Open AccessExperiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic
Author(s) -
Donald E. Pathman,
Jeffrey Sonis,
Jerry N. Harrison,
Robert G. Sewell,
Jackie Fannell,
Marc Overbeck,
Thomas R. Konrad
Publication year - 2021
Publication title -
public health reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.202
H-Index - 92
eISSN - 1468-2877
pISSN - 0033-3549
DOI - 10.1177/00333549211054083
Subject(s) - medicine , pandemic , mental health , family medicine , safety net , ethnic group , health care , occupational safety and health , covid-19 , environmental health , psychiatry , pathology , infectious disease (medical specialty) , sociology , anthropology , economics , economic growth , disease
Objectives: The impact of the COVID-19 pandemic has been particularly harsh for low-income and racial and ethnic minority communities. It is not known how the pandemic has affected clinicians who provide care to these communities through safety-net practices, including clinicians participating in the National Health Service Corps (NHSC).Methods: In late 2020, we surveyed clinicians who were serving in the NHSC as of July 1, 2020, in 20 states. Clinicians reported on work and job changes and their current well-being, among other measures. Analyses adjusted for differences in subgroup response rates and clustering of clinicians within practices.Results: Of 4263 surveyed clinicians, 1890 (44.3%) responded. Work for most NHSC clinicians was affected by the pandemic, including 64.5% whose office visit numbers fell by half and 62.5% for whom most visits occurred virtually. Fewer experienced changes in their jobs; for example, only 14.9% had been furloughed. Three-quarters (76.6%) of these NHSC clinicians scored in at-risk levels for their well-being. Compared with primary care and behavioral health clinicians, dental clinicians much more often had been furloughed and had their practices close temporarily.Conclusions: The pandemic has disrupted the work, jobs, and mental health of NHSC clinicians in ways similar to its reported effects on outpatient clinicians generally. Because clinicians’ mental health worsens after a pandemic, which leads to patient disengagement and job turnover, national programs and policies should help safety-net practices build cultures that support and give greater priority to clinicians’ work, job, and mental health needs now and before the next pandemic.