Impact of the COVID-19 Pandemic on Clinical Practice and Work–Life Integration Experienced by Academic Medical Faculty

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Stephanie Garner
Sonia Anand
Natalie Campbell
James Douketis
Mimi Wang
Shamir Mehta
Patricia Liaw
MyLinh Duong

Keywords

Abstract

Introduction: Before the COVID-19 pandemic, reported physician burnout was endemic in North America, with rates as high as 51%. The pandemic placed an increased demand on physicians’ time both in their work and home lives. We sought to identify the frequency of burnout in a large academic institution and its impact on clinical practice, non-clinical work, and home life.
Methods: All academic physicians and non-physician faculty members in the Department of Medicine (DOM) at McMaster University were invited to participate in an anonymous survey between January 22 and February 21, 2021. The survey elicited information on how clinical practice, work, and home life changed throughout the pandemic. Responses to questions were captured on a 1-to-5 Likert scale. Descriptive statistics were calculated and the Mann–Whitney U-test was used to determine statistical significance (p < 0.05). The results were compared to the 2019 DOM survey which included a question on burnout.
Results: Among 330 faculty, 76.7% completed the survey. The reported burnout was high at 75.9%, affecting women to a greater extent than men (82.5% vs 70.4%, p < 0.01). Early career faculty also reported proportionally more burnout (83.5% vs 65.7%; p < 0.001). Medical-legal liability of phone-based care was a concern for 48% of physicians. The reported hours of work per day were significantly higher amongst women than men compared to pre-pandemic (80.4% vs 58.0%; p < 0.001). Loneliness (64.1% vs 51.4%; p < 0.05) and hours spent on caring for dependents (54.5% vs 31.1%, p < 0.01) were higher for women versus men. Both genders reported career fulfillment and research productivity were overall lower by 51.2% and 52.3%, respectively.


Conclusions: The COVID-19 pandemic has increased burnout amongst DOM academic faculty, and disproportionately affected women and early career faculty. A thoughtful systems-level approach, with dedicated resources, is needed to address the impact of the COVID-19 pandemic on medical faculty.


Résumé
Introduction: Avant la pandémie de COVID-19, l’épuisement professionnel des médecins était endémique en Amérique du Nord, les taux de déclaration atteignant 51 %. La pandémie a exercé une pression accrue sur le temps des médecins, tant dans leur travail que dans leur vie privée. Nous avons cherché à déterminer la fréquence de l’épuisement professionnel dans un grand établissement universitaire et ses répercussions sur la pratique clinique, le travail non clinique et la vie privée.


Méthodologie: Tous les médecins universitaires et les membres du corps professoral non-médecins du Dépar-tement de médecine de l’Université McMaster ont été invités à participer à un sondage anonyme qui s’est tenu du 22 janvier au 21 février 2021. Le sondage a permis de recueillir des renseignements sur les changements survenus au cours de la pandémie en ce qui a trait à la pratique clinique, au travail et à la vie privée. Les réponses aux questions ont été consignées sur une échelle de Likert de 1 à 5. Des statistiques descriptives ont été calculées et le test U de Mann-Whitney a été utilisé pour déterminer la signification statistique (p < 0,05). Les résultats ont été comparés à ceux du sondage mené en 2019 auprès du Département de médecine qui comporte une question sur l’épuisement professionnel.


Résultats: Parmi les 330 membres du corps professoral, 76,7 % d’entre eux ont répondu au sondage. Les déc-larations d’épuisement professionnel sont élevées à 75,9 %, et les femmes sont touchées dans une plus grande mesure que les hommes (82,5 % contre 70,4 %, P < 0,01). La proportion de déclarations d’épuisement professionnel est également plus élevée chez les membres du corps professoral en début de carrière (83,5 % contre 65,7 %; p < 0,001). La responsabilité médico-légale de la prestation de soins par téléphone est une préoccupation chez 48 % des médecins. Le nombre d’heures de travail par jour déclaré est considérablement plus élevé chez les femmes que chez les hommes comparativement à avant la pandémie (80,4 % contre 58,0 %; p < 0,001). De la même façon, la proportion des femmes est plus élevée que celle des hommes en ce qui concerne la solitude (64,1 % contre 51,4 %; p < 0,05) et le nombre d’heures consacrées au soin de personnes à charge (54,5 % contre 31,1 %, p < 0,01). Les deux sexes font état d’une diminution globale de 51,2 % du senti-ment d’accomplissement professionnel et de 52,3 % de productivité en recherche.


Conclusions: La pandémie de COVID-19 a entraîné une augmentation des cas d’épuisement professionnel parmi le corps professoral du Département de médecine, et a touché d’une manière disproportionnelle les femmes et les membres du corps professoral en début de carrière. Une approche réfléchie à l’échelle du système, assortie d’une affectation de ressources, est nécessaire pour pallier les répercussions de la pandémie de COVID-19 sur le corps professoral en médecine.

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