A New Normal for Healthcare Providers

“Insanity is doing the same thing over and over again and expecting different results.”

-Attributed to Albert Einstein

I was talking to a fellow physician the other day as she finished a long work week of COVID infection control measures, ZOOM meetings, and feelings of isolation. “I can’t wait until everything just returns back to normal,” she said. I smiled and replied, “Do you really want to return to what was ‘normal’ for us”?

The COVID pandemic has taught us that, as medical practitioners and healthcare institutions, we can’t return to the “normal” of the past and expect a different outcome. 

According to the Medscape Annual Physician Burnout Report for 2020, all indicators of physician burnout and mental illness went from bad to worse over the last year, especially for female physicians. Factors cited include lack of adequate personal protective equipment, grief from losing patients, watching families suffer, long hours, and difficult working conditions. “One tenth considered it severe enough to consider leaving medicine,” survey authors write, “an unexpected outcome after having spent so many years in training to become a physician” (Medscape – Jan 25, 2021).  

Holding healthcare providers on pedestals as heroes only intensified the pressure to strive for perfection, even at the cost of our own physical and mental health.

Elective surgeries and procedures that maintain healthcare’s narrow profit margin stopped completely as we all scrambled to find the space and equipment to care for skyrocketing numbers of critically ill COVID patients. 

Primary care providers in small towns and rural areas had to lay off their staff, use their retirement savings or take out loans to keep their practices afloat. Many ended up closing their offices completely due to decreased patient visits.  

Getting “back to normal” is neither desirable nor possible after the trauma we have all experienced and continue to experience as a result of pandemic.

What we need is a new normal, which values medical providers as essential contributors to society, and honors their common humanity–by supporting their physical, emotional, and spiritual well-being. 

Let’s shift the culture of medicine from “self-sacrificing superheroes” to “committed, fully human practitioners.” Let’s nurture and sustain realistic expectations, with the mutual respect and support of individual providers, healthcare organizations, and society at large. 

According to Dr. Eileen Barrett who lost a medical colleague to suicide, “It’s time we step back from the notion of resilience as an individual trait and see it as an attribute of an organization and honor the belief that we can reshape the culture from within. It’s far past time to examine the ways in which we used the concept of ‘professionalism’ when we meant ‘conformity.’…We may be fated to endure significant hardship in the coming months, but we needn’t contribute to our own oppression. We can’t simply accept being chained to the cliff, hoping we can regenerate enough of ourselves overnight to endure another day.” (JAMA. 2020;323(22):2235-2236. doi:10.1001/jama.2020.5205)

Here are some suggestions on how to create your own new normal.

Individual Clinicians

• Develop well-being routines that work for you, including adequate sleep, exercise, mindfulness practices, exposure to nature, restorative time with family and friends.
• Work with a coach, mentor, counselor, or peer group to help discern what brings you joy in your work and what drains you. This can provide a foundation for self-advocacy with leadership.
• Reach out to colleagues who are facing similar challenges, to support each other in prioritizing well-being and healthy boundaries at work.  

Healthcare Institution Leaders

• Implement some of the recommendations made by institutions such as the National Academy of Medicine’s Taking Action Against Clinician Burnout or the Institute of Healthcare Improvement’s Guide to Promoting Healthcare Workforce Well-being During and After the COVID-19 Pandemic. Both organizations have done extensive research into documented effective methods to promote provider well-being.

How do you want to create your own new normal as a health professional?