Increase in COVID-19 Cases May be Leading to Clinician Burnout

Hospitals across the U.S. are experiencing nearly twice as many COVID-19 patients as last winter. Coupled with clinician staffing shortages, the situation is leading to increases in provider burnout. 

“I think all clinicians in the country are tired. Last year the volumes in the hospitals had decreased as people were afraid of going to the hospital, and now volumes are back, and people who are vaccinated feel comfortable going to the hospital for non-COVID-related illnesses. On top of that volume, you now have the surge volume, which is causing a significant strain on our clinicians,” said Dr. Mansoor Khan, senior vice president at Envision Healthcare, a leading national medical group headquartered in Nashville, Tennessee. 

To address the shortage, Khan and his team established ENVOY which currently consists of 400 multi-specialty clinicians from across the country able to be deployed to any facility which might have staffing shortages.

By the end of 2020, Khan and his team had deployed 500 clinicians to eight states hit hardest by the pandemic, including nearly 200 in New York and New Jersey, close to 300 in Florida, over 80 in Texas, and the rest sent to Arizona, Colorado, Kansas and Kentucky.

Now, Khan and his team are working to deploy about 130 clinicians to address the surge in COVID-19 cases and hospitalizations happening in Texas and Florida, a majority of which are hospital medicine clinicians and emergency medicine doctors trying to help sick patients in the ICU.

“There’s a direct correlation between surges and shortages,” said Khan. 

Florida, Louisiana, and Texas are recording hospitalization rates at least twice as high as any other health region, according to data from the Centers for Disease Control and Prevention.

“There’s only a finite number of clinicians and you can’t just have anyone fill in, there’s a lot of training and education that goes into making clinicians what they are. When everyone is tapping into the same pool, that in itself causes issues,” said Khan. 

Khan said getting those clinicians into the facilities that need them is difficult, as there are different requirements for licensing and credentialing in each state. 

However, he said that due to COVID-19 hospitals realized the need to expedite the credentialing process for deploying physicians to quickly address the shortages in hospitals inundated with sick patients. 

“The normal [deployment] process would take 3-4 months, but now we can do it in about a week. In some instances, we streamlined the credentialing process, which enabled us to deploy providers overnight to sites,” said Khan. 

It’s not only in the U.S. that Khan and his team are working to provide assistance, but through their Disaster Assistance Response Team, also known as DART, they’ve begun to deploy clinicians to other disaster areas in places like Honduras or the Dominican Republic.

While Khan has successfully deployed clinicians to sites in need since the start of the pandemic, he said that the problem of provider burnout is still a challenge once they have arrived. 

“In normal circumstances, a hospitalist takes care of 20 patients, and now they may be taking care of 40. We take pride in providing quality care and taking care of an overwhelming number of patients can make that challenging,” said Khan. 

That’s why Khan and his team are working to ensure that the providers they deploy have the resources they need to overcome mental health challenges associated with surges and shortages. 

The group has worked to provide resources, including free therapy with licensed professionals, peer-to-peer support groups, advocating for a regulatory environment that eliminates the stigma of addressing mental health in care providers, and providing mandatory debriefs following deployment to a COVID-19 hot spot. 

“As clinician leaders, we stay close to our clinicians on the ground, to see how everyone is doing. It takes a toll, and we have clinicians we’ve had to send home who broke down,” said Khan.