The COVID-19 pandemic has taken a significant toll on cardiovascular clinicians, many of whom provide direct care to patients with or at greater risk of the virus. As a result, the prevalence of burnout among cardiovascular professionals nearly doubled when comparing pre- to peak COVID-19 pandemic levels, according to results of ACC's 2020 Well-Being Study presented May 16 during ACC.21.

A survey was sent via email in November 2020 to 10,019 cardiologists, fellows in training (FITs) and cardiovascular team members. A total of 1,288 people responded to the survey (456 U.S. and 436 international cardiologists, 128 FITs and 268 cardiovascular team members). Because peaks in COVID-19 disease activity differed by region, questions were structured to ask about feelings of burnout before the COVID-19 pandemic and during the peak of the COVID-19 pandemic in their region.

Among those surveyed, burnout increased from 20% to 38% during the peak of the pandemic. Rates of burnout pre- and peak COVID-19 pandemic increased across all members of the cardiology care team and was particularly striking among cardiovascular team members, which researchers said may be because they were more likely at the bedside as patients were dying. Among all cardiovascular clinicians – cardiologists, physician assistants, nurse practitioners, nurses, pharmacists and imaging technologists – half provided direct care to patients with COVID-19, and yet one of five reported not having adequate personal protective equipment (PPE). Not surprisingly, the rate of burnout was higher in this group.

The survey also revealed that some cardiovascular clinicians are thinking about leaving their jobs, in some cases, because of COVID-19. Plans to reduce clinical work hours in the next year, leave their current practice or retire early were reported by 23%, 13% and 13% of respondents, respectively, and notably higher among those who reported feeling burnt out. For some, COVID-19 is the key influencer for these decisions, with 17% of clinicians planning to reduce their clinical work hours, 12% planning to leave their current practice and 11% planning to retire due to COVID-19.

The survey also revealed financial stressors exacerbated by the COVID-19 pandemic, with 41% of respondents reporting that their salary had been reduced to some degree. Roughly the same percentage of clinicians also reported inadequate health system support during the pandemic related to workers' basic needs, such as food, lodging, transportation, child care and emotional support.

"[The results] clearly show that there are lots of opportunities to improve the work environment; COVID-19 has really put a magnifying glass on the fact that things were bad and now have significantly worsened," says Laxmi S. Mehta, MD, FACC, the study's lead author and chair of ACC's Task Force on Clinician Well-Being. Supporting clinician wellness by providing potential solutions to alleviate some of the job pressures associated with burnout has become a strategic priority for the ACC, Mehta adds.

"Burnout is a metric, but well-being is the goal and what we are striving for," she says. "While we are resilient, these results show that we really need to be focusing on fixing the work environment, including ensuring that we have enough PPE, feeling valued and safe at work, improving team dynamics and efficiencies, which are all essential whether there is COVID-19 or not. Organizations need to focus on improving workforce care not just patient care."

Mehta and her team will be examining the data more closely to understand gender and career stage differences.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, COVID-19 Hub, Diabetes and Cardiometabolic Disease, Dyslipidemia, Geriatric Cardiology, Congenital Heart Disease

Keywords: ACC Annual Scientific Session, ACC21, Dyslipidemias, Geriatrics, Heart Defects, Congenital, COVID-19, SARS-CoV-2

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