When President Biden announced the formation of his COVID-19 task force in November, many of us in healthcare were encouraged by the news. The diverse expertise of the team signaled a science-based, compassionate path forward in addressing the pandemic. Since then, members of the healthcare community have highlighted opportunities to improve the teams working on COVID-19 strategy -- by adding a focus on health equity, for example -- and these requests have been met in the recent announcements of members of the COVID-19 Response Team under White House COVID-19 coordinator Jeff Zients. Yet, one critical aspect of the COVID-19 response still needs to be addressed: the wellbeing of frontline healthcare workers.
How will we take care of America if we don't have a plan to care for our clinicians?
Before the pandemic, of all U.S. nurses and doctors reported experiencing burnout. This occupational phenomenon is caused by chronic workplace stress that results in increased medical errors, higher healthcare costs, and early departure from the profession. Cresting the first surge, an alarm was sounded about clinicians suffering from mental health issues , further threatening a population under duress.
While President Biden's all-star COVID-19 response team and task force have expertise around policy, equity, social connection, stress, and empathy, they lack specific expertise on the complex field of clinician burnout. If we do not address this facing our clinicians, America faces slower times to vaccinating our communities, worsening staffing shortages in our hospitals, and a traumatized workforce that will be unable to provide quality care for America post-pandemic.
As Biden stated during his inaugural address, "We're entering what may be the toughest and deadliest period of the virus." America's healthcare team is already exhausted from working 24/7 throughout the pandemic. Even with a strong foundation, the lift for the COVID-19 team is tremendous. The response team should integrate strategies to address clinician burnout into their planning now and tap into existing expertise to do so.
Here is what Biden's team should do to keep our frontline clinicians well:
Reduce administrative burden.
Before the pandemic, U.S. physicians were spending spent directly caring for patients. Each additional data entry request not only takes up time, but also decreases the for doctors, nurses, and other clinicians to make high-level decisions about a patient's care.
Biden's team should ensure that any future federal COVID-19 related data requests do not fall on the shoulders of frontline clinicians, and encourage local leadership to do the same for currently tracked facility-level data (such as hospital/ICU bed capacity, number of patients on ventilators, and COVID-19 complications and vaccination rates).
Stop rolling back coverage for virtual care, and make it permanent.
In March, when HHS relaxed restrictions around telemedicine and Congress passed the CARES Act, we saw an exponential rise in the use of all types of virtual care. While Medicare will continue to cover virtual care until the public health emergency status is lifted, commercial insurance plans and several Medicaid plans have changed their rules and deadlines for what they will cover, with some insurers already rolling back coverage as of . Uncertainty over virtual care reimbursement and nonsensical complexity on the part of insurers is preventing patients from seeing their doctors and putting clinicians at unnecessary risk of contracting coronavirus.
The response team should convene insurers to standardize coverage for virtual care, particularly telehealth, and work with Congress to make Medicare coverage of virtual care permanent by passing bills such as . The team should also advocate for legislation that expands broadband access to vulnerable communities and advances health equity, such as .
Ensure that no clinician is left behind.
With the push in the medical community over the last decade to address clinician burnout, some health systems already had robust wellbeing infrastructures in place pre-pandemic, with wellbeing executives sitting in the C-suite. Most do not. Therefore, whether a clinician can access a trauma-trained mental health professional, has a peer proactively check in on them, or has a leader who is trained in psychological first aid depends largely on where they work. Every clinician deserves to work in an that maximizes their opportunity to heal from this pandemic and minimizes their risk of long-term burnout and post-traumatic stress.
The team should ensure that no clinician is left behind by identifying best practices, such as those mentioned above, and disseminating these best practices to health systems. Because of the urgent need for clinician access to mental and physical healthcare, the team should also allocate dedicated federal funding so that all health systems can make investments to provide these services to their clinicians now.
Biden's COVID-19 team is a shining beacon of hope to a beleaguered clinician workforce, and it is rolling out the most comprehensive plan to contain a pandemic in our nation's history. The success of executing this strategy rests on the backs of our clinicians and caregivers, and we strongly encourage the team to acknowledge and address the of clinician burnout.
We've got one shot to get it right, and an additional focus on wellbeing will help us to . Let's not skip over this crucial step.
, is the CEO of TNT Health Enterprises, a wellbeing consulting company; she served in the Obama and Trump administrations where she led VA efforts to address wellbeing. , is chief wellness officer of ChristianaCare and leader of the ChristianaCare Center for WorkLife Wellbeing.