BY SANDRA JACOBS, VITAL SIGNS EDITOR
Illustration by Chris Twichell
When Massachusetts Medical Society (MMS) President Carole E. Allen, MD, MBA, FAAP, met in recent months with physician members across the state, she wanted to hear directly from them about physician and patient experiences during the COVID-19 pandemic.
The dominant theme was that mental health needs had created what one member described as “a social earthquake.” Physicians, coworkers, patients, and nearly every family were affected.
The unique situation for physicians includes pre-pandemic burnout, followed by the moral injury of working without adequate protective equipment in early 2020, crushing workloads, patient suffering, ever-changing practice needs, and, more recently, workforce
shortages.
Dr. Mark Albanese
“Physicians are tired of what seems like a blindness to their plight,” says Mark Albanese, MD, medical director of Physician Health Services, Inc. (PHS). Physicians who are struggling with workplace or
behavioral health difficulties fear that the problem “is with them, not with the system,” he says. “But the challenges of being a physician predate COVID. It’s not like it became an impossible job in March 2020. It already was.”
In 2021, as Dr. Albanese was considering taking on this role at PHS, he surveyed the health care landscape and saw “a public health crisis of a lifetime.”
“As an addiction specialist, I’d been dealing with an opioid epidemic,” he says. “Now we’re in another epidemic that is COVID. Despite these challenges, I think the real crisis in health care is the health and well-being of not only physicians but really
of all health care providers.”
As MMS advocacy continues in the Massachusetts Statehouse and in Washington, DC, for policies to address physician
administrative burden, staffing shortages, and health care workers’ mental health, PHS is focused on physicians’ individual needs.
A nonprofit corporation founded by the MMS, PHS annually supports about 400 Massachusetts medical students and physicians experiencing health-related and other challenges that have the potential to impact their work. Callers receive confidential guidance
and direction toward the most appropriate and helpful resources.
In today’s climate of need, PHS has continued its physician-to-physician assistance. Dr. Albanese, a psychiatrist and addiction specialist on the faculty of Harvard Medical School, served for 25 years on the PHS Clinical
Advisory Committee before taking on his current role.
“Massachusetts physicians have access to a well-developed program that can be helpful in providing assessment and/or in recommending resources that physicians may not be aware of,” he notes. “You may end up in a monitoring relationship with PHS, or not.
Or you may take advantage of resources recommended by PHS.”
The Validation and Wisdom of “Fellow Travelers”
An informal survey of a subset of MMS district members suggested that over 85% of the small pool of physicians who responded believe the pandemic has impacted their own psychological well-being.
“Physicians are tired of hearing, ‘If only you would exercise. Or meditate,’” Dr. Albanese says. “But people already are doing that.” What resonates more, he says, is hearing from peers who are coping with the challenges of a physician’s life right now.
At a recent roundtable webinar on physician health, he was struck by “how much physicians in the online chat appreciated the dialogue around ‘self-care.’ The validation and wisdom of fellow travelers is what was so helpful.”
Workplace Challenges “Beyond Burnout and into Exhaustion”
PHS Executive Director Bara Litman-Pike, PsyD, lately sees depths of exhaustion that physicians don’t always recognize in themselves. While telehealth has provided great access equity for patients, online patient care and administrative Zoom meetings
leave some physicians drained instead of providing the boost they may receive from in-person interactions.
“We’re beyond burnout and into exhaustion,” Litman-Pike says. And the toll may be affecting trust and interactions with coworkers. Current staffing shortages, combined with exhaustion, can lead to challenging workplace behaviors, she says. In response,
on June 2 and 3 PHS is offering “Managing Workplace Conflict: Improving Leadership and Personal Effectiveness,” a two-day, in-person educational event that explores the complex relationships of the medical work environment and provides focused
feedback to improve leadership and communication skills. For more information (including comments from prior participants) and registration, visit massmed.org/mwc.
The Toll of Isolation on those Struggling with Addiction
Since its early days, addressing physician substance use and addiction as part of overall physician health has been one focus of PHS. The isolation of the pandemic “really takes a toll on the segment of the population for whom part of the treatment is
the fellowship of other people with the same addiction,” Albanese says. He also has seen relapses of people who were in decades of recovery. PHS is able to provide confidential resources, including individual therapy and peer support and assistance
in returning to in-person treatment.
How to Approach a Colleague in Need
PHS leaders emphasize the value in reaching out to colleagues who may be struggling, even in subtle ways. “It’s important to have that conversation. We owe it to each other as friends and colleagues,” Dr. Albanese says. “As doctors we know that prognosis
is better if you intervene early, whether it’s prostate cancer or diabetes or physician health.”
As a starting point, Drs. Albanese and Litman-Pike offer these suggestions for initiating a conversation with a colleague:
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It’s alright to ask someone if he or she is doing OK. “Reaching out is a good thing, not a bad thing,” says Litman-Pike. “It all comes back to connection and community.”
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Begin any conversation non-judgmentally and with empathy.
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You can start by saying, “I’m concerned enough about you as a friend to bring this up.”
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Another way to begin is to say, “You don’t seem yourself. We’ve all kept up a hard pace lately. I think it’s important for you to do something for yourself.”
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Suggest that they might benefit from talking to a therapist or someone outside of work, or say you’ve noticed he or she is replying to emails well into the evening or seems very focused on wine.
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Have a low threshold for suggesting that PHS can be a resource.
While PHS resources are for physicians, Dr. Albanese suggests reaching out to any co-worker who may be struggling with workplace challenges or other individual needs.
“We’re all working very hard. We need to be kind and compassionate to each other in health care whether it’s a physician colleague or not. And people respond to that,” Dr. Albanese says. “As physicians we need to say, ‘As committed as I am to my patients,
I also have to commit myself to my colleagues, too.’”
For an initial, confidential meeting with PHS call (781) 434-7404. To learn more about PHS, call (781) 434-7404 or email PHS@mms.org.
