Views from the trenches: California family physicians’ challenges and resilience factors while providing patient care during the initial wave of COVID-19

Abstract

This study examined challenges and factors promoting resilience among 20 California family physicians (FPs) during the first six months of the COVID-19 pandemic. A subset of academic, community, and resident FPs who responded to an online survey also participated in a semi-structured interview that explored concerns, moral distress, burnout, resource needs, support systems, coping strategies, and motivation to continue caring for patients. Thematic analysis was used to identify common themes in participant interviews. Interviewees demonstrated adaptability, resilience, and grit (i.e., commitment to completing a valued goal in the face of setbacks and adversity) despite challenges disrupting patient care, fears for family and self, and frustration due to the politicization of the pandemic. Factors promoting well-being and perseverance included professional and personal support, strong coping skills, and focusing on the meaning derived from practicing medicine. A service orientation that permeates family medicine philosophy and values motivated practitioners to continue to provide patient care while dealing with overwhelming personal and structural challenges. FPs drew strength from their internal coping skills, core family medicine values, and external support, notwithstanding demoralizing effects of mixed messages and politicization of the pandemic. FPs demonstrated resilience and grit in the face of challenges created by the COVID-19 pandemic. Ensuring adequate resources to promote a physically and psychologically healthy workforce while increasing access to care for all patients is crucial to prepare for the next healthcare crisis.

Factors associated with cognitive impairment and the quality-of-life among COVID-19 survivors working as healthcare workers

“…A previous study, predominantly involving doctors as participants, found that most respondents reported a significant increase in stress levels during the pandemic [33]. However, higher resilience was linked to reduced stress, anxiety, fatigue, and sleep disturbances, indicating that greater resilience and grit served as protective factors against personal and systemic stressors during the COVID-19 pandemic [33,34]. The MoCA scores reveal mild cognitive impairment across the group, with particular deficits noted in the language domain.…”

Female Family Medicine Physicians Especially Prone to the Effects of Moral Distress on Burnout During the Initial Wave of the COVID-19 Pandemic in California

“…3 These themes were echoed in the present study and in the interviews performed with a subset of 20 respondents. 22 Strengths and Limitations:…”

“…20 Factors hypothesized in our study to contribute to providers' moral distress during the pandemic were based on the research team's experience, literature review 2,13,20,21 and our initial pilot interviews. 22 Identi ed factors were inadequate resources, working under conditions that posed risk to providers' and their families' lives, restricting patient visitors during end-of-life care, limited availability of personal protective equipment (PPE), and providing only virtual patient visits that might compromise quality of care. 20 As early as medical school, health professionals who experience higher moral distress tend to become more burnt-out.…”

“It’s real. It’s a thing:” Mental health counselors’ listening exhaustion during COVID-19

“…In turn, burnout leads to poorer client and provider outcomes, facilitating conditions for MHPs to exit the profession (Delgadillo et al, 2018 ). The COVID-19 pandemic further exacerbated the strain on healthcare workers, including MHPs (Fischer et al, 2022 ).…”