• BurnsKaren E AKEAUnity Health Toronto - St. Michaels Hospital, Toronto, ON, Canada.Department of Medicine and the Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada., Marc Moss, Edmund Lorens, Elizabeth Karin Ann Jose, Claudio M Martin, Elizabeth M Viglianti, Alison Fox-Robichaud, Kusum S Mathews, Kathleen Akgun, Snigdha Jain, Hayley Gershengorn, Sangeeta Mehta, Jenny E Han, Gregory S Martin, Janice M Liebler, Renee D Stapleton, Polina Trachuk, Kelly C Vranas, Abigail Chua, Margaret S Herridge, TsangJennifer L YJLYNiagara Health, St. Catharines, ON, Canada., Michelle Biehl, Ellen L Burnham, Jen-Ting Chen, Engi F Attia, Amira Mohamed, Michelle S Harkins, Sheryll M Soriano, Aline Maddux, Julia C West, Andrew R Badke, Sean M Bagshaw, Alexandra Binnie, W Graham Carlos, Başak Çoruh, Kristina Crothers, Frederick D'Aragon, Joshua Lee Denson, John W Drover, Gregg Eschun, Anna Geagea, Donald Griesdale, Rachel Hadler, Jennifer Hancock, Jovan Hasmatali, Bhavika Kaul, Meeta Prasad Kerlin, Rachel Kohn, D James Kutsogiannis, Scott M Matson, Peter E Morris, Bojan Paunovic, Ithan D Peltan, Dominique Piquette, Mina Pirzadeh, Krishna Pulchan, Lynn M Schnapp, Curtis N Sessler, Heather Smith, Eric Sy, Subarna Thirugnanam, Rachel K McDonald, Katie A McPherson, Monica Kraft, Michelle Spiegel, Peter M Dodek, and Diversity-Related Research Committee of the Women in Critical Care (WICC) Interest Group of the American Thoracic Society.
• Unity Health Toronto - St. Michaels Hospital, Toronto, ON, Canada.
• Crit. Care Med. 2022 Dec 1; 50 (12): 168917001689-1700.

ObjectivesFew surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.DesignCross-sectional survey using four validated instruments.SettingSixty-two sites in Canada and the United States.SubjectsAttending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.InterventionNone.Measurements And Main ResultsWe analysed 431 questionnaires (43.3% response rate) from 25 states and eight provinces. Respondents were predominantly male (229 [55.6%]) and in practice for 11.8 ± 9.8 years. Compared with prepandemic, respondents reported significant intrapandemic increases in days worked/mo, ICU bed occupancy, and self-reported moral distress (240 [56.9%]) and burnout (259 [63.8%]). Of the 10 top-ranked items that incited moral distress, most pertained to regulatory/organizational ( n = 6) or local/institutional ( n = 2) issues or both ( n = 2). Average moral distress (95.6 ± 66.9), professional fulfilment (6.5 ± 2.1), and burnout scores (3.6 ± 2.0) were moderate with 227 physicians (54.6%) meeting burnout criteria. A significant dose-response existed between COVID-19 patient volume and moral distress scores. Physicians who worked more days/mo and more scheduled in-house nightshifts, especially combined with more unscheduled in-house nightshifts, experienced significantly more moral distress. One in five physicians used at least one maladaptive coping strategy. We identified four coping profiles (active/social, avoidant, mixed/ambivalent, infrequent) that were associated with significant differences across all wellness measures.ConclusionsDespite moderate intrapandemic moral distress and burnout, physicians experienced moderate professional fulfilment. However, one in five physicians used at least one maladaptive coping strategy. We highlight potentially modifiable factors at individual, institutional, and regulatory levels to enhance physician wellness.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.

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