I recently discovered an app called TikTok. From what I can tell, it seems to be used primarily by younger people who record themselves performing short music videos, lip-syncing scenes, or absurdities with their unsuspecting family members and pets. Most of my friends and family scoff at the fact that I downloaded the app—after all, I am a 38-year old Internal Medicine physician at a prominent academic medical center and on the front lines of the COVID-19 pandemic. I assumed I would be in the very small minority of TikTok users in my professional demographic. But I was wrong.
Burnout in the field of health care has been a problem for a very long time. The major factors leading to burnout usually include the seeming impossibility of balancing work and home life, time pressures, emotional intensities of patient encounters, EMR demands, competing patient and institutional goals, and insurance constraints. All of these issues can contribute to moral injury over time. With healthcare burnout increasing in the United States and correlating with disturbing rates of provider depression and suicide, many hospital systems have devoted significant energy and resources into promoting the concept of “wellness.” Examples include opening wellness centers, procuring wellness apps, creating wellness newsletters, and making wellness rounds. While these efforts can be helpful, in my opinion, most of their effects are transient at best. Furthermore, few of them meaningfully address the fundamental contributors to burnout in the first place. Most providers realize that without broad, federal-level policy change to address these underlying issues, there is not a whole lot that hospitals, even with the best of intentions, can do to mitigate burnout beyond offering relatively superficial remedies. So, in the absence of timely legislation, what do healthcare providers really want? I believe most of us simply want to do the work we were trained to do, and to feel valued and respected for doing it. In my experience, when healthcare providers feel validated, appreciated, and respected, the pangs of burnout truly do dissipate.
Fast-forward to the year 2020 and the COVID-19 crisis. Suddenly healthcare providers were thrust onto an unfamiliar battlefield, fighting an unseen enemy with no known treatment and with no vetted weapons at our disposal. Coupled with perpetual PPE shortages, fear about personal and family safety, stress about staffing demands, anxiety about running out of ventilators, the onset of the coronavirus pandemic was a perfect recipe for a burnout explosion. Indeed, the physical and psychological toll of this pandemic on frontline providers is yet to be fully realized and likely will not be for years to come.
Remarkably, instead of increased feelings of acquiescence, what I am witnessing more than anything amongst my fellow colleagues is a striking and renewed sense of duty, purpose, and passion. And I found evidence of this in the most unexpected place: TikTok. After I joined, I started scrolling. I was surprised to see hundreds of examples of a distinctly similar scene: assorted groups of frontline healthcare workers—decked out in different-colored scrubs and a variety of PPE—performing dances, re-enacting hilarious healthcare scenes, promoting “Stay at Home” messages, or simply showing others what it’s like to don layer upon layer of PPE. Some healthcare TikTok users use the platform in more educational ways: to dispel myths or prevent the spread of medical misinformation. But why is it that so many healthcare workers are turning to TikTok these days? How did this become a “thing?”
I suspect that for a few minutes, and in the company of their coronavirus comrades, these healthcare TikTok users are connected once again to the feelings that burnout took away: Joy. Purpose. Camaraderie. A collective sense of accomplishment. Validation. Satisfaction. Whether these providers realize it or not, they are essentially using TikTok as a wellness tool. I have seen it at my own hospital: I recently persuaded a group of COVID unit doctors, residents, and APPs to do the “Blinding Lights challenge” on the roof of our hospital. None of us are particularly good at dancing or have any significant social media following, but that did not matter—the act of making the video brought us together as a team where everyone felt needed and valued. It required all of us to take risks (of looking dumb), but in a safe space. It built resilience by reminding us that practice makes perfect (or in our case, not really perfect). “Right foot left foot challenge” came the next day, followed by the “Oh nanana challenge” shortly thereafter. Each exercise brought smiles to faces and palpably improved moods, and each was a true manifestation of teamwork. And then naturally, as positivity seems just as infectious as the coronavirus itself, the videos permeated everyone’s e-mails and social media platforms, and that positivity ended up spreading to others. Sadly, none of us is going to become the next sleeper TikTok star, but the simple act of taking a few minutes away from the intensity of managing COVID patients for a frivolous but genuine morale-boost might be one of the most unanticipated, authentic exercises in wellness in which I have participated.
To be clear, I am not suggesting that an app like TikTok answers the extraordinarily complicated issue of healthcare provider burnout. Actually, this is not really about TikTok or social media at all, but rather about what we gain when we take a moment to come together for a common cause. To me, TikTok highlights an important aspect about what “wellness” in the healthcare setting genuinely means. Ultimately, the real essence of wellness is found in the enduring importance of feeling like a valued member of a team—an authentic sense of belonging—whether at a patient’s bedside or in a silly 10-second dance video. If an app meant for bored teenagers can help provide that, I’m all for it.
And if you start scrolling, you will see that I am not alone.