pandemic has taught us three critical things. First, the economic cost of physician burnout. Second, getting used to the new normal, which has impacted everyone, including the doctor’s life and family that has also had to change. Third, as said in the words of Amy Edmondson at the Harvard Business School, “Psychological safety at work takes effort.”

Physician’s burnout costs

Physician burnout costs the US healthcare industry $4.6 billion a year but there are no such studies from India. There is a huge population explosion and the doctor–patient ratio in the country is dismal, especially in the North-East and rural areas. Outpatient load is further compounded by the inpatient load, attending to emergencies, looking after the administrative responsibilities, etc.

Further, if the doctor is a trainee or a teacher/supervisor, they have the additional load of academics, teaching, and supervising the academics. This is further compounded by medico-legal issues, different laws governing the medical profession, and violence against medical professionals.

A report by WHO titled “The State of the World’s Nursing 2020” calls for urgent investment in nurses. Nurses account for over half of all the world’s health workers, providing vital services throughout the health system. There is a need amongst countries who are experiencing shortages to increase the total number of nurse graduates by on average 8 per cent per year, along with improved ability to be employed and retained in the health system.

It is important to note that physicians, nurses and paramedical staff have taken major life decisions of working in stressful work environments, not just because the virus is little understood, but because in most settings they are under-protected, overworked and themselves vulnerable to infection. They are staying away from family to ensure the infection is contained and not spread. They moved into unfamiliar clinical areas, joined new rotations at short notice, and covered gaps created by the pandemic. They have left other roles in research and education to help with the clinical efforts, increased working hours. Teaching programmes and learning opportunities are yet to restart. There lies an underlying need for employing trusts, local education and training boards, specialty societies, and colleges who embrace technological solutions to continue the engagement.

One of the notable trends of the new normal scenario has been that your “Doctor is online”. As a neonatologist, I notice, parents no longer had to take time off work or find transportation to get their children to an appointment. “I’m asking questions and answering questions,” seeing kids in their homes and with their families.

It feels like a very complete visit. The pandemic taught us that tele-consultations are the new normal and we as doctors have made full-scale transition to it.

Preserving mental health

Finally, it is important to understand that healthcare workers are not just treating a flood of critically ill patients during the pandemic, at the same time they are risking their own health, witnessing higher rates of death and experiencing acute stress that could lead to mental health issues. And the concern to be addressed is to provide therapeutic support for our doctors.

The writer is Founder Chairman and Neonatologist, Cloudnine Group of Hospitals, Bengaluru

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