Otolaryngologist Leaders Share Reflections on Pandemic Challenges

For most frontline physicians and healthcare workers, the Omicron surge at the beginning of 2022 was the hardest to manage. It seemed that the public cared less than ever before. Those who refused to get vaccinated or boosted, or to wear a mask, were even more indignant, and the escalating stress and exhaustion as the pandemic continued were reported by countless media. Today, mental health crises have become a secondary pandemic (Parker-Pope T, et al. Why 1,320 Therapists Are Worried About Mental Health in America Right Now. New York Times. Dec. 17, 2021).

The significant impact on patient volume and the corresponding decrease in revenue had dire consequences, including layoffs, salary reduction, the expectation to work more with fewer resources, and less of the individual flexibility I had once intentionally created for my team. My core values and advocacy for well-being and resilience were in stark contrast with health system realities and financial imperatives. (A shout out to my fellow pediatric otolaryngology chiefs, who joined weekly and monthly calls to share information and ideas, and provide peer support.)

Through it all, I’ve asked myself, “What has it been like for other otolaryngology leaders?” With safety and stability nowhere in sight and endless changes inflicted upon our daily workflow, how are our leaders doing? Above all, I’ve wondered, “Are leaders human?”

Our otolaryngology leaders often seem infallible, tenacious, unflappable, and gifted with foresight and omniscience. They seem to never tire. The weight of leadership often isn’t visible to others, but stress can and will take its toll, even among the strongest of leaders.

Leaders shield us from the tsunami of health systems’ pressure to generate income and rush to centralize resources and decision making. They’re warriors who battle for individual and group autonomy, advocating for patients and care providers. Amidst COVID-19 risks, they have ensured that patients received high quality, safe care that’s aligned with our values, not just measured by metrics and patient survey responses.

Why should we care deeply about those who lead us? Because the well-being of physician leaders is associated with their leadership effectiveness—and our own well-being. In a 2020 study on the “association of burnout, professional fulfillment, and self-care practices of physician leaders with their independently rated leadership effectiveness,” 9.8% of the variation in leaders’ aggregate leadership behavior scores was associated with their own degree of burnout (JAMA Netw Open. 2020;3:e207961). After adjustment for age and sex, each one-point increase in leader burnout score was associated with a 0.19-point decrease in leadership behavior score (P = .02), whereas each one-point increase in their professional fulfillment and self-valuation scores was associated with a respective 0.13-point (P = .03) and 0.15-point (P = .03) increase in their leadership behavior score.