Burnout, Compassion Fatigue, and the Long Haul of Caring for Long COVID, 2024, Ramers et al

[Andy]

Abstract

The current landscape of clinician burnout is prompting the need for our health care system to revise its approach toward complex conditions such as long coronavirus disease (COVID), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other postinfectious fatiguing illnesses (PIFIs). We discuss our efforts here at Family Health Center of San Diego (FHCSD) to help share insight and glean perspective from clinicians who have participated in our Centers for Disease Control and Prevention (CDC)–funded 3-year continuing professional development initiative. The Long COVID and Fatiguing Illness Recovery Program uses multidisciplinary team-based case consultation and peer-to-peer sharing of emerging best and promising practices (ie, teleECHO [Extension for Community Healthcare Outcomes]) to support the management of complex cases associated with long COVID, ME/CFS, and other PIFIs. We believe that this perspective captures a key moment in the trajectory of postpandemic clinician burnout and prompts further reflection and action from the health care system to improve clinician- and patient-level outcomes related to the care of patients with postinfectious fatiguing illnesses.

Open access, https://academic.oup.com/ofid/article/11/3/ofae080/7603019

 

[SNT Gatchaman]

Pretty good, but as a small criticism I didn't see any discussion of the role long Covid is playing directly on some of the clinicians, as opposed to them being indirectly affected — unable to treat their patients.

Sadly, these reports of patients having their concerns dismissed hint at a weakness in our current system to properly manage symptoms that do not fit into traditional diagnostic paradigms.

There are indeed such hints...

Additionally, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a serious and debilitating condition, shares many features with more severe long COVID and may share underlying pathophysiology

Unfortunately, as with long COVID, many of these conditions are dismissed as lacking legitimacy due to lack of a clear case definition, understanding of the pathophysiology, and effective treatment options, creating tension between a weary medical workforce and an often “gaslit” and suffering patient population.

Our current system of siloed, efficiency oriented medical care is ill-equipped to adequately address such complex chronic conditions.

On the front lines of long COVID in primary care clinics around the country, well-meaning but overworked clinicians, often frustrated that they can offer no or inadequate meaningful help in a 15-minute visit, struggle to attend to the needs of desperate patients.

a more immediate goal must be improving education and awareness and collaborative problem-solving among providers and encouraging symptomatic treatment when symptoms persist that are otherwise medically unexplained. Meeting the emotional needs of patients who have lost their identity, experienced trauma at the hands of medical professionals, and struggle to cope with a condition not widely recognized by medical providers starts with the simple phrase, “I hear you and believe you.”

 

[rvallee]

Meeting the emotional needs of patients who have lost their identity, experienced trauma at the hands of medical professionals, and struggle to cope with a condition not widely recognized by medical providers starts with the simple phrase, “I hear you and believe you.”

I don't want my emotional needs to be met by clinicians. I could not care less about this, it's not going to happen anyway, this is not what medicine is for. Certainly not as long as they work in a system that is responsible for failing and mistreating us.

I also don't care about hearing simple phrases that aren't backed by actions. Words are cheap. So damn cheap. I frankly don't even want to hear those words, I only want to see action that gives them substance. The words could never be uttered once for all I care, if the actions are there. It's not us who need to hear those words, it's their system, their colleagues, their schools, their leaders. Turn around and say it loud, then do something about it. It's MDs who need to hear it and do something about it, not us. The rest is irrelevant.

 

[Sean]

I don't want my emotional needs to be met by clinicians.

Yeah, whenever I hear this kind of stuff I run quickly in the direction of away.

I do not need or want manufactured displays of sympathy that do nothing but waste my damn time and hope.