Frontline Physician Perspectives on Their Experiences Working During the First Wave of the COVID-19 Pandemic

Abstract

Background During the first wave of the COVID-19 pandemic physicians worked on the front lines, immersed in uncertainty. Research into perspectives of frontline physicians has lagged behind clinical innovation throughout the pandemic. Objective To inform ongoing and future efforts in the COVID-19 pandemic, we conducted a qualitative exploration of physician perspectives of the effects of policies and procedures as well as lessons learned while caring for patients during the height of the first wave in the spring of 2020. Design A confidential survey was emailed to a convenience sample. Survey questions included demographic data, participant role in the pandemic, and geographic location. Eleven open-ended questions explored their perspectives and advice they would give going forward. Broad areas covered included COVID-19-specific education, discharge planning, unintended consequences for patient care, mental health conditions to anticipate, and personal/institutional factors influencing workforce well-being amid the crisis. Participants We received fifty-five surveys from May through July 2020. Demographic data demonstrated sampling of frontline physicians working in various epicenters in the USA, and diversity in gender, race/ethnicity, and clinical specialty. Approach Inductive thematic analysis. Key Results Four themes emerged through data analysis: (1) Leadership can make or break morale; (2) Leadership should engage frontline workers throughout decision-making processes; (3) Novelty of COVID-19 led to unintended consequences in care delivery; and (4) Mental health sequelae will be profound and pervasive. Conclusions Our participants demonstrated the benefit of engaging frontline physicians as important stakeholders in policy generation, evaluation, and revision; they highlighted challenges, successes, unintended consequences, and lessons learned from various epicenters in the first wave of the COVID-19 pandemic. There is much to be learned from the early COVID-19 pandemic crisis; our participants’ insights elucidate opportunities to examine institutional performance, effect policy change, and improve crisis management in order to better prepare for this and future pandemics. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-022-07792-y.

The impact of COVID‐19 on Australian clinicians' decision making in line with the principles of Choosing Wisely

“…The need for healthcare providers and clinicians to work collaboratively to enable systems that efficiently and effectively deliver patient care was highlighted during the first wave of the pandemic and is expected to remain vital beyond the pandemic (Gonzalez et al, 2022).…”

“…Such directives provided little opportunity for autonomy in how clinical teams implemented these decisions ‘on the floor’ and resulted in challenges such as under‐staffed services. The need for healthcare providers and clinicians to work collaboratively to enable systems that efficiently and effectively deliver patient care was highlighted during the first wave of the pandemic and is expected to remain vital beyond the pandemic (Gonzalez et al, 2022 ).…”

Development and Initial Psychometric Validation of the COVID-19 Pandemic Burden Index for Healthcare Workers

“…Previous studies developed new scales for HCWs to measure fear, anxiety, and stress due to COVID-19, [12][13][14][15][16] but important aspects of pandemic-specific burdens such as fatigue, 3,4,17 discrimination, 18,19 and inadequacy as a medical professional were lacking. [20][21][22] To measure the burden of the COVID-19 pandemic adequately, a comprehensive scale focused on the pandemic is needed.…”