A Qualitative Investigation of the Impact of COVID-19 on Emergency Medicine Physicians’ Emotional Experiences and Coping

doctors hands using stethoscope

UMass Amherst graduates and current PhD students of the Affect and Social Cognition Lab directed by Linda Isbell have authored a new paper in press at the Journal of the American College of Emergency Physicians. This project is part of the grant "Emotional Influences on Diagnostic Error in Emergency Medicine: An Experimental Approach to Understand Diagnostic Failure and Facilitate Improvement for Patients with and without Mental Illness" funded by the Agency for Healthcare Research and Quality.

Authors: Welsh, Margaux; Chimowitz, Hannah; Nanavati, Janvi; Huff, Nathan R., & Isbell, Linda M.

Study objective: Throughout the COVID-19 pandemic, emergency medicine providers in the United States have faced unprecedented challenges, risks, and uncertainty while caring for patients in an already vulnerable healthcare system. As such, the pandemic has exacerbated high levels of negative emotions and burnout among emergency medicine providers, but little systematic qualitative work has documented these phenomena. The purpose of this qualitative investigation was to study ED physicians’ emotional experiences in response to COVID-19 and the coping strategies that they employed to navigate the pandemic.

Methods: From September 2020 to February 2021, we conducted semi-structured interviews with 26 ED physicians recruited from two early COVID-19 epicenters: New York City and the Metro Boston region. Interviews, coding, and analyses were conducted using a grounded theory approach.

Results: ED physicians reported heightened anxiety, empathy, sadness, frustration, and anger during the pandemic. Physicians frequently attributed feelings of anxiety to medical uncertainty around the COVID-19 virus, personal risk of contracting the virus and transmitting it to family members, the ED environment, and resource availability. ED physicians also discussed the emotional effects of policies prohibiting patient family members from entering the ED, both on themselves and patients. 

Sources of physician anger and frustration included changing policies and rules, hospital leadership and administration, and pay cuts. Some physicians described an evolving, ongoing coping process in response to the pandemic, and most identified collective discussion and processing within the emergency medicine community as an effective coping strategy.

Conclusions: Our findings underscore the need to investigate the effects of physicians’ pandemic-related emotional stress and burnout on patient care. Evidence-based interventions to support ED providers in coping with pandemic-related trauma are needed.