By: Dr. Luis J. Rivera, Psiquatra

Psychiatrist - FHC Medical Director – MCS Provider Network

Life in Puerto Rico changed on March 15, 2020. After the first positive case of COVID-19, measures to reduce contagion with the SARS-CoV-2 virus have produced a significant burden on all medical professionals. The healthcare services field has been affected, as it works with new technological methods to manage patients, staff reductions, myths about the pandemic, the risk of exposure to the virus, and patients whose physical and mental health have deteriorated. Although these changes were the most overwhelming in 2020, they remain, and adapting to the new normal is exhausting.

Providing medical services in the office, hospitals and other scenarios during a pandemic makes the doctor’s work titanic, but can you deal with all this and continue to offer health? COVID-19 has caused burnout in many professionals. While this attrition is not a psychiatric illness, it’s not a trivial problem either, as it can deteriorate one’s physical and mental condition, create practice vulnerabilities, and even lead to ethical errors. However, it can be mitigated through self-awareness and personal and professional self-care.

The first step to self-care is to identify burnout. Once you recognize it, you can become involved in self-care activities, such as regular exercise, sleep hygiene, a healthy diet, time for family and friends, the manifestation of creativity, a commitment to a religious or spiritual life, and time spent with nature. For professional care, you can participate in peer study groups, initiatives to improve the organization, team-building activities, and other interactions related to your medical specialty.

Another important element is to make the work environment more welcoming. Activities such as learning about burnout self-awareness, setting aside time for reflection, learning and teaching technical skills, establishing mentoring programs, providing opportunities to socialize at work, and reviewing task volumes are extremely effective. In addition, it also helps to have a detailed daily agenda that includes time to rest, eat and deal with unforeseen events and personal matters, while identifying the days and hours with the greatest productivity for organizing tasks, according to the style of work and operation. Organizing appointments according to the management required for each type of patient (e.g., new, follow-up, etc.), is also a useful tool to maximize productive hours without affecting service quality and wellness.

If you must manage patients with mental health needs, it’s important to provide a sense of security, tranquility, hope, care, and compassion, while adapting communication to the person’s knowledge level and recognizing his or her priorities and preferences. If necessary, refer the patient to a mental health professional, while recognizing that not every person needs a psychiatrist, and that psychologists can attend to many mental health conditions in conjunction with a non-psychiatrist who oversees medication.

The issue of burnout or attrition in doctors is one that has taken off in recent years. However, the strategies used to manage it are already known and recommended. The challenge is to make peace with not having control of everything, in order to avoid wear and tear. Solving problems is part of training and the medical practice, and many solutions are within reach of the experience and knowledge acquired. The key is to pause, assess the pace of your personal and professional life, and consult a colleague if a second opinion is needed for both personal and patient needs.