To All My Physician & Nursing Colleagues, Our Time is Now!

Are you a physician, a surgeon, a nurse, a therapist or someone in training to become one? Listen, we are at a point in time where physicians are on the front-line, taking on the role of saviors like never before. In times of crisis is when leaders and nations define their destiny. This is our time! This is our moment! We not only have to deliver but this is where and when physicians need to outperform and outclass the system-failures. It is time to lead. Understandably, the general sense of unhappiness, fatigue, and fear among physicians and other healthcare providers is palpable. There are concerns about our own health and our families' safety. There are a lot of genuine concerns. We are in real danger.

I'll give you an example from my own work life to illustrate my point. After working for three weeks and weekends in a row, I am totally burned-out. Being an attending at an academic program, I had never before had to write lengthy daily progress notes or place orders in the EMR on my busy stroke service. I had only ever attested and signed notes that my team of residents and nurse practitioners had written and sent my way. Until a few weeks ago. When I realized that our residents & nurse practitioners were either going into quarantine or getting sick, and our medical students were being asked to stay home, I chipped in. Rounding on patients, writing my own notes, being on call for coverage for other smaller rural hospitals in the state for three weeks non-stop undoubtedly took its toll on me in the form of extreme burn-out. But I did it anyway, not because I had to or because anyone had forced me to. But because this is what I hope all physicians and healthcare workers are doing in these unprecedented times that are calling upon healthcare workers to go above and beyond our call of duty.

Prior to the current Covid-19 crisis, I was embroiled in a months-long rift with the leadership in my department that had resulted in a toxic work environment. So much so that I was on the verge of either quitting altogether or hitting back hard. When the pandemic hit, however, I swallowed my ego, put aside my anger, and decided to come to work and do what I could to mitigate the fear and uncertainty that are prevailing. Every day for the last 3 weeks, I have been coming back home scared and worried about bringing the lethal virus home, exposing my 4-year old daughter, my third-trimester pregnant wife, or my in-laws who are in their late 60s. In a pre-Covid-19 era I would never have fathomed doing something like this voluntarily, but such are the times we are living in.

Compared to what many emergency physicians, intensivists, urgent care providers, and front-line nurses are doing in this time of crisis, I realize my actions don't even come close to the sacrifices my colleagues are putting in. In Italy and Iran, in New York and Seattle, patients and physicians are dying every day. We recently heard of an oncologist and a cardiology fellow who sadly lost their battle against this virus. Dozens of physicians in China, Iran, and Italy have already passed away. As depressed as I am being a doctor, these numbers are fortunately very small compared to how many public lives we have lost to this virus. To top it all off, we are all painfully aware of the dearth of equipment and PPE, lack of support, and a lack of true leadership. It feels like nothing short of doomsday.

In October last year, I authored a book called, "Why Doctors Need To Be Leaders: A Call To Action Amidst The Evolving Complexities of Healthcare". I was worried about physician fatigue and burnout, documentation burden, and the lack of independence for physicians, nurses in healthcare; I complained about how physicians and patients alike are miserable, while insurance firms, pharmaceuticals, bureaucracy, and hospital administrators were thriving. I lambasted the phenomenon of physicians losing their prestige and respect, and brought attention to how patients are despairing while fighting for prior authorizations and approvals to get basic testing done. As the healthcare system crumbles, a chunk of the blame is placed on us physicians.

I had barely finished crusading against this unfair assessment of doctors and reiterating our need to step up and take our place at the helm of affairs, that I now find ourselves in this unprecedented crisis. An era in which we can only stare in shock as we review the CDC guidelines on using bandannas and scarves to protect ourselves from a highly fatal virus.

On one hand, we see Elon Musk, with no prior experience in manufacturing ventilators, pledging to deliver ventilators in response to this crisis. On the other hand, we have the political leadership showing incredible nearsightedness and incompetence in not being able to put in place a program for rapid production and distribution of face-masks and other PPE. I find this to be a sad commentary on the state of our nation and its leadership.

Would the powers-that-be allow regular folks access to a portion of their 401k (retirement funds) without tax or penalty in this time of increasing unemployment? Or would ruffling the financial mafia's feathers at this time be too politically risky? How about taking away the insurance companies' privilege of prior authorization so that patients can be discharged to facilities to make room for the incoming COVID-19 patients? Or would that risk losing election campaign funding via said insurance companies? Instead of bold decisions that are the need of the hour, what you hear instead is another guideline stating that in case of a healthcare worker's exposure to the coronavirus, there's no need for them to be tested or isolated. Just put on a face mask and go back to work!

I am writing this article so that I may speak heart to heart with my peers. To let them know how proud your colleagues, patients, and the public are for all you are doing. These are unbelievable times. What is happening around us is real, and it is beginning to hit home. Many of us feel like we are being pushed against the wall. But let me remind us of the Hippocratic Oath:

- I will prevent disease whenever I can, for prevention is preferable to cure...

- I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug...

- I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

- If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

My friends in healthcare, this is a defining moment in the history of mankind. As physicians, let us all become leaders of our teams, of our families, of our patients. Remember, we are soldiers in this war. Every life we save that brings a loved one back to his/her family from the horror of this new and mysterious illness has an un-measurable impact. This is the time for sacrifice, and for reason in the face madness. This is our time to take back the reigns of leadership that we had lost over the last several decades, and in doing so transform the world. While it's hard to see the light at the end of the tunnel, it is imperative that we persevere. When all is said and done, it will be the front-line doctors and nurses who will be remembered as heroes and martyrs; who raised the world from its knees back to its feet. To all my physician and nursing colleagues, let this moment count. Let us lead the world into a new era of health and bright smiles. For folks like me who were lucky to get a Sunday off, let's get back to work. I'll see you on the other side, where health and happiness thrive........very soon!

Written by: Atif Zafar, MD

#healthcare #physicians #doctors #healthcareleadership #corona #COVID19 #nurses #patients

Atif Zafar, MD is a physician, entrepreneur, and the author of the book "Why Doctors Need To Be Leaders: A Call To Action Amidst The Evolving Complexities of Healthcare". He can be reached at atif@doctorsmovement.com.

The book is available on Amazon: www.atifzafar.com/book