The Urgent Need to PROTECT and COMPENSATE Physicians in the Wake of the COVID-19 Pandemic

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Yury Parra, MD
Yury Parra, MD signed this petition

The COVID-19 pandemic is wreaking havoc among all walks of life, but disproportionately harming frontline workers. In particular, healthcare workers have been forced to put themselves and their loved ones at risk, working with limited personal protective equipment (PPE) in the face of an unrelenting deluge of sick and dying patients. This tremendous emotional stress is causing adverse consequences unique to physicians who carry the ultimate responsibility for patients’ lives. Doctors are becoming sick and they are dying in alarming numbers. For those who survive, the mental anguish will likely last a lifetime. This sacrifice should be acknowledged with concrete protections.

It should be noted that physician moral injury (a.k.a. “burnout”) was an epidemic before this pandemic. As Danielle Ofri, MD aptly pointed out in the NY Times, the business of healthcare exploits physicians and nurses. Health systems know that physicians will do what is right for patients even to their own detriment and thus capitalize on physicians’ altruistic qualities. Current strenuous work conditions, inadequate protections, and legions of sickness and death will likely cause a surge in physician substance use disorders, depression, anxiety and suicide. The U.S. healthcare system will take years to recover from this fallout. Nearly 400 physicians die by suicide each year; physicians complete suicide at far higher rates than the general population, including the military. The documentary film, Do No Harm, which was virtually-screened on April 19th, 2020, outlines each of the aforementioned issues adversely impacting physicians.  

Furthermore, the financial cost of physician burnout is astronomical. As Pein Huang noted in What’s doctor burnout costing America? in Shots Health News from NPR, the cost of physician burnout is $4.6 billion per year. In fact, this may be an underestimate as dead doctors will never work again. Moreover, it is possible that it will become even more difficult to recruit future physicians to fill those left by deceased or burned out clinicians.

Despite the epidemic proportions of physician burnout, our instrumental role in the pandemic response is grossly undervalued. New York City Health + Hospitals, for instance, is seeking physicians to work at least five different 8-hour shifts in the busiest hospitals as unpaid workers. Similarly, many other hospital systems in the city have deployed their physicians to emergency rooms and inpatient COVID units without discussion about their protections or hazard pay. Meanwhile, out-of-state doctors are being offered $40,000 to work in New York for two weeks and nurses are appropriately being paid anywhere from $4000 to $10,000 per week. In addition, resident and fellow physicians, i.e. house staff or physician trainees, are particularly vulnerable; they are reusing PPE, working longer hours than usual, often in higher-risk clinical units, demoted to lower roles despite their skills which could be used to maximize physician capacity, and being excluded in scheduling and assignment decisions, thus, further limiting their voice. Duke resident, Dr. Jacquelyn Corley, painfully documents resident struggles in her recent Forbes pieceIn addition, Governor Cuomo just endorsed hazard pay for frontline workers, specifically a 50% bonus. 

We, the undersigned, acknowledge that the clinical needs in New York City and State remain extraordinarily high. We recognize the suffering of patients and how critical our unique skill set is in responding to the pandemic. However, we cannot forget that physicians are human too, and not heroes; we can only tolerate so much work-related trauma. We are healers but we cannot heal others or ourselves when we are asked to work in hazardous conditions without rigorous protections and fair compensation. We urge that elected officials and hospital leadership respond to this urgent need. 

For the safety, health and wellbeing of physicians - as well as the entire healthcare system - we ask that the following measures take effect immediately:

  1. Access to appropriate PPE for all physicians, regardless of hospital or clinic affiliation
  2. Hazard pay in addition to an hourly wage, for residents, fellows and attending-level physicians 
  3. Disability and malpractice insurance coverage specific to the COVID-19 crisis
  4. Transparency and open discussion regarding scheduling and assignment decisions for house staff and attendings
  5. Access to mental health services that include protected time and cost for sessions with a mental health provider
  6. Protection from retaliation for speaking out as endorsed by Physicians for Human Rights 
  7. Prevent cutbacks to current physician salaries

Physicians train for years, at significant personal, economic and emotional cost, for the privilege of caring for society’s sickest and most vulnerable. However, working in a sick healthcare system without adequate physical, emotional or financial security will only exacerbate moral injury among physicians and adversely impact patient care. We ask for what is fair, and that physicians be protected and compensated immediately. These measures are critical to allow us to sustain ourselves while ensuring patient safety.

In Solidarity,

Lynette Charity, MD (Anesthesiology)

Robert S. Kurtz, MD, FACS (Trauma Surgery)

Yury Parra, MD, AAHIVS (Family Medicine and HIV Medicine)

Lipi Roy, MD, MPH, FASAM (Internal Medicine and Addiction Medicine)

April Soto, MD (Family Medicine and HIV Medicine)

If you are a physician, we strongly encourage you to add your credentials and specialty next to your last name.  Last name (MD/DO, Specialty)