Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID-19 Pandemic

Robert M Rodriguez; Anthony J Medak; Brigitte M Baumann; Stephen Lim; Brian Chinnock; Remi Frazier; Richelle J Cooper

doi:10.1111/acem.14065

Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID-19 Pandemic

Acad Emerg Med. 2020 Aug;27(8):700-707. doi: 10.1111/acem.14065. Epub 2020 Jul 21.

Authors

Robert M Rodriguez¹, Anthony J Medak², Brigitte M Baumann³, Stephen Lim⁴, Brian Chinnock⁵, Remi Frazier⁶, Richelle J Cooper⁷

Affiliations

¹ From the, Department of Emergency Medicine, University of California at San Francisco School of Medicine, San Francisco, CA, USA.
² the, Department of Emergency Medicine, University of California at San Diego School of Medicine, San Diego, CA, USA.
³ the, Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA.
⁴ the, Section of Emergency Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
⁵ the, Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Fresno, CA, USA.
⁶ Academic Research Systems, University of California, San Francisco, CA, USA.
⁷ and the, Department of Emergency Medicine, University of California at Los Angeles School of Medicine, Los Angeles, CA, USA.

Abstract

Objective: The objective was to assess anxiety and burnout levels, home life changes, and measures to relieve stress of U.S. academic emergency medicine (EM) physicians during the COVID-19 pandemic acceleration phase.

Methods: We sent a cross-sectional e-mail survey to all EM physicians at seven academic emergency departments. The survey incorporated items from validated stress scales and assessed perceptions and key elements in the following domains: numbers of suspected COVID-19 patients, availability of diagnostic testing, levels of home and workplace anxiety, severity of work burnout, identification of stressors, changes in home behaviors, and measures to decrease provider anxiety.

Results: A total of 426 (56.7%) EM physicians responded. On a scale of 1 to 7 (1 = not at all, 4 = somewhat, and 7 = extremely), the median (interquartile range) reported effect of the pandemic on both work and home stress levels was 5 (4-6). Reported levels of emotional exhaustion/burnout increased from a prepandemic median (IQR) of 3 (2-4) to since the pandemic started a median of 4 (3-6), with a difference in medians of 1.8 (95% confidence interval = 1.7 to 1.9). Most physicians (90.8%) reported changing their behavior toward family and friends, especially by decreasing signs of affection (76.8%). The most commonly cited measures cited to alleviate stress/anxiety were increasing personal protective equipment (PPE) availability, offering rapid COVID-19 testing at physician discretion, providing clearer communication about COVID-19 protocol changes, and assuring that physicians can take leave for care of family and self.

Conclusions: During the acceleration phase, the COVID-19 pandemic has induced substantial workplace and home anxiety in academic EM physicians, and their exposure during work has had a major impact on their home lives. Measures cited to decrease stress include enhanced availability of PPE, rapid turnaround testing at provider discretion, and clear communication about COVID-19 protocol changes.

MeSH terms

Anxiety / epidemiology
Anxiety / psychology*
Burnout, Professional / epidemiology
Burnout, Professional / psychology*
COVID-19 / epidemiology
COVID-19 / psychology*
COVID-19 Testing / statistics & numerical data
Cross-Sectional Studies
Emergency Medicine
Female
Humans
Male
Pandemics
Physicians / psychology*
SARS-CoV-2