HJNO Sep/Oct 2020

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2020 47 patients’ needs, and with COVID-19, help- ing them survive, is gratifying and stimu- lating. This is what we do best. However, the system (national, public health) has contributed to frustrations because it was not, and is still not responding adequately to the crisis.” Since the beginning of the COVID-19 pandemic, physician burnout has become a more important challenge than ever. Louisiana physicians are working tire- lessly to help patients manage skyrock- eting anxiety levels, while simultaneously trying to manage their own. Those on the front lines are concerned about carrying COVID-19 home. Some physicians, work- ing amid shortages of protective gear, have chosen to limit in-person contact even with family members, who are a valuable source of solace and support. Physicians are deeply concerned about their significant loss of control, which is a huge driver of burnout. Frontline physi- cians are taking care of patients with a very contagious, deadly virus, often without ap- propriate personal protective equipment (PPE), and are being asked to work longer hours. Due to social distancing, many phy- sicians are not able to see patients in clinic settings unless it is something emergent. Others are learning how to provide tele- medicine care, along with all the rules and regulations that go along with that emerg- ing resource. A terrible history in getting effective testing up and running, not enough per- sonal protective equipment, and certainly in the beginning, confusing and contradic- tory messages from national leadership have contributed significantly to the frus- trations of physicians. Although physicians strive to always put patients first, other issues often get in Jim Pittman Executive Director Orleans Parish Medical Society (OPMS) the way, such as prior authorizations, costs of drugs, co-pays, high insurance deduct- ibles, formulary exemptions, malpractice risks, and private equity, leading to deeper frustration and burnout. Though Louisiana physicians may make an array of life-saving health decisions daily, their career is inherently risky. Their professions come with unique mental and physical occupational hazards, from dan- gerous pathogens and hostile patients, to demanding workloads and high-stakes decision making. The COVID-19 pandemic in our state has only multiplied those dai- ly challenges, and the occupational stress that comes along with them. “So, if you want to relate all these chal- lenges to physician burnout, it is the failure of the system to provide the organization and structure physicians need to care for their patients,” said Dr. Rigamer. In August 2018, Dr. Rigamer presented a CME event for Orleans Parish Medical So- ciety (OPMS) and Jefferson Parish Medical Society (JPMS) members titled Provider Well Being – Burnout Strategies for Suc- cess, hosted by OPMS, JPMS, and LAMMI- CO. This was a first attempt by the medical societies at helping Louisiana physicians to manage or potentially avoid burnout. More recently, in focus groups with New Orleans area physicians conducted by OPMS and JPMS in the Fall of 2019, physi- cian burnout was a concern that rang loud and clear. Now, the two societies want to help address issues causing and fueling physician burnout—including time con- straints, technology, and regulations—to better understand and reduce the chal- lenges physicians face. In an effort to continue to meet the ever-changing needs of Louisiana physi- cians, especially those resulting from the COVID-19 pandemic, OPMS and JPMS are exploring sponsorship of new programs and services to help physicians experi- encing burnout, or those trying to avoid the syndrome. The societies hope to focus on factors causing burnout at the system level, assess well-being, and offer guidance and targeted solutions to support physi- cian well-being and satisfaction. Most likely, until the need for social distancing subsides, OPMS and JPMS will look to online education and telehealth to help physicians and residents cope with the challenges of burnout. The organizations are now exploring best practices and solutions, and would like to begin introducing them in the fourth quarter of 2020. n “When physicians believe they are not able to give their patients the care they need, they feel guilty and frustrated,” said Elmore Rigamer, MD, MPA, medical director for Catholic Charities Archdiocese of New Orleans, practicing psychiatrist in the Mercy Health System, and consultant with LAMMICO on physician health issues.