Berks County Medical Society Medical Record Summer 2020 - 45

M e d i c a l R ec o r d F e a t u r e

Beyond burnout: Lasting effects of
COVID-19 on physician mental health
by Heather A. Wilson, MSW, CFRE, FCPP
Executive Director, The Foundation of the Pennsylvania Medical Society

B

urnout is an issue familiar to medical professionals long
before COVID-19. But the added stress of treating patients
during a pandemic has made a huge impact on physician
well-being around the country.
According to Maslach and colleagues, who first developed the
Maslach Burnout Inventory, burnout is a work-related syndrome
involving emotional exhaustion, depersonalization and a sense of
reduced personal accomplishment. In studies of both physiciansin-training and practicing physicians, rates of burnout symptoms
now have been shown to exceed 50 percent (West et. al).
There are still many unknowns when it comes to the long-term
mental health impact of treating COVID-19. We are anticipating
a number of medical professionals on the frontline experiencing
traumatic stress. Left unchecked, the traumatic experiences of
working in emergency rooms, hospital wards or intensive care
units can manifest as severe trauma/stressor-related disorders,
including acute stress disorder (ASD) or post-traumatic stress
disorder (PTSD).
The diagnostic criteria for ASD and PTSD overlap; however,
ASD is diagnosed within the first month after exposure to the
trauma. A PTSD diagnosis cannot be given until symptoms have
lasted at least one month. While rates of ASD and PTSD vary
based on the traumatic experience, survivors can show rates of
ASD anywhere between six to 33 percent within one month of the
trauma.
Post-traumatic stress in addition to an environment conducive
to physician burnout can increase a medical professional's risk for
diminished function, dysfunction and distress. Left unmitigated,
the effects of either burnout or trauma/stressor-related disorders,
such as ASD or PTSD, jeopardize the well-being and safety of
physicians in the workplace and at home.
What matters most in this situation is not necessarily
distinguishing between burnout and ASD or PTSD yourself.
Rather, understanding the potential risk and remaining aware of
possible signs and symptoms can help change the trajectory of
the distress. Both stressors can operate independently or co-exist,
exacerbating each other.

The next best step if you have concern about any emerging
signs of burnout or PTSD is to reach out to a mental health
professional. This can be through a trauma-informed counselor,
therapist, psychologist or psychiatrist who specializes in working
with medical professionals. If you are part of a larger organization,
then some viable options include inquiring with your Employee
Assistance Program (EAP), designated Wellness Officer, or
Wellness Committee or Group. Another good resource to find a
mental health professional is by referring to the behavioral health
coverage included with your medical insurance.
The Pennsylvania Physicians' Health Program (PHP) can also
help physicians and other medical professionals, including trainees,
physician assistants and dental professionals, by connecting
individuals with a list of clinicians in their area who can help
assess, diagnose and treat negative symptoms related to the
aftermath of current pandemic. To learn more, you can contact the
PHP at (800) 228-7823 or visit www.foundationpamedsoc.org/
physicians-health-program/physician-burnout-resources.
A longer version of this article originally appeared in the summer
2020 issue of Connections newsletter.
Edwin Kim, MD, MRO, is a medical director
at the Physicians' Health Program, part
of the Foundation of the Pennsylvania
Medical Society. He is also an assistant
professor in clinical psychiatry at the
University of Pennsylvania and medical
director of the Charles O'Brien Center
for Addiction Treatment, an outpatient
addiction psychiatry clinic in Philadelphia.

References
West, CP, Dyrbye, LN, Shanafelt, TD. (Mayo Clinic, Rochester,
MN; and Stanford University Medical Center, Stanford, CA, USA).
Physician burnout: contributors, consequences and solutions (Review).
J Intern Med 2018; 283: 516-529.

SUMMER 2020

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Berks County Medical Society Medical Record Summer 2020

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