COVID-19 Impacts on Frontline Physicians | Center for Healthcare Policy and Research

The COVID-19 pandemic has presented an unprecedented healthcare challenge to the world. In the United States, the healthcare and public health responses have been complicated by misinformation and political polarization.

As cases increased rapidly, initial shortages of personal protective equipment, accurate and rapid testing, and lack of effective therapeutics hampered the ability of physicians to respond to the pandemic. Testing, therapeutics, and vaccines became available fairly quickly in the U.S., but misinformation and inequities in access have continued to challenge frontline physicians. 

The COVID-19 Impacts Project examined how physicians most likely to care for patients infected with COVID-19 (Primary Care, Critical Care, Emergency Medicine, Hospitalists and Infectious Disease physicians) experienced the effects of the pandemic over time. A series of focus groups and interviews with frontline physicians in April-May 2020 informed survey development. A random sample of physicians from the AMA Masterfile was surveyed by email in four different time periods: June-July 2020, December 2020-January 2021, August 2021, and June 2022.

Listening to the voices of frontline physicians can improve responses to the ongoing pandemic and improve planning to organize safer and more equitable care in future pandemics. Attention to the wellbeing of healthcare providers is critical to the future of healthcare in the U.S.—Joy Melnikow, professor emeritus, UC Davis Department of Family and Community Medicine

The initial survey evaluated changes in practice driven by the pandemic, physician burnout, and sought input from respondents on needed changes to improve the pandemic response. Follow-up surveys evaluated changes in physician perspectives on the pandemic and physician burnout over time; physician strategies for conversations with vaccine hesitant patients, and in the third year of the pandemic, physician burnout and perceptions of workplace support.

Use of the AMA Masterfile as a sampling frame enabled comparisons of the characteristics of survey respondents and non-respondents, and weighting to insure proportional representation of sampled specialties and to adjust for non-response

A paper on physician burnout over the first year of the pandemic, suggesting rising burnout in most frontline specialties, was published in BMC Health Services Research in 2022. The research has received attention in news media as well as being cited in numerous papers, including a systematic review on physician burnout during the pandemic.

A paper on physician strategies for addressing vaccine hesitancy is under review, and papers on changes in telehealth utilization resulting from the pandemic and on the implementation of workplace support interventions and their relationship to physician burnout are in preparation.

Findings from the COVID-19 Impacts Project have been presented to the North American Primary Care Research Group, the Center for Healthcare Policy and Research (CHPR) Seminar Series, and to the Department of Family and Community Medicine at UC Davis Health. 

The COVID-19 Impacts Project will continue to analyze and publish results. The project is led by Joy Melnikow, a CHPR affiliate and professor emeritus of family and community medicine.