After the ordeal of combating the pandemic, clinicians require time to recuperate. Organizations and their leaders should approach the concept in much the same way they do when developing other employee benefits. Determine who qualifies and then provide those clinicians a clear set of options for their personal recovery, including details on how and when those options can be exercised. Physical recovery could include temporary leaves of absence, temporary role changes, a more relaxed workflow, reduced hours, alongside meaningful opportunities to emotionally recover and address collective trauma.
For many doctors and nurses, the pandemic will not end when it does for the rest of us. The physical, emotional, and psychological toll of the past year will persist — and in some cases deepen — even after the volume of daily Covid-19 cases reaches a trickle. Clinicians aren’t just burned out; many are traumatized. Some will suffer from post-traumatic stress disorder (PTSD) as a result of their experience. That’s not just a problem for the individuals impacted. If the workforce can’t recover, then our already-strained supply of care providers might reach its breaking point.
We must provide clinicians with a recovery period. That means literally giving doctors and nurses time to step back, access tools to heal and treat their trauma, and ultimately return to the workforce.
This is not a novel concept. After risking their lives on the front lines, members of the military earn a period of reprieve from their service. In my own time in the U.S. Army, my friends and peers came to rely on this cycle of service. In the peak of the wars in Iraq and Afghanistan, the knowledge that after months in combat we could come home and be afforded the time and space to recover helped prepare us for whatever our service demanded next.
The way we approach military health is by no means perfect. But the premise underlying a tour of duty is instructive: to sustain engagement and health among service members over the long term, we can’t expect them to operate under combat conditions indefinitely.
What would a recovery period look like in health care? Organizations and their leaders should approach the concept in much the same way they do when developing other employee benefits. Determine who qualifies and then provide those clinicians a clear set of options for their personal recovery, including details on how and when those options can be exercised. Physical recovery could include temporary leaves of absence, temporary role changes, a more relaxed workflow, reduced hours, alongside meaningful opportunities to emotionally recover and address collective trauma.
To be clear, these need not be mandatory for staff, though an opt-out approach — you are automatically included in the program and have to explicitly choose not to participate — may be useful to counteract the “I’m fine” instincts of many health workers. Nor should organizations rely on their existing benefits package to provide recovery. Telling physicians suffering from PTSD that they must use their existing paid time off (PTO) won’t address the root causes of trauma and may ultimately lead to more burnout and turnover. And just as important, organizations cannot stop at offering reduced working hours. Indeed, it will be the combination of time (leaves of absence, reduced hours) and tools (group therapy, emotional support) that makes recovery efforts effective.
Giving clinicians the time and space to recover seems like a radically simple idea in the abstract. But the practical challenge is that the health care industry is already supply-constrained. There are no reserves or national guard standing by to send into battle when one tour ends. And unlike the military, we can’t rapidly train a group of new clinicians with the knowledge and skills to deliver high-quality care.
And yet, if the clinical workforce is unable to recover, the industry’s fears that physician and nursing shortages will become much worse may come to fruition far sooner than anticipated. During the worst months of the Covid-19 crisis, the health care industry got a snapshot of what competing for a limited supply of talent and expertise would look like. Some hospitals were left with unsafe staffing ratios (or nurses’ perception of unsafe ratios), even as they paid four or five times the market rate for travel nurses — those who are placed by an agency in temporary, short-term assignments at hospitals in need — to come to the rescue. Competing over a limited supply of talent and expertise will no doubt impact clinical outcomes and increase turnover, making supply challenges even worse. Our best shot at preventing a major shortage in the long term is to create a smaller, temporary shortage in the near term.
Fortunately, there are measures leaders of health organizations can take to protect supply even while giving clinicians the recovery period they need.
First, they can prioritize and sequence how a recovery period is made available. In truth, not all clinicians will need or want to step back. The experience of a nurse working on the frontlines of a Covid-19 unit may be very different than their peers observing from afar. Leaders should develop a principled set of criteria for determining which staff roles to prioritize. Even those who qualify for a recovery period won’t necessarily want to use it in the same way.
Second, leaders can continue using flexible staff arrangements that they developed out of necessity during the pandemic. Throughout the past year they asked staff to work varied hours, shift lengths, and locations. This flexibility was a welcome change for the clinical workforce. Breaking the narrow definitions of role and shift not only creates more capacity, it also gives clinicians more autonomy over their career paths, even allowing them to match the specifics of their roles to the realities of their lives. And those same approaches will help make a recovery period more viable.
Finally, the biggest opportunity to stretch capacity while creating room for recovery lies in tech-enabled care. For instance, offloading time-intensive administrative tasks — like patient record keeping — from clinicians to a software program can free up valuable bandwidth. Investing in AI-powered bots to perform routine intake and even certain diagnostic activities can ensure clinicians’ time is reserved for the most important steps in the treatment process. We at the Advisory Board have written extensively on the role that telehealth and technology can play in boosting clinician supply, particularly in the ambulatory space. An efficiency-focused view of tech-enabled care that breaks the one-size-fits-all way of delivering care would be necessary in response to future clinician shortages anyway. Now just seems like the right time to finally make the investment.
We must play the long game here. Giving clinicians a recovery period is the best opportunity to promote their individual well-being and protect future workforce supply, even if it requires near term tradeoffs. As a society, it seems like the least we could do