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We must create culture of medicine that values health, well-being of workforce

May 1, 2021

Pediatricians have battled changes in practice and caseloads, financial shortfalls and challenges associated with caring for adult patients during the COVID-19 pandemic.

A recent survey conducted by Medical Economics found that half of physicians reported financial concerns, and 65% reported increased burnout due to the pandemic (

The stress of these burdens and the uncertainty of what the future may hold for the profession have created anxiety and distress, as well as ramifications for health care delivery.

Understanding and accepting how our distress or that of our colleagues may manifest plays a critical role in addressing what may be our new normal.

This distress can be attributed to moral injury, which has been described as “the challenge of simultaneously knowing what care patients need but being unable to provide it due to constraints that are beyond our control” (Dean M, et al. Fed Pract. 2019;36:400-402). Distress may manifest as anxiety, depression, loneliness, imposter syndrome, compassion fatigue and posttraumatic stress disorder.

During a webinar titled It’s OK Not to Be OK: Physician Burnout and Mental Health (, the National Institute for Health Care Management Foundation shared recent data and expert perspective on why physicians are experiencing even greater levels of stress and burnout. A survey of 12,339 physicians from more than 29 specialties conducted from August through Nov. 5, 2020, found that 20% had symptoms of clinical depression and 13% reported suicidal ideation (Medscape National Physician Burnout & Suicide Report 2021,

It is more important than ever that we evaluate ourselves and support our peers and mentors. We must notice, encourage and support each other in times or experiences of distress. While the signs may be subtle, colleagues who work closely together are well-poised to notice changes and can make a difference by approaching the person with open-ended and caring, supportive conversation.The feeling of distress, anxiety, depression, burnout and compassion fatigue are not unique to one physician.

Communicating with transparency, listening with empathy and avoiding normalizing our experiences as rare and exclusive can be important strategies for reaching colleagues.

The Federation of State Physician Health Programs supports physicians struggling with physical or mental illness (see resources). Physicians can either be referred to these programs or self-refer for confidential treatment. Previously, mental health programs often focused on physicians with substance use problems, but some states are broadening the scope of their support.

We all have a role to play in reducing stigma about the need for help. If we cannot acknowledge our own need for help, how can we support families who desperately need our help?

In health care organizations as well as interactions with our colleagues, we have the responsibility to create systems of peer support and garner access to health and well-being services for our staff and colleagues. We must emerge from these challenges by creating a culture of medicine that values the health and well-being of our workforce. It is critical in the context of COVID-19 and the ongoing uncertainties we are facing to embrace this culture of wellness.

Dr. Tait is AAP chief medical officer and senior vice president.

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