A year ago, a number of predictions were being made about how the Covid-19 pandemic would affect the physician landscape in the United States. Looking back at those predictions, Advisory Board's Sarah Hostetter and Daniel Kuzmanovich talk with Radio Advisory's Rachel Woods about what has changed in the physician landscape over the past year and what hasn't.

Read a lightly edited version of the interview below and download the episode for the full conversation.

Rachel Woods: We're reflecting on the things that have changed in the physician landscape one year into the epidemic. And one of the biggest changes I've felt is just in the way we talk about doctors.

Daniel Kuzmanovich: I sure have. I feel like at the start of the epidemic we were all lined up around the metaphorical ship as it went off to fight the battle with the doctors and nurses on board, and a year into this, we're now doing our day to day.

This has felt a little more normalized to us and physicians have fallen a little bit out of the national conscience, but they are still fighting the good fight against the pandemic.

Woods: I think that is why the conversation today isn't so much dominated by consolidation or compensation. It is all about burnout. But the three of us have been talking about burnout for a long time. This isn't necessarily a new challenge for the workforce, but perhaps it's that the root causes of burnout and the way leaders address it, those certainly have changed.

Kuzmanovich: Absolutely. The causes of burnout that we've been paying attention to when the three of us have done this research have been largely about the administrative burden of medicine, which is very significant. And about feeling like a cog in the wheel, kind of in this context of security versus control, and feeling like I have a voice or a say in the organization and what it's doing. And also a sense of isolation.

All of that has still been going on, but that sense of isolation is not just isolation from my colleagues, but isolation from my patients, isolation from my families. Amid the challenges and the trauma, physicians are often well conditioned to say, "I am not traumatized by this event," but that can even result in a blind spot when it comes to what they've experienced. Physicians have been through a time, whether it's the professional burnout piece or the personal anxiety, trauma, distress, fear that they have experienced.

Recovery: It's time for the physician workforce to heal

Woods: I want to give each of you an opportunity to talk about how leaders should address the specific challenge of today and the specific challenge of trauma that is different from what we've said about burnout in the past.

Kuzmanovich: I'm going to do a twofer here. So the first one, when we talk to physician leaders, the word that they almost consistently use to describe their physicians is exhausted. And going after the administrative burden of medicine, maintaining whatever gains have happened over the last year where leaders look at the work being done and saying, "Hey, this doesn't need to be done," or, "Hey, this is not the right time to launch this big strategic initiative." Addition by subtraction, adding to physicians' lives by taking away.

Woods: That is really important. we talked about this last week with Yulan Egan, where she admitted that her biggest concern in recovery is that we're not prepared to deal with burnout when we still have to keep adjusting our strategic plan and investing in telehealth and doing all of this other stuff. And you're actually saying, to move forward, you might have to take something off the clinician's plate.

Kuzmanovich: 100%. Right now, the bill comes due is a real concern that our physician leaders have around the nation, that the challenges of burnout prior to the pandemic and then what physicians have been through, not just as professionals, but fundamentally as human beings over the last year, now is not the time to go launch every major strategic initiative to bring the organization back. It's actually going to take some time to bring the workforce back, to recover, to heal both from where we were and from what we've been through.

Sarah Hostetter: I think it's really easy to kind of think about this as a front line physician problem, right? As in the physicians who were actively in the hospitals fighting Covid-19 problem. But one of the things that Daniel said that resonates with me every time I think about burnout is, humans are traumatized after the last year. So that applies to all of your clinicians, all of your staff, it applies whether you have clinicians on the front lines or who were sidelined, right?

That was a big theme we talked about a year ago, is this division in the workforce. And I think this advice that Daniel's giving, it's really important to reflect on that across the entirety of the health care landscape and across every practice setting.

Woods: Yeah. And we got into this a little bit in the episode we did on resiliency. And I want to circle two of the words that Daniel said which is, "If we need the workforce to heal, then we need to allow the workforce to recover." And that is a real challenge that is going to affect not just the physician workforce, but it's going to affect how people think about their strategic plan, how they're doing capital planning, right? This is going to have its fingers in the way that we do everything in health care, because everything we do in health care comes through our clinicians, and comes through our physician workforce.