Francisca L Chou1, David Abramson2, Charles DiMaggio3, Christina W Hoven4,5,6, Ezra Susser4,5,6, Howard F Andrews4,6,7, Stanford Chihuri1, Barbara H Lang1, Megan Ryan4, Daniel Herman8, Ida Susser9, Franco Mascayano4,5, Guohua Li1,5. 1. Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA. 2. Program on Population Impact, Recovery and Resilience; School of Global Public Health, New York University, New York, New York, USA. 3. Departments of Surgery and Population Health Science, New York University Langone Medical Center, New York, New York, USA. 4. New York State Psychiatric Institute, New York, New York, USA. 5. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA. 6. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA. 7. Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA. 8. Silberman School of Social Work, City University of New York, New York, New York, USA. 9. Hunter College, City University of New York, New York, New York, USA.
Abstract
OBJECTIVE: The aim of this study was to identify factors associated with distress experienced by physicians during their first coronavirus disease 2019 (COVID-19) triage decisions. METHODS: An online survey was administered to physicians licensed in New York State. RESULTS: Of the 164 physicians studied, 20.7% experienced severe distress during their first COVID-19 triage decisions. The mean distress score was not significantly different between physicians who received just-in-time training and those who did not (6.0 ± 2.7 vs 6.2 ± 2.8; P = 0.550) and between physicians who received clinical guidelines and those who did not (6.0 ± 2.9 vs 6.2 ± 2.7; P = 0.820). Substantially increased odds of severe distress were found in physicians who reported that their first COVID-19 triage decisions were inconsistent with their core values (adjusted odds ratio, 6.33; 95% confidence interval, 2.03-19.76) and who reported having insufficient skills and expertise (adjusted odds ratio 2.99, 95% confidence interval 0.91-9.87). CONCLUSION: Approximately 1 in 5 physicians in New York experienced severe distress during their first COVID-19 triage decisions. Physicians with insufficient skills and expertise, and core values misaligned to triage decisions are at heightened risk of experiencing severe distress. Just-in-time training and clinical guidelines do not appear to alleviate distress experienced by physicians during their first COVID-19 triage decisions.
OBJECTIVE: The aim of this study was to identify factors associated with distress experienced by physicians during their first coronavirus disease 2019 (COVID-19) triage decisions. METHODS: An online survey was administered to physicians licensed in New York State. RESULTS: Of the 164 physicians studied, 20.7% experienced severe distress during their first COVID-19 triage decisions. The mean distress score was not significantly different between physicians who received just-in-time training and those who did not (6.0 ± 2.7 vs 6.2 ± 2.8; P = 0.550) and between physicians who received clinical guidelines and those who did not (6.0 ± 2.9 vs 6.2 ± 2.7; P = 0.820). Substantially increased odds of severe distress were found in physicians who reported that their first COVID-19 triage decisions were inconsistent with their core values (adjusted odds ratio, 6.33; 95% confidence interval, 2.03-19.76) and who reported having insufficient skills and expertise (adjusted odds ratio 2.99, 95% confidence interval 0.91-9.87). CONCLUSION: Approximately 1 in 5 physicians in New York experienced severe distress during their first COVID-19 triage decisions. Physicians with insufficient skills and expertise, and core values misaligned to triage decisions are at heightened risk of experiencing severe distress. Just-in-time training and clinical guidelines do not appear to alleviate distress experienced by physicians during their first COVID-19 triage decisions.
Authors: Monisha Sharma; Claire J Creutzfeldt; Ariane Lewis; Pratik V Patel; Christiane Hartog; Gemi E Jannotta; Patricia Blissitt; Erin K Kross; Nicholas Kassebaum; David M Greer; J Randall Curtis; Sarah Wahlster Journal: Clin Infect Dis Date: 2021-05-18 Impact factor: 9.079
Authors: Armand H Matheny Antommaria; Tyler S Gibb; Amy L McGuire; Paul Root Wolpe; Matthew K Wynia; Megan K Applewhite; Arthur Caplan; Douglas S Diekema; D Micah Hester; Lisa Soleymani Lehmann; Renee McLeod-Sordjan; Tamar Schiff; Holly K Tabor; Sarah E Wieten; Jason T Eberl Journal: Ann Intern Med Date: 2020-04-24 Impact factor: 25.391