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There’s no question that the healthcare professions have undergone a sea of change recently. Patients today are more skeptical of their doctors and care providers than ever before, and they also have greater agency over their choices. They often view their providers as partners in their care, rather than omniscient beings who have all the answers. The COVID pandemic heightened awareness of many of the challenges that healthcare professionals deal with, but on the flip side provided solutions to ongoing problems.
We gathered thought leaders from several health care disciplines for a roundtable discussion advising future professionals on how to deal with the rapidly changing landscape. Here’s what they had to say.
The pandemic placed a tremendous burden on healthcare systems and public resources, generating emotional loss, tragedy, and trauma for millions of professionals and patients. Moreover, the pandemic’s toll proved to be unnecessarily deadly for certain communities— including minority groups and populations of color—highlighting endemic social inequities and failures in health messaging, resource distribution, and outreach. These deficiencies, along with other factors, only perpetuated a growing distrust of the medical establishment.
Janani Krishnaswami, MD, MPH, advises doctors to take an empathetic, inquisitive approach when communicating with patients: “Often, individuals and communities have legitimate, deeply held beliefs and experiences that inform their distrust of medical professionals. But there are paths forward to begin to rectify past harms and overcome distrust. First, really listen to people’s stories. Go back to the foundation of empathy: putting yourself in someone else’s shoes, really working to see things from the other person’s perspective. Avoid arguing or trying to ‘correct’ a person’s point of view, which can be seen as paternalistic. Instead, making an effort to listen can create effective communication channels in which both parties can learn from one another and an opportunity for clearing up misconceptions naturally emerges. Also, compartmentalization is essential: a patient’s mistrust or unpleasant words are really not about you as a person, but represent a bigger emotional and historical picture. Not only will you see patients who push your buttons (as a result of your own personal and emotional history), but you’re also going to see tragedy and unfairness—things that should never have happened.”
Empathy isn’t just a tool for patients; it’s also for medical providers. The adage that you need to take care of yourself before you can take care of others is absolutely on point regarding burnout in the profession. Dr. Krishnaswami said, “Healthcare has always demanded a high bar from professionals, taxing emotional, mental, and intellectual reserves. In recent years, this challenge has intensified to new heights. It’s essential to learn and regularly practice concrete methods to decompress and relax. Even if it’s just for 10 or 15 minutes daily, it strengthens your resilience and ability to cope with inevitable stress. Think of it as the mental equivalent of training in the gym. Examples include practicing mindfulness or meditation, conscious deep breathing, meditative listening to music, or immersing oneself totally in an enjoyable hobby. Also, take time off when you can, and practice the same healthy lifestyle habits you would want your patients and loved ones to adopt (eating nourishing foods, exercising, sleeping restfully, refraining from relying on substances for stress relief.) You could jeopardize patient safety, and your own well-being, if you don’t properly take care of yourself.”
Burnout has been an issue for physicians and nurses for years now, but the pandemic heightened an already difficult situation for many hospitals and providers. Andy Ortiz, senior vice president of human resources at Cedars-Sinai, said, “Preventing burnout is key to the future of healthcare. Caring is at the heart of what we do at Cedars-Sinai, and this starts with caring for the well-being of our own people. What healthcare workers worldwide have experienced in responding to this pandemic has been overwhelming and at times traumatic. It remains more important than ever that we help our employees and staff in taking care of themselves as they continue saving lives and caring for others.”
Cedars-Sinai recognized early on that they needed to bolster employee support during the pandemic, so they implemented programs that addressed a variety of issues: free access to mental health counselors, reimbursements for child and elder care, hotel accommodations for frontline staff, and paid leave for employees with COVID symptoms. They also offered meditation sessions for interested employees, and have repurposed old linen closets into Zen rooms for short mental health breaks.
Dr. Krishnaswami advises physicians to be more empathetic towards patients for personal reasons as well. “Showing empathy is good for you as well as your patients. It assists you in building a strong relationship with your patients and promotes a feeling of fulfillment as a physician, which in turn lowers your risk of burnout and fatigue. Remember that people are at their most vulnerable when you’re caring for them. It may be your everyday job, but it can represent a major emotional and mental struggle for them.
A recurring theme among our roundtable participants was that, regardless of specialty, physicians had to provide a much higher level of emotional support to patients during the pandemic. Although it does seem counterintuitive in an environment where patients held so much distrust for the medical profession, they did trust their care providers more than usual for mental health issues.
Pediatrician Nicholas Rister put it this way: “Doctors quickly had to take on a much bigger emotional support role during the pandemic. Building a relationship of trust and transparency was more key during this period than ever before. I often spent more time sitting down with a family and figuring out their options than I did dispensing strict medical advice. No one knew what would happen in the coming months—and we still don’t, yet—and this required medical staff to really become quasi-counselors in the hospital setting. Building a relationship of trust and transparency was more key during this period than ever before.” As we move into a less acute stage of the pandemic, Dr. Rister said, “Doctors must stay sensitive to parents’ worries, especially in times of ambiguity or medical uncertainty, and seek ways to provide a listening ear and emotional support.”
La’Quisha Colby, APRN, FNP, notes that despite the advancements in diagnostic technology in recent years, physicians and other healthcare providers should always include their patients in formulating treatment plans. “A patient’s feedback and individual experience can be a tremendous asset to the medical profession. Feedback starts the first moment you begin interacting with your patients. Enhance these interactions by actively listening and taking detailed notes during each visit. By following this technique, the provider can assess how the patient feels about their overall experience with the practice early in the encounter instead of waiting for the after-visit survey.”
Another bit of post-pandemic insight, according to Dr. Paul Pourhassani, DO, is the importance of building strong relationships with colleagues. “The pandemic has shown us that regularly connecting with other physicians and building out your professional network can be a long-term benefit that will help you tap into their expertise and advice in many different areas. This can help you improve the overall health of the patient.”
Dayne Hollmuller, PA-C, CAQ-Psychiatry, chimed in to say that even experienced clinicians benefit from being lifelong learners and educators. “It is always smart to view every clinical and professional encounter as an opportunity for learning and growth. Situations will arise with patients that you may have never encountered before, and each one presents the opportunity to approach care in a new way. It is through strong, open lines of communication with our clinical colleagues that we are able to pass along what we have taken from these learned experiences, which ultimately benefits the entire clinical practice team.
Medicine has not been immune to “The Great Resignation,” as medical professionals have left their positions for a variety of reasons. Roundtable participants had career-related concerns, and they also offered some shared advice based on their professional experience. Dr. Pourhassani had this to say about second-guessing your career. “You should always be passionate about the specialty you have chosen to go into. If you find your passion is pointing you in a different direction, consider switching specialties or roles. This could ultimately help you find more personal fulfillment in your work and improve the level of care you can provide to your patients.”
Finally, the roundtable participants collaborated on this advice for anyone considering a career in medicine.
Medicine as a profession is changing as rapidly as the research and technological advances that are improving outcomes. Recognizing that interpersonal interactions can be just as important as the data is a critical step towards success.
Dr. Janani Krishnaswami, MD, MPH, is board-certified in preventive medicine, internal medicine, and lifestyle medicine. She serves as a content author for UWorld’s online tools to prepare for medical exams, practices medicine at Academic Medical Associates and serves as a medical consultant and physician for Medici LLC, and Lin Health. She can be reached at [email protected] or found on LinkedIn here.
Andy Ortiz is senior VP and chief human resources officer at Cedars-Sinai in Los Angeles. He has a BA in Speech Communication, an MA in Organizational Leadership, and additional certifications in healthcare management.
Nicholas Rister, MD is a pediatric infectious disease specialist and is board certified in both fields. He participates in annual mission trips to Belize to provide primary pediatric care to rural regions of that country.
La’Quisha Colby, APRN, NP, is a nurse practitioner in Irving, TX. She is certified in family care and practices in Irving, TX at Academic Medical Associates.
Dayne Hollmuller, PA-C, CAQ-Psychiatry is a certified physician assistant and practicing psychiatric provider.