The novel coronavirus 2019 (COVID-19) is one of the most difficult and challenging events of modern times, upending clinicians’ sense of order and control,1 inundating medical facilities with patients and potentially overwhelming the healthcare system in the United States.2 According to a new report, the US “has fewer practicing physicians per capita (2.6 per 1000 people) than most other similarly large and wealthy countries” and also fewer physicians per 1000 people than Italy (4.0) and Spain (3.9), both of which have “already seen their workforce overwhelmed by the COVID-19 crisis.”2 While natural disasters, such as Hurricane Katrina, were self-limiting, the open-ended nature of the pandemic, together with the burden on hospitals and healthcare systems, has put unprecedented strain on physicians and other healthcare providers.1

A recent article published in the Annals of Internal Medicine provided “practical suggestions to encourage a culture that will sustain the clinician workforce during the pandemic,” recommending that organization leaders “should provide clear messages that clinicians are valued and that managing the pandemic together is the goal.”1

Additional guidance offered by the authors includes adjustment of work schedules that “promote physician resilience; reduction of noncritical work activities (eg, nonessential administrative tasks); open discussion of challenges and stressors; fostering spiritual resilience; and a supportive work culture.1

To what extent are these recommendations being followed in clinical practice? How realistic are they? What support do physicians feel they need? How might they engage in self-care?

To shed more light on these questions, we spoke to Jesse Clark, DO. Dr Clark is Associate Program Director of Education at the Community East Family Medicine Residency and Clinical Chairperson of Family Medicine at Marian University College of Osteopathic Medicine, Indianapolis, Indiana.

What is your role in your health and hospital system?

As Associate Director of Education at Community East Family Medicine Residency, I am responsible for creating the panel of rotations, managing residents’ schedules, and making sure that our residents get the education and patient care that they need. I also see patients.

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What do you regard as your greatest struggle?

I think one of the biggest struggles clinicians face is the rapid speed at which this situation has been changing, which has several components. One is the science, for example, the nature of the virus itself, how it spreads, and what factors might or might not be protective. It seems as though almost every day there is a new scientific insight, which can impact how we treat our patients and organize our systems.

Another has to do with the decisions taken by our healthcare system, such as the closing of ambulatory sites and the transition to telehealth, although one clinic is being kept open in each region of Indianapolis.