Teamwork, protecting doctors' well-being during the pandemic

A survey of health professionals reveals that many feel unprepared to handle another wave of the pandemic. The study's authors offer four recommendations to improve the physical and mental well-being of those caring for COVID-19 patients.

• 42% of health professionals surveyed in Catalonia feel more tired and less prepared to deal with a second wave of COVID-19.
• The pandemic's impact on the physical and emotional welfare of the health professionals surveyed has meant that 24% have at some point considered abandoning the practice.
• Teamwork clearly provides a protective element for the doctors' well-being and helps reduce stress and mitigate ethical conflicts when making decisions.

The COVID-19 pandemic is having a huge impact on the physical and emotional health of the general population. But healthcare professionals are a particularly vulnerable group, as they have to cope with the daily stress of being on the frontline of care, a lack of means, the pressure of making difficult decisions on a daily basis and a fear of contagion. In fact, before the pandemic, several studies had shown that health professionals generally have a worse perception of their own mental well-being than the general population.

In the midst of the pandemic, preliminary data from a study on the impact of COVID-19 on the well-being of healthcare professionals --which was carried out by the Galatea Foundation, the CoMB and the professors Núria Mas of IESE and Judit Vall of the Barcelona Economics Institute (IEB-UB)-- confirms that the current crisis has not only negatively impacted the physical and mental well-being of doctors, but that, as a result, this group is entering the fall and winter more tired and less prepared to handle the second wave of the pandemic. This is affirmed by up to 42% of doctors who are more pessimistic about the coming months.

The exhaustion shown by Catalonia's healthcare workers is also evident in the 24% who say that, at some point over the last few months, they have questioned whether they wanted to continue working in their profession (22% have considered leaving their jobs, while 2% have considered this option more seriously). However, the bulk of the group still maintains a firm commitment to the profession and to their patients, despite the harsh environment they have experienced since the outbreak of the pandemic.

The survey confirms the worsening physical and mental health of medical doctors from several indicators: the frequency with which they experience physical and emotional exhaustion, headaches, stomachaches or back pain; as well as the capacity to deal with problems, among others. The values of these indicators are compared at three different times: before the pandemic, during the outbreak of the first wave (March-April 2020) and during the summer. The most negative results were obtained in the March-April period, while the summer showed some improvement, but not enough to return to pre-pandemic levels.

The study finds that there are certain groups that show worse health indicators, such as the doctors working in primary care, those who worked in intensive care units (ICUs) and emergency services, and those who decided to self-isolate during the harshest months of the pandemic to protect their relatives. These groups also show a slower recovery than their peers.

Among primary care doctors (25.7% of the sample), more have considered leaving the profession: 31.7% have considered it at some point, well above the 21.3% of their colleagues in the hospital field and 22.2% in other areas. They also indicate that they feel less prepared to deal with what is left of the pandemic: 48.4% of primary doctors say this is the case, while the same feeling is reported by 44.5% of hospital doctors and 34.8% from other areas.

As for doctors who worked in ICUs and in emergency services, up to 68% stated that at the peak of the pandemic (March-April) they felt tired always or very often (above 57.6% of the total sample), a percentage that before the crisis was 27.7% (18.9% in the total sample) and still remained at 47.4% in July-August (42% in the total sample).

Teamwork as a protective element

One of the most positive aspects revealed by this study is the role of teams as protective elements for the health and well-being of doctors. Professionals who work in teams where goals are shared and where there is a sense of belonging report better indicators of physical and emotional health than the rest. These professionals face fewer ethical conflicts and less stress in their daily activity, as decisions and problems are shared.

According to the study, up to 31.2% of medical doctors who do not have the support of a "protective team" say they face ethical conflicts frequently, a percentage that drops to 24.5% among professionals who feel integrated and supported by a team.

General recommendations

The preliminary results of the study make it possible to formulate general recommendations aimed at improving the well-being of healthcare professionals, reducing risk factors and promoting preventative activity:

• Reform the current health system. Move towards having adequate human and financial resources and more autonomy for health professionals and teams.
• Prioritize the well-being of health professionals. They must be offered adequate care, in terms of treatment, prevention and the promotion of their health.
• Promote professional training. Improve preparedness in relevant areas such as management of emotions and stress, and complex decision-making.
• Promote and support working in teams. Facilitate how teams can operate best, as they are one of the main protective elements that the system itself can offer.

Methodology, very briefly

The preliminary data from this study comes from a survey of 1,648 medical doctors in Catalonia who responded between July and August 2020. Going forward, and in collaboration with Spain's Organización Médica Colegial and Mutual Médica, the study will be expanded to include other regions in Spain and other healthcare professionals