“Out of sight but not out of mind”: perspectives from non-patient facing doctors during the covid-19 pandemic

The covid-19 pandemic has presented immense challenges to the National Health Service, but also to the NHS workforce. With up to one third of staff off with covid-19 or self-isolating at the start of lockdown, emergency rotas were rolled out and annual leave cancelled to maintain standards of care for service delivery.

Media attention has focussed on frontline professionals (and rightly so), but there is also a minority of doctors, who would under normal circumstances work despite living with significant health conditions. Yet, in the rise of the global pandemic, these professionals were more susceptible to infection and subsequently at risk of increased morbidity and mortality, if frequently exposed to covid-19. Consider as well the doctors who may be putting loved ones, who are vulnerable, at significantly high risk by nature of their occupation.  

The very identity of a doctor is to treat their patients, to be integral to the delivery of care and to endeavour to make the sick better, with patient contact at the centre of this vocation. Imagine then the moral dilemma and difficulties faced by doctors with coexistent health conditions who were not able to do this in quite the same way. Nevertheless, this group of doctors have chosen to accept a whole new challenge by working in a non-patient facing role throughout the global pandemic. 

To share their side of the story, we present three perspectives of non-patient facing doctors, at different stages of training, to highlight their experiences during the covid-19 pandemic, from a tertiary maternity teaching hospital in the UK.

“Despite it being a hard decision to come away from the patient contact that means so much to me, I took every opportunity to embrace my role as a non-patient facing doctor. I worked in a multidisciplinary team to turn the transformation of virtual antenatal clinics into a quality improvement project with multiple plan, do, study, act cycles. This resulted in a virtual clinic that was feasible and well received by patients and colleagues alike and which will be implemented in the longer term. Also, given the rapidly evolving situation of the pandemic, we quickly identified the need to monitor covid-19 incidence and review case reports; I therefore worked with one of our consultants to provide weekly updates to our department regarding the local covid-19 maternity statistics. This provided an overview of the situation locally and trend-analysis, which influenced clinical practice and ensured decisions were based on objective evidence. This shift in role has enabled me to learn about systems and processes, and how to adapt them to deliver patient-centred care; these experiences have been invaluable and I will carry them forward throughout my medical career.”

Lauren Quinn, Foundation Year Doctor

“My passion for Obstetrics & Gynaecology hinged partly on its diversity in practice was put to the test by being limited to conducting virtual clinics on a daily basis. My desire to continue to provide care for my patients has, however, kept me going. The experience has been a very fulfilling one, a learning process and an excellent development opportunity.

I was involved in setting up the virtual clinics across two sites of the hospital. I prepared the rota for non-patient facing doctors on a weekly basis to ensure appropriate and adequate staff allocation to these clinics. I coordinated and provided patient-centred care at the general and specialist virtual obstetric clinics with positive feedback from patients and colleagues. 

I have been involved with writing patient information leaflets and was part of a team that carried out two quality improvement projects to assess and improve patient satisfaction and quality of care from the virtual clinics. This has also inspired me to pursue an advanced training skill module in Obstetric Medicine.”

Oluwafumbi Olajide, Specialty Registrar ST5

“Covid-19 dramatically changed my training and work schedule within a week. I am a sub-specialist trainee, whose completion of the core curriculum allowed me to predominantly focus on fine tuning my reproductive gynaecological skills and operating. This however is not feasible in a non-patient role in a global pandemic. I felt uneasy in a virtual obstetric role, without the physical interaction with patients which many doctors define their role by. However, the only way to excel in new roles is to embrace it and be an advocate for an effective and proficient service and so I threw myself into it. 

The advantage of being in a minority is that by its nature you become a team. Our virtual team supported each other through our initial stumblings and adaptations as we fine tuned the clinics and our reactions to the societal changes and worries about the pandemic. I’ve been very fortunate to have developed new relationships with colleagues while keeping myself and my family safe.”

Polly Ford, Subspecialty Trainee in Reproductive Medicine

Despite the inevitable feelings of guilt experienced, we have continued to serve, to learn, to care, and to adapt, alongside our patient facing colleagues. We have all faced changes because of the pandemic, but as we reflect on our journeys, we hope this will provide encouragement for the positives that can arise, regardless of the magnitude of the problem faced.  

“As a patient facing colleague, the journeys of my non-patient facing team have provided immense inspiration because they have gone ‘above and beyond’ to transform care services in the background, whilst other colleagues were on the frontline.  Although they have been ‘out of sight’ from a patient perspective, they have very much been in their colleagues’ minds. It has also given me an opportunity to reflect on my role as a clinical supervisor to understand the challenges faced by these colleagues and to help in supporting them to  achieve their goals and aspirations in challenging times”

Manjiri Khare, Consultant Maternal, Fetal medicine

Going forward, we encourage you to take the opportunity to reflect upon and learn about the experiences of your own non-patient facing colleagues, so that we can all appreciate each and everyone’s valuable contributions to patient care during the covid-19 pandemic. 

LM Quinn, Foundation Year trainee, Department of Obstetrics and Gynaecology, University Hospitals of Leicester NHS trust,

O Olajide, Specialist Registrar, Department of Obstetrics and Gynaecology, University Hospitals of Leicester NHS trust

P Ford, Subspecialty trainee Reproductive medicine, Department of Obstetrics and Gynaecology, University Hospitals of Leicester NHS trust

M Khare, Consultant Maternal Fetal medicine, University Hospitals of Leicester NHS Trust, UK, Hon Senior Lecturer, University of Leicester

Competing interests: None declared.


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