By MIKE MAGEE, MD
As we struggle to control a second wave of Covid-19, we are reminded once again of the nurses and doctors who place themselves at risk willingly and consistently. They are struggling uphill with a deeply segmented health care system that chronically rewards the have’s over the have-not’s, and a President clearly intent on creating as much havoc as is humanly possible on the way out the door.
Filling the leadership void this week, we witnessed the unusual appearance on network television of two national leaders from the professions of Nursing and Medicine, Dr. Susan Bailey (President, AMA) and Debbie Hatmaker (Chief Nursing Officer, ANA) appearing in tandem.
The united front presented by these two women leaders was reassuring. They didn’t pull punches, but spoke truth to power, describing the nation’s condition as “very grim” and “quite stark.”
In many ways, their joint appearance was a reflection of a changing reality in communities large and small across America. A Medscape survey released this week found that women’s roles in health care are growing in leaps and bounds. For example, in Family Medicine, close to 40% of the physicians are now women, and they work approximately the same number of hours per week as their male counterparts.
These women doctors are increasingly working in team settings. The majority of Family Physicians (71%) now work within a team that includes either a Nurse Practitioner (NP) or Physician’s Assistant (PA).
Covid-19 has placed a huge burden on this workforce physically and financially. Aside from the obvious risk of contracting the disease themselves, regulatory precautions have impeded normal access to care. During the first wave of the pandemic, physician practices reported a 55% decline in revenue and a 60% decrease in patient volume. In March of 2020 alone, 43,000 healthcare workers were laid off nationwide, and nearly 1 in 10 practices closed their doors, at least temporarily. Picking up some of the slack, reimbursable virtual patient visits increased 225%.
While our attention over the past months has centered on emergency departments and intensive care units, it’s important to remind our selves that our system of care (where it exists) relies heavily on a primary care base for access to both standard and emergency evaluation and treatment. And among Primary Care doctors, women are especially disadvantaged. The just released Medscape survey documented a striking gender gap in salary, with males earning 26% more than women.
Regardless of gender, 2/3’s of Family Medicine doctors would chose the same career path again, reporting that the three top sources of their job satisfaction are: 1) Gratitude/relationships with patients, 2) Knowing I’m making the world a better place by helping others, 3) Being very good at what I do/ Finding answers, diagnoses.
ANA surveys of nurse satisfaction levels roughly mirror the same determinants. In both professions, these women and men are physically, emotionally, and spiritually exhausted.
What can we do to help them?
1) Give Thanks: Expressing gratitude is always welcome. But perhaps the best way to express this in 2020 is to limit gatherings around Thanksgiving, What we don’t need at the moment is super-acceleration of an already bad situation.
2) Drop the Political BS. The election is over, and going mask-less in meaningless, and dangerous. Be a good citizen. Wear your mask and a smile.
3) Be Patient and Compliant. We’ve got vaccines on the way. But we have a few months to go. When they arrive, get vaccinated without delay.
Mike Magee is a Medical Historian and Health Economist and author of “Code Blue: Inside the Medical Industrial Complex.“