Table 3 Sub-themes pertaining to relationships
Relationship | Themes | Sample Quotes |
|---|---|---|
Patients | Difficult conversations with patients (e.g., vaccines, misinformation, political views) strained relationships | “I’m thinking of one person that stuck out in my mind in particular but there are lots of patients like this; I’ve had a relationship with them for 20 years and they’ve always trusted me to provide health care and provide advice and now they did not trust what I was telling them. And it was frustrating and disheartening and kind of made me really feel sad about our relationship with some of these people that if I saw him on the soccer field, would spend time chatting with and ‘how are the grandkids?’ and now they didn’t believe the advice I was giving them.” (Participant #1) |
Physicians felt out of touch with patients | “I think the main thing was just that gap, that distance, that feeling you weren’t available to them (patients) in the way that you wanted to be.” (Participant #5) | |
Changing perceptions of some patients based on patient beliefs about the pandemic | “I’ve learned so many things about people I wish I didn’t know, like patients I felt really kind of close to and it was so disappointing to find out that they didn’t believe this [masking for the pandemic] was a concern and didn’t feel that they had a role in protecting other people even if they didn’t want to do things themselves….It was pretty disheartening.” (Participant #1) | |
Physicians described feelings about losing patients to COVID | “I definitely remember a patient where he and I weren’t really seeing eye on eye to eye on how to best protect ourselves against covid and getting vaccinated and he was really high risk. And I remember having some back and forth conversations that I knew I wasn’t going to win. And then he ended up on a ventilator for a few weeks, and then he ended up dying from COVID.” (Participant #8) | |
Staff | Physicians had stronger relationships, working through difficult times together | “I feel like we’re a much stronger, more cohesive group than we were pre pandemic. So my story had a happy ending.” (Participant #10) |
Physicians were proud of staff for complying with mitigations strategies and taking care of people | “I’m very proud of the staff that that came through and put PAPRs on and put masks on and took care of people, and we sent them home and yet they came back and they’re still working and they’re still taking care of patients.” (Participant #3) | |
Differences in views of vaccines and mitigation efforts as well as misinformation caused friction in relationships | “There have been several times in the clinic where I will walk into a room and hear some discussion happening and had to just confront misinformation that was being floated around the clinic. So, I think there’s some degree our relationship got a little strange because I was pushing back on a lot of kind of, again, misinformation that we’re speculating, but I think it was important that I did that. (Participant #7) “Our clinic director is a nurse practitioner and we have always seen eye to eye on stuff, and our relationship has really, really changed because of pandemic for the worse. So she does not believe in the vaccine, and she doesn’t encourage students to give the vaccine and she has repeatedly tried to show me research that she’s done on why the vaccine can be harmful. She will be like, here’s a binder of stuff…I’m not even interested in wasting my time reading it. And so that’s been really frustrating.” (Participant #11) | |
Physicians experienced loss of connectivity of in-person communications (e.g., people staying in their offices, no team building activities) | “We do have our own offices. So primarily we stayed in our own offices and for the meetings we had, it was all pretty much zoom based; Even now” (Participant #11) | |
Work from home option offered to some staff but not others, creating tension | “My nurses had to do things, they had to come to work. They couldn’t do their job remotely.” (Participant #6) “Our MAs and our nurses weren’t able to work from home. So, even though they sent the physicians home, the nurses and the MAs still came in the clinic pretty much for the majority of the pandemic. And I think that resulted in a little bit of resentment. You know, ‘why can you work from home? But we have to be here?’ And I think part of that was the organization’s mitigation efforts are trying to reduce the number of people in a building but, they essentially didn’t let our MAs, nurses, or schedulers, work from home very much. So there was a little bit resentment surrounding that.” (Participant #7) | |
Colleagues | Different ways of communicating and keeping in touch were developed | “…the group text that that we have going with my primary care partners, the family docs and nurse practitioner that I mentioned was really, really helpful…initially it [the pandemic] changed so quickly that it was just felt overwhelming to just try and keep up with things… And then just, you know, what are you guys doing to stay sane?” (Participant #1) |
Relationships suffered from not meeting in person and feeling disconnected | “That suffered; the relationship with colleagues is much more distant now and less personal and that’s because of the way that the pandemic kind of pulled us apart and put us into our little silos. And I don’t know that we’re going to get back together again. That’s kind of a bummer. It’s become less personal and collegial than it was before the pandemic.” (Participant #10) | |
Teams protected other physicians (e.g., older or pregnant physicians) | “We have some older physicians, and we really tried to keep them safe and maybe not have them see patients as much as some of us who are younger. We had a pregnant physician. We didn’t want her going into isolation rooms when it first, when the pandemic was super bad. So we all worked really well together and we’re all on the same page and everybody was happy to help as much as they could.” (Participant #11) | |
Communities | Some positives with community appreciating work of clinicians, including testing | “If testing became available to us that we could offer it to our patients. All of that was very important for us to continue to be a community resource throughout the pandemic.” (Participant #4) |
Some businesses and schools did not follow guidelines | “There were a lot of businesses that were not going to enforce the mask mandates…I actually called one of the community leaders…’I’m reaching out to you as a community leader if you could step up in this really important public health crisis…and have your employees mask.’ He said, ‘I can’t make my employees mask ‘and was having none of it.” (Participant #1) | |
Politics shaped community responses and relationships | “In general, it probably hurt it a little bit because most of our political leaders and civic leaders, they thought it was all bunch of crap. It was hurting their business. And anybody who didn’t subscribe to their political agenda was wrong.” (Participant #9) “It made us aware of those political ideological differences. I think in some ways, I learned a lot more about how certain organizations in the community function and how they really stepped up during the pandemic and, you know, honestly met a lot more staff that work at public health and, different spaces. So, in some ways, I think brought us closer.” (Participant #5) | |
Family | Virtual tools helped stay connected to family | “We were still able to communicate with family and friends virtually.” (Participant #8) |
Staying at home with family | “I had a lot of support at home with my wife and kids and, ironically, we had a lot more time with each other, with lock down and people at home. So, that was kind of foundational to keep the stress down.” (Participant #8) | |
Worry about ensuring safety of family | “When you get home, you’re going to change your clothes in the garage, and then go and shower and sleep in a separate room. One of our friends−his wife made him stay at a hotel for a month at the start of the pandemic, because she was so worried about him getting their kids sick.” (Participant #5) | |
Different experiences vs. family/friends in jobs that slowed down | I was trying to I was trying to participate to be an empathetic family member, but really, at the time I was, I was living a totally different experience than what they were living because I felt like I was barely sleeping because I was trying to do so many things and I just didn’t have enough hours in the day. I was trying to still be a doctor and do all these other things. So it was it was weird. (Participant #10) | |
Challenges with childcare and virtual learning for children | “There were struggles with virtual school and online learning and kind of a hybrid schedule and you know, the, our kids had some variable experiences with that.” (Participant #8) | |
Family members not believing in the pandemic disrupted relationships | “They found out I had Covid and I say this matter of factly, they don’t bring soup. They don’t offer to help with the kids. They offer to bring me some of their secret stash of ivermectin” (Participant #2) | |
Schools | Schools not taking medical advice strained relationships | “I became so frustrated with that [School Advisor role] that I stopped because they continue to ask my advice, but then not follow it.” (Participant #11) |
Failures of at-home schooling impacted views of physicians | “There’s kind of that love hate relationship, because we were the ones who told people in the school board to mask, and send people home…And, of course, now kids are struggling because there was no internet or it didn’t work well, or they didn’t get whatever they need…. So, I think rural communities are reeling a bit. (Participant #3) |