Reflections and experiences of physicians working during the COVID-19 pandemic: A qualitative study

Background: The need to recognize and attend to physician health and wellness has recently been emphasized, due to high levels of documented distress and burnout. The global pandemic has imposed even greater stressors and novel work demands on clinicians. Aim: To understand the experiences of physicians providing care during a global pandemic. Methods: Semi-structured interviews were conducted with physicians across Canada about their experiences providing care to patients during the COVID-19 pandemic. Thematic analysis methodology was used to describe overarching themes. Results: Twenty-three physicians (12 specialized palliative care, 5 intensivists, 6 general internists) were interviewed. Interim analysis of 16 coded interviews revealed 8 main categories: confusion and uncertainty;exhaustion and burnout;trauma;ethical considerations;isolation;professional re-evaluation;altruism;and cohesion. Confusion and uncertainty related mainly to the novel virus, leadership, and institutional preparedness. Exhaustion and burnout encompassed workload, personal protective equipment, family life, and complexity. The trauma theme included visitor policies, family surrogates, and patient management. Ethical considerations included job demands vs personal and family safety. Isolation was largely related to infection control measures. Professional re-evaluation items included job satisfaction due to changed patient encounters or novel structuring. Altruism items included unique personal contribution to pandemic response and societal needs. Cohesion items included supporting each other and team building. Conclusion: Preliminary analysis revealed trauma and distress, but also altruism and cohesion. These findings may inform interventions for physician health and wellness, as well as indicating ways to integrate meaning and purpose into negative experiences to promote resilience.