Emergency physician stressors, concerns, and behavioral changes during COVID-19: A longitudinal study

Area of Science:

• Emergency Medicine
• Public Health
• Epidemiology

Background:

• The COVID-19 pandemic significantly impacted healthcare systems globally.
• Emergency physicians faced unique challenges due to direct patient exposure and high-stakes decision-making.
• Understanding the psychological toll on this critical workforce is essential for targeted support.

Purpose of the Study:

• To longitudinally assess anxiety, work, and home concerns among U.S. emergency physicians during the COVID-19 pandemic.
• To identify factors associated with increased risk for posttraumatic stress disorder (PTSD).

Main Methods:

• A longitudinal, cross-sectional email survey was conducted with emergency physicians across seven academic centers.
• Surveys assessed COVID-19 patient exposure, testing availability, anxiety/stress levels, and PTSD risk using the PC-PTSD-5 screener.
• Logistic regression analyzed factors associated with a high PC-PTSD-5 score (≥3).

Main Results:

• Nearly all surveyed physicians (97.3%) treated suspected COVID-19 patients, yet most (61.8%) had not been tested themselves.
• Physicians' primary concern was the potential for a second wave due to relaxed social distancing.
• Women physicians were significantly more likely than men to screen positive for PTSD at both initial and follow-up assessments (OR=2.48).

Conclusions:

• Despite near-universal exposure to COVID-19 patients, emergency physicians reported a decrease in stress levels over the study period.
• Female sex emerged as a significant independent risk factor for elevated PTSD symptoms among emergency physicians.
• Findings highlight the need for gender-specific mental health support for healthcare professionals during pandemics.