Table 3.

Concerns of psychiatric physicians across the country during the COVID-19 pandemic

Class	Example
Personal prevention	What personal protective equipment (PPE) is available for me in my work setting? How does the frequent change in guidance about PPE affect my trust in the system and guidance? How effective is a surgical mask, N95 mask, face-shield or goggle, gloves, or gown to prevent infection? Given limited supply, will I be forced to prove my worthiness as essential in order to obtain these? Am I eligible to be tested for the coronavirus? Which is the best test?
Personal treatment	If I get infected, what treatment is available? Since there is no FDA approved treatment, how effective are experimental treatments like hydroxychloroquine, azithromycin, remdesivir? Will I live or die?
Effects on others	What if I catch the disease and spread it to my children and elderly parents? What if I bring it home from work and spread it to my roommates? If I catch the disease how will I continue caring for and/or breastfeeding my infant? Will I need to delay further childbearing due to my workplace exposures?
Economic stress	How will this pandemic disrupt my income? Will my patient panel change and will I be asked to work fewer or longer hours? What if I can't adjust to providing care via telehealth and that's the only option at this moment in my setting? What if I am required to be physically present as essential, and I only feel safe working remotely? Will I lose my job? Will I quit? What if I have preexisting conditions and am at high risk to die if I catch the infection – should I quit my job altogether and risk financial stress versus work and risk exposure and death?
Ethical considerations for self	How do I balance the tenets of the Hippocratic oath while also working in systems that may not be optimized for prevention, with a risk that I may die?
Ethical considerations toward others	How do I properly provide informed consent at time of psychiatric admission around risk for COVID-19 infection while the patient is on the psychiatric unit? How can I conduct HIPPA-compliant telepsychiatry interviews from home with my family present? How do I balance providing voluntary professional services to others in need whilst I struggle to maintain afloat financially? If I am trained to be a physician, does this mean I should answer the call to front-line service and if I don't, am I guilty of not serving my profession well?
Training considerations	Will this pandemic affect my learning opportunities? Will I attain all competencies required for graduation? If I get quarantined or sick, will that affect my graduation date? How do I respond to policy that makes me feel unsafe? Is quitting even an option for trainees?