The COVID-19 pandemic has profoundly impacted the medical profession, reshaping how healthcare is delivered, managed, and perceived worldwide. This case study uses insights from our doctors to examine key areas where the profession has undergone significant changes, focusing on telemedicine, workforce resilience, mental health, and public health infrastructure.
Dr Amran Dhillon is an anaesthesia registrar and a long-time advocate for changing the ‘work till you drop’ culture in many hospitals.
“Doctors are supposed to be amongst the smartest people, but we do a lot of dumb things, too,” he says. “The 14-hour shifts that doctors work can be soul-destroying and really impact on their wellbeing. One of the problems is that doctors are used to working hard from a very early age, but the workload can be relentless.”
Ironically, the COVID-19 pandemic has resulted in some much-needed changes to health systems, staffing levels, and the culture of working long hours.
“It has taken a worldwide pandemic to improve staffing levels in hospitals,” Dr Amran says.
“Thanks to federal and state governments' support, hospitals have brought in more staff. Hopefully, this will be a permanent change and improve patient-staff ratios.”
The Shift to Telemedicine
One of the most notable transformations was the rapid adoption of telemedicine. Before the pandemic, telehealth was an emerging but underutilised service. COVID-19 made it necessary for healthcare providers to maintain patient care while minimising physical contact.
During the initial phase of the COVID-19 pandemic, Australia experienced a significant surge in telehealth consultations. In April 2020, 36% of all general practice consultations were conducted via telehealth, with 96% of these being telephone consultations and 4% via videoconference (Fisher, k, Davey A., and Magin. P, (2022, August 8 Volume 51, Issue 8,). Telehealth for Australian general practice: The present and the future RACGP. Retrieved November 26, 2024).
This rapid adoption was facilitated by introducing 281 temporary Medicare Benefits Schedule (MBS) item numbers for telehealth services on 13 March 2020, of which 56 were designated for primary care. (Fisher, k, Davey A., and Magin. P, (2022, August 8 Volume 51, Issue 8). Telehealth for Australian general practice: The present and the future RACGP. Retrieved November 26, 2024).
Similar trends were observed globally, with telehealth usage increasing by over 5,000% from February to March 2020. (Wikipedia, Impact of the COVID-19 pandemic on the telehealth industry. Retrieved November 26, 2024).
- Statistics: In Australia, telehealth consultations increased by over 4,000% in the first half of 2020. Similar trends were seen globally.
- Benefits: Increased accessibility for remote patients, continuity of care during lockdowns, and reduced strain on physical facilities.
- Challenges: Limited access to technology for some patients, difficulty performing physical exams, and privacy concerns.
Telemedicine is now an integral part of healthcare, and many countries have adopted permanent policies to support its use post-pandemic.
"In hindsight, I am so proud of what we did. Two weeks before Sydney’s “locking down,” we converted most of our consultations to telehealth and screened everyone who needed to come into the practice. If anyone with respiratory symptoms needed review, they were seen in an isolation room wearing PPE, and COVID testing following public health recommendations was routine. We had cleaning protocols. We taught our support staff how to don and doff masks. We actually locked the doors of our practice. Some patients understood we were making these changes in an attempt to protect our community and were grateful; others found the changes we made really difficult and were frustrated they couldn’t easily see their doctor,” Dr Amanda Wijeratne told Medworld Institute.
Workforce Resilience and Burnout
The pandemic exposed vulnerabilities in the healthcare workforce. Long hours, lack of personal protective equipment (PPE), and the emotional toll of treating critically ill patients led to unprecedented levels of burnout.
Key Findings:
- In 2021, a Medscape report revealed that 42% of doctors experienced burnout, compared to 29% pre-pandemic.
- Healthcare professionals faced moral injury from having to ration care during resource shortages.
Efforts to address these issues include improved mental health support, such as wellness programs and initiatives like New Zealand’s Wellbeing Budget, which allocates funds for healthcare worker support.
A survey conducted on January 26th, 2022, by medical company Medworld (a partner of the Medworld Institute) confirmed that 95% of Australasian doctors believe we are in a workforce emergency.
There are around 125,000 doctors in Australasia. Medworld contacted their database of 20,000. Responses received totaled a 10% segment of the total doctor market.
“Before COVID-19, doctors reported a burnout rate of over 50%, but this survey shows that it has now moved to 60%. What shocked us was the number of doctors claiming to be working beyond their scope; this was 80%,” said Dr Sam Hazledine, Medworld Institute CEO and Founder.
Reevaluation of Public Health Systems
COVID-19 highlighted the importance of robust public health systems and exposed gaps in preparedness.
Lessons Learned:
- Underinvestment in public health left many systems ill-prepared for large-scale emergencies.
- Coordination between public health bodies and governments was often inadequate, leading to delayed responses.
Governments are now prioritising pandemic preparedness, with increased funding for public health research, stockpiling of essential resources, and enhanced global collaboration.
Medical Education and Training
The pandemic disrupted medical education, forcing universities and hospitals to adapt quickly.
Changes:
- Medical students transitioned to online learning, significantly reducing practical sessions and clinical placements.
- The focus shifted to training on infectious disease management and crisis response.
These adaptations have reshaped the future of medical training, integrating digital learning and crisis simulation into standard curricula.
Dr Hanieh Asadi, ICU Doctor and Co-founder of Generation Leader told Medworld.
The global disruption caused by the Covid-19 pandemic has revealed the effects of the increasing demand on healthcare systems as well as highlighting both abilities and areas requiring additional coordination and development. As seen in the media, the pandemic has unveiled the central role of healthcare systems and how they make a difference in human lives. However, more importantly, during these times, it is the leadership skills, adaptability, and resilience of the healthcare professionals and hospital board members that have a central role in leading successful and safe working environments.
I believe that the pandemic has underlined the importance of the combined knowledge and expertise of healthcare professionals from different professional backgrounds, to support a working environment that many of us never experienced before. The pandemic itself is incredibly stressful for healthcare professionals as we have had to distance ourselves from our families to keep them safe as well as fearing for our safety by looking after patients infected with the Covid-19 virus. Going to work at the hospital also means following certain routines such as having a temperature check, only entering the hospital via certain entrances and wearing face masks at all times. It also means that we have a larger number of patients in the intensive care unit (ICU) and working with new team members.
The pandemic has brought together teams, changed hospital infrastructure around patient care pathways and our routine working patterns. At one of the intensive care units (ICU) I have been working in during the pandemic, our morning handover has changed the structure to include the team of ICU doctors, anaesthetists, surgeons, ward managers and matrons and medical students who have graduated sooner to provide extra help on the ICU. The on-call ICU consultant for the day starts the meeting by ensuring all team members are present with allocated roles, clarifying the number of occupied ICU beds, specifying the number of patients on the wards with the potential requirement for ICU admission and the night doctors highlighting any patients at risk of deterioration. Any issues, be it patient-related or logistical, are addressed as well. At the end of the meeting, the team leaders for the different groups are given walkie-talkies to facilitate communication between different teams. At the end of the meeting, the team leaders meet in individual groups to discuss the plan for the day and task allocations within their teams. This change in working pattern has been facilitated by non-urgent operations being cancelled, which freed up both surgeons and anaesthetists to work with new teams and in other areas of the hospital. The structure in the hospital wards have also changed, the healthcare professionals are no longer only looking after patients within their speciality but allocated towards according to the greatest patient care needs. This also means that they have had to familiarise themselves with new equipment and work within new teams.
The necessity of the combined strength of multidisciplinary teams has been underlined further and reflects how healthcare professionals from different specialities and backgrounds are vital for a well-functioning organisation, which influences and optimises patient care. However, to lead or be part of a well-run organisation there are essential skills required, which doctors are not taught during their medical training. Leadership is in everything we do as healthcare professionals and is not only about clinical decision-making but also a way of thinking in broader and more inclusive ways. Leadership is in a range of activities that we undertake regularly in the clinical setting, such as; communicating with colleagues, leading multidisciplinary team meetings, conducting difficult conversations with relatives and patients, supporting team members and knowing how to facilitate the development of their best qualities.
Open and honest communication
As an employee, I value open, inclusive and honest communication. This is not only to reassure staff during times of uncertainty but also makes employees feel heard and included. The capability of leaders to adapt to the demands of staff that are overstretched in their roles is key as well as dealing with psychological stressors which will be detrimental to their motivation and morale.
Practice active listening
I learnt that listening and observing provides valuable information about team members as well as helping to maximise the capabilities of each individual. Having a network of teams that are connected from the front line to the management team will optimise the communication pathways and lead to tactical decision-making. Local teams are the best in making decisions based on the perception and their judgment of the situation around them. The responsibilities can also be distributed as well as creating an opportunity for team members to share their experience. This will not only make them feel valued but also provide new knowledge that could help create new strategies and work policies.
Lead by example
One of the greatest learning points for me has been realising the importance of leading by example. A skilful leader can stimulate and extracting the best qualities in the team members whilst facilitating an environment of safety. I do appreciate the urgency of decision making during a crisis, but with this pandemic uprooting our normal working patterns, we have to think about long-term planning as much as short-term crisis management.
Utilise different decision-making styles
The integrative decision-making style is useful early on during the restructuring phase of the hospital to the increasing demands of the crisis. This involves the inclusivity of many teams where the options of multiple courses of action can be derived from. In addition, a decisive approach to the more task orientated assignments such as creating new policies and care pathways are useful.
Empower people
By empowering staff members they will feel valued and committed to their job as well as experiencing a positive impact on their personal development and growth. This can be done by leading, managing and coaching; the three main tasks for team leaders as per West in Effective Teamwork [1]. Leaders should also be self-reflective about their ways and ask for feedback from team members. A top-down model of managers dictating various tasks to the team members might result in feelings of anxiety and undermining of the abilities of the staff.
I believe that in the healthcare sector there is an unspoken rule about the nature of our job role that drives us to adhere to our duties beyond expectations. The pandemic does not only mean that we are working in a challenging environment with an increased workload but involves fears and concerns around our welfare by being part of a professional group that is on the frontline of a health crisis. In addition to the negative impact of this on the mental wellbeing of healthcare workers, the restrictions in meeting with families and friends will exacerbate this further. I have come to understand that during times of a crisis it is skilful, empathetic leaders who encourage camaraderie in an environment of flattened authority that will increase productivity and boost morale amongst staff.
The medical leadership training that I undertook meant that I became more confident in my role as a physician by understanding leadership in greater detail, my awareness around leadership styles improved and I was also able to easier identify the transferable skills that I utilised to co-found Generation Leader. This made me realise the need for making training in management and leadership available for all healthcare professionals and students in a more flexible way, adapted to their clinical and academic commitments to fit their skills gaps and interests.
Mental Health Awareness
COVID-19 placed healthcare workers’ mental health under the spotlight. Frontline workers reported high levels of anxiety, depression, and PTSD.
Key Initiatives:
- Peer-support networks were established in many institutions.
- Governments and professional bodies implemented mental health programs tailored to healthcare workers.
This increased awareness has resulted in a cultural shift, reducing stigma around seeking mental health support within the profession.
During the pandemic doctors like, Dr Amran Dhillon stayed positive and resilient: “We are up for the challenge,” said Amran Dhillon, Anaesthetics Registrar
Conclusion
COVID-19 has permanently altered the medical profession, accelerating innovation while exposing critical challenges. The pandemic has reshaped how healthcare is delivered and managed, from telemedicine to workforce well-being and public health preparedness. These lessons provide a foundation for a more resilient, efficient, and compassionate medical profession in the future.
This case study outlines the pandemic’s transformative effects, offering a comprehensive view of its impact on the medical profession.
References
- Fisher, k, Davey A., and Magin. P, (2022, August 8 Volume 51, Issue 8). Telehealth for Australian general practice: The present and the future RACGP. Retrieved November 26, 2024.
- Michael A West. Effective Teamwork, p.76. Wiley-Blackwell 2012. ISBN: 9781119966005
- Medworld Institute (2024) , 2022 Medworld survey of doctors shows omicron workforce emergency. Retrieved November 26, 2024.
- Wikipedia, Impact of the COVID-19 pandemic on the telehealth industry. Retrieved November 26, 2024.
