U.S. Surgeon General Vivek Murthy, MD, labeled the nation's loneliness and isolation issue as an epidemic in May, and the healthcare industry lacks immunity to it, hospital leaders told Becker's.
Camaraderie levels among hospital physicians are dipping for multiple reasons, including the surge of specialization and subspecialization in medicine, the changing employment model and high workforce attrition rates.
"Before, moving through the halls, there was a lot more familiarity within physician and nursing staff who had been at the hospital for a very long period of time," said Neil Gandhi, MD, emergency medicine regional medical director of Houston Methodist Hospital System.
"What we're seeing now is higher levels of change in new faces," Dr. Gandhi, who's also a practicing emergency medicine physician, said. "It's very welcome to have new physicians and staff members join our team and just care for patients, but, subtly, at times what might be lost there is there's something to be said for a 10, 15, 20-year relationship with another medical staff member."
It isn't just relations among hospital physicians that are weakening as turnover rises. Healthcare professionals at large are becoming more secluded as primary care physicians disappear from hospital rounds and COVID-19-era practices, such as virtual meetings, stay stuck on calendars.
Face-to-face collaboration is also less common because of the increased use of EMRs, according to Nkem Iroegbu, MD, president of Milwaukee-based Aurora Sinai Medical Center and interim president of Aurora Medical Center Grafton (Wis.).
One example is physician lounges, which have been called ghost towns for the past two decades and became more bare because of the COVID-19 pandemic. In some of them, it's a place for leaders to post performance metrics and rank each physician against one another, which can spur more discontentment.
"For a doctor to see their name or their number on a board, and to have to look at that board and contemplate what people must think about them, is really a very unfriendly experience," Ted Hamilton, MD, senior adviser of physician well-being at Altamonte Springs, Fla.-based AdventHealth and chair of the Coalition for Physician Well-Being, said. "They just don't go to the physician lounge anymore."
"Even though there's a sign on the door," he said, "it's not a welcoming sign in lots of places."
The dwindling camaraderie levels isn't a problem about physicians not being "warm and fuzzy," Gerald Hickson, MD, founding director of the Center for Patient and Professional Advocacy at Vanderbilt University Medical Center in Nashville, Tenn., said: It's about a culture that lacks respect.
Dr. Hickson defined strong teams as those that have common values, know and respect every individual's role, and are comfortable questioning others. The last factor is one of the hardest to achieve, he said, since between 3 percent to 5 percent of professionals per discipline have difficulty working with others.
"Sometimes, we find leadership that want to look the other way about those challenging individuals," Dr. Hickson said. There's a common reasoning that difficult physicians "bring — what is perceived to be special value to the organization, and everybody else can just accommodate. That's a major challenge we have in medicine that we don't like to deal with, but it's so important in creating the right environment."
Doctors are more susceptible to burnout when they have strained relationships with their co-workers, according to research. In 2007, a study evaluating burnout levels in physicians working in intensive care units found that negative relationships among colleagues were associated with higher burnout scores, but improved relationships between intensivists and nurses were associated with a lower burnout score.
Most of the leaders who spoke with Becker's mentioned positive strides in hospitals working to foster connection among staff, but to overcome this loss of harmony, Dr. Hickson said, "leaders need to quit blinking and address the issues that might be right in front of them."