Radiologists Can Thrive in the Midst of COVID-19—And Beyond

Andrew F Simon, PhD, PsyD; Erin Simon Schwartz, MD, FACR


Appl Radiol. 2020;49(4):16-19. 

In This Article

Thriving Through Challenge

Beyond developing basic practices around maintaining structure and physical well-being, radiologists can adopt lessons from psychology to facilitate success in working in AWAs now and into the future. Research on people who perform well and experience satisfaction in everyday settings, as well as those who have survived life-threatening circumstances, indicate that fostering a mindset of opportunity and clarity of purpose can enhance success working under AWAs.[14]

The Importance of Mindset

The mindset or perspective from which people interpret their environment shapes possibility. Effective adaptation – through positive emotions and productive actions – tends to favor those who accept their current circumstances as they are. In contrast, those who see their world in relation to how it used to be or how they want it to be are often less successful. Problems emerge among those who wait for their environment to 'return to normal' or who rigidly maintain a model of the world that no longer matches reality. Accepting the need for AWAs and profound reductions in case volume does not mean these circumstances will forever remain this way. Rather, an opportunistic mindset is one that works with these conditions as they are, not as one wishes they were.

Several notable qualities characterize those who thrive. First, they move at a sustainable pace. Survivalist trainers teach the value of taking breaks and resting before feeling tired.[15] The threat of becoming overburdened has impacted radiologists for some time; burnout is rampant throughout the profession.[18] There is reason to believe that the coming months will bring even greater workloads. As volumes recover, medical imaging practices that have had to reduce staffing may find themselves understaffed, further contributing to the demands on those who remain.[15] Radiologists can prepare by learning more about burnout,[19] the financial importance of investing in physician well-being,[20] and how technology can be used to reduce burnout.[21]

Radiologists will be well served to anticipate workflow and financial uncertainty indefinitely; resisting the desire to target an end date by when things will go back to 'normal' can facilitate success. As predictions about subsequent waves of infection and the economic downturn persist, radiologists who can institute flexible and self-sustaining structure and effective practices that can endure over time will be more likely to thrive.

Second, engaging a mindset of gratitude has been shown to be highly effective in improving mood, even contributing to competent problem solving.[22] Gratitude should not be conflated with the common trope to just "think positive." The latter often feels burdensome and insincere; forcing one to overlay a positive attitude on top of a negative experience. This advice frequently backfires, as efforts to suppress negative thoughts typically cause them to surge even more powerfully.[23] However, radiologists who can acknowledge aspects of their circumstances for which they can be grateful may experience more positive emotions and enhanced decision making.[24] Gratitude can come in recognizing that large segments of the population, including some in radiology, are currently unemployed, underemployed, or engaged in unfulfilling work. Those currently seeking meaningful work, whether employed or unemployed, may benefit from reflecting on the unique skills and expertise they can bring to flexible work arrangements, including teleradiology. Acknowledging strengths can direct one's thinking toward novel possibilities rather than current limitations.

Cultivating a flexible, adaptable mindset involves remaining open to new and changing information, and filtering out the "noise" from non-credible sources. Following the excessive speculation in the lay press and on social media about the pandemic can be exhausting. Focus instead on what is and can be known; obtain credible information from reputable sources, such as the Centers for Disease Control and Prevention,[25–27] the American College of Radiology, and the American College of Surgeons, and others that are providing guidelines for safely reopening practices and conducting imaging services and elective procedures. The Radiological Society of North America recently offered valuable guidance for post-COVID surge preparedness.[28]

Cultivate a Sense of Purpose

Purpose refers to knowing one's aims and direction in life.[29] Having a clear purpose has notable benefits, irrespective of environmental conditions.[30] Many psychology studies have documented those whose clarity of purpose fueled their resilience through trying circumstances.[31] Individuals have persisted through the worst of conditions because of a clear commitment to a meaningful purpose, such as reconnecting with loved ones.[32] A clear purpose also supports decision making.[33] Indeed, focusing on or rediscovering why one has chosen to specialize in radiology can serve as a touchstone while navigating challenges.

In addition, a sense of purpose helps reframe the threat and instability brought on by the pandemic. Many healthcare providers have a commitment to serving others that motivates their actions despite the risk of contracting the virus. Those who feel enriched by their work exemplify what happens to those who maintain and act on a meaningful purpose; they move concretely toward a goal ("I will contribute to patient care in a way that utilizes my expertise"), as opposed to avoiding or moving away from difficulties ("I hope to not lose the connections and opportunities I've built over time"), or merely tolerating their situation, waiting for it to change ("I will find meaningful work or see better case volumes once a vaccine is available").

Clarifying a purpose can be frustrating, often because of an erroneous assumption that that purpose must be singular and world-changing (eg, setting out to transform health care). Purpose around work is often different from purpose at home, although the two should not conflict. Purpose may also change over time.[34] The challenge is not so much to sit down and craft a formal statement of purpose (although that is possible) as it is to reflect and clarify why one is engaged in work. This reflection can be empowering, opening a line of inquiry that can lead to new possibilities.

The broad range of subspecialties and practice settings across radiology likely reflects an equally broad range of reasons why radiologists do what they do. Irrespective of how one defines this reason, knowing it can help preserve a calm, focused perspective while the COVID-19 pandemic continues to impact radiology. The radiologists most likely to thrive in this environment are those who recognize that, no matter the level of uncertainty, they have the ability to alter the way they interpret and relate to their circumstances. Engaging in effective practices – creating a supportive work structure, adopting a mindset of opportunity, and clarifying their sense of purpose — can help radiologists to thrive in the most challenging of environments.

By doing so, they not only empower themselves to successfully navigate the current pandemic, but also to lay the groundwork for future success.