Preliminary Report: US Physician Stress During the Early Days of the COVID-19 Pandemic

Mark Linzer; Martin Stillman; Roger Brown; Sam Taylor; Nancy Nankivil; Sara Poplau; Elizabeth Goelz; Christine Sinsky; American Medical Association–Hennepin Healthcare System Coping With COVID Investigators

doi:10.1016/j.mayocpiqo.2021.01.005

Preliminary Report: US Physician Stress During the Early Days of the COVID-19 Pandemic

Mayo Clin Proc Innov Qual Outcomes. 2021 Feb 2;5(1):127-136. doi: 10.1016/j.mayocpiqo.2021.01.005. eCollection 2021 Feb.

Authors

Mark Linzer¹, Martin Stillman¹, Roger Brown¹, Sam Taylor¹, Nancy Nankivil¹, Sara Poplau¹, Elizabeth Goelz¹, Christine Sinsky¹; American Medical Association–Hennepin Healthcare System Coping With COVID Investigators

Collaborators

American Medical Association–Hennepin Healthcare System Coping With COVID Investigators:
Michael Barbouche, Crissy Buhr, Frank Byrne, Bernadette Lim, Michael Tutty, Colleen McLoughlin, Kyra Cappelucci, Crystal Audi, Michele LeClaire, Kate DeBaene, Kerra Guffey, David Joerres, Subbu Ravi

Affiliation

¹ Hennepin Healthcare and University of Minnesota, Minneapolis; University of Wisconsin School of Nursing, Madison; and American Medical Association, Chicago, IL.

Abstract

Objective: To assess the impact of the COVID-19 crisis on physician stress and mental health.

Methods: The 10-item Coping With COVID survey assessed stress among 2373 physicians from April 4 to May 27, 2020. A stress summary score with 4 items (a single-item [overall] stress measure, fear of exposure, perceived anxiety/depression due to COVID, and work overload, each scored 1-4) ranged from 4 to 16. Hypothesized stress mitigators included enhanced purpose and feeling valued by one's organization. Multilevel linear regression tested associations of variables with overall stress and stress summary scores.

Results: In 2373 physicians in 17 organizations (median response rate of 32%), mean stress summary score was 9.1 (SD 2.6). Stress was highest among women (stress summary score, 9.4 [SD 2.5] vs 8.7 [SD 2.6] in men; P <.001), inpatient physicians (stress summary score, 9.4 [SD 2.8] vs 8.9 [SD 2.5] in outpatient physicians; P <.001), early- and mid-career physicians (stress summary score, 9.5 [SD 2.6] vs 8.6 [SD 2.5] in late-career physicians; P <.001), and physicians in critical care (stress summary score, 10.8), emergency departments (10.2), and hospital medicine (10.1). Increases in perceived anxiety/depression (regression coefficient, 0.30), workload (0.28), and fear (0.14) were associated with higher overall stress (P values <.001). Increases in feeling valued were associated with lower stress summary scores (regression coefficient, -0.67; P <.001) and explained 11% of stress summary score variance at the physician level and 31% of variance at the organizational level.

Conclusion: Mental health support, modulation of workload, and noting physicians' organizational value should be explored as means to reduce COVID-related stress.

Keywords: AMA, American Medical Association.