Pandemic burnout hounds hepatology providers

Burnout is experienced by nearly half (~40 percent) of hepatology providers during the COVID-19 pandemic, as shown by the negative impact of emotional well-being, including work fulfilment and satisfaction, according to a study.

Among those who are more likely to report burnout are women, advanced practice providers (APPs), and early and mid-career clinicians.

“Identified strategies to cope with burnout include virtual platforms to facilitate networking, mentoring, and virtual discussions on strategies to cope with changes in practice resulting from the pandemic,” the investigators said.

This study was presented by Mark Russo from Atrium Health-Wake Forest in North Carolina, US, at The Liver Meeting by the America Association for the Study of Liver Diseases (AASLD 2021).

Russo and his team sought to describe the impact of the COVID-19 pandemic on clinical practice and burnout among hepatology providers through an electronic survey conducted from February to March 2021. Respondents included US AASLD members who were adult and paediatric hepatologists, gastroenterologists, and APPs, as well as those who practiced hepatology.

AASLD COVID-19 committee members developed the survey, which included questions on the impact of the pandemic on clinical practice and emotional well-being using questions from validated instruments.

A total of 2,803 survey forms were emailed to AASLD eligible members in the US, of whom 230 completed the survey: 107 (47 percent) were adult transplant hepatologists, 43 (19 percent) adult general hepatologists, 14 (6 percent) adult gastroenterologists, 12 (5 percent) paediatric hepatologists, 45 (19 percent) APPs, and nine (4 percent) others. [AASLD 2021, abstract 42]

During the pandemic, 124 (54 percent) respondents reported switching to primarily telemedicine, 69 (30 percent) had a reduction in compensation, 92 (40 percent) had reduction in staff, and 21 (9 percent) closed their practice.

Some of the respondents reported that burnout was “not at all true or somewhat true,” 21 percent said “they felt worthwhile at work,” 16 percent “work was satisfying,” and 19 percent “contributed in ways they value most.”

On the other hand, few respondents reported burnout was “very or completely true,” that during the past 2 weeks before the survey, they “experienced a sense of dread” (16 percent) or “were physically or emotionally exhausted at work” (16 percent and 19 percent, respectively). Of note, 100 respondents (43 percent) reported having experienced burnout.

Burnout occurred more frequently among those aged <56 years (odds ratio [OR], 2.2), women (OR, 2.2), White (OR, 1.8), APPs (OR, 2.7), and transplant hepatologists (OR, 0.51). Multivariable analysis revealed that only age <56 years was associated with burnout (OR, 2.3, 95 percent confidence interval, 1.1–4.8).

The most common reasons for burnout were too many bureaucratic tasks, lack of time to take care of themselves, and not enough time to spend with family and friends.

The respondents also suggested ways the AASLD can help, namely through virtual platforms for networking, mentoring, and coping with the changes in practice due to the COVID-19 pandemic.

“The COVID-19 pandemic has impacted the clinical practice of medicine with a risk of exacerbating provider stress, emotional ill being, and burnout risk,” the investigators said.