From Hopelessness to Hope

It’s been a while since I have covered burnout in this column, but addressing this issue has never been more critical than it is today.

Burnout rates were high before COVID-19, due to administrative burdens, stricter government regulations, insurance hassles, lack of work-life balance, increasing inflation, the failure of the federal government to give us a fee schedule, and other factors that took the joy out of practicing dermatology. The ongoing pandemic, along with the economic and emotional stress it placed on all health care workers, has dramatically increased the already high rates of burnout and depression and drawn attention to its potentially tragic consequences.

Consider Lorna Breen, MD, an emergency room physician at New York-Presbyterian Hospital in Manhattan and the director of the emergency room at the Allen Hospital in New York City. Dr. Breen died by suicide on April 26, 2020.

By all reports, she was passionate about her job. Dr. Breen treated COVID-19 patients, contracted the virus, and returned to an overwhelming number of sick patients. She worked around the clock with limited personal protective equipment.Dr. Breen was struggling with feelings of anxiety and depression but felt afraid to ask for help as she thought it would be seen as a sign of weakness and/or be held against her.

She isn’t alone. Four hundred physicians die by suicide each year and likely feel just as isolated as Dr. Breen did.

Even one suicide is too many, and the Dr. Lorna Breen Heroes’ Foundation is doing everything that it can to make sure no other physicians suffer in silence and die by suicide. The family set up the Foundation to provide mental health support to health care professionals via grants that reduce and prevent suicide and burnout and fund mental and behavioral health treatment.

At press time, the Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) passed in the House but was bounced back to the Senate for re-approval due to a small change in the final text. Once the Senate passes the legislation, President Biden is expected to sign it into law.

Some of the funding has already been dispersed. The Health Resources Services Administration recently allocated $103 million to 46 medical institutions and universities to train health students, residents, or health care professionals in evidence-based strategies to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders. This money was earmarked under the American Rescue Plan Act of 2021, also called the COVID-19 Stimulus Package, as part of the Dr. Lorna Breen Health Care Provider Protection Act.

Once signed into law, the Dr. Lorna Breen Health Care Provider Protection Act will also provide grants that improve health care professionals’ well-being and job satisfaction and identify and disseminate evidence-based best practices for reducing and preventing suicide and burnout among health care professionals. It will establish a national evidence-based education and awareness campaign targeting health care professionals that encourages us to seek support and treatment for mental and behavioral health concerns. Moreover, the Dr. Lorna Breen Health Care Provider Protection Act will provide grants for employee education, peer-support programming, and mental and behavioral health treatment, especially in current or former COVID-19 hotspots. The Act also calls for a comprehensive study on health care professional mental and behavioral health and burnout, including the impact of the COVID-19 pandemic.

We in dermatology must support these efforts. We must also use our voices to destigmatize physician suicide and mental health disorders within the dermatology community by encouraging support groups, increasing our vigilance of the signs of burnout and depression in colleagues (and ourselves), and not hesitate to do or say something when we recognize that a colleague is struggling.

For more information on the Dr. Lorna Breen Heroes’ Foundation: drlornabreen.org