With work-from-anywhere as the new norm, communications platforms with video, text, and voice capabilities have gone from conference call annoyances to everyday necessities. But workers now find themselves bouncing between calls without a moments' rest, and losing productivity to constant app-switching.

These issues have always been a focus of ours at 8x8, and are why we provide a unified voice, video and chat app. They're also why we now embed advanced voice capabilities directly into the apps you already use, including Microsoft Teams, Salesforce and ServiceNow. In our new eBook, Connect Everywhere, we discuss how to give Microsoft Teams users a break from context switching and communicate with anyone, anywhere from one central location.

To learn more about the effects of video fatigue I sat down with Dr. Jessi Gold, MD, MS, who is an Assistant Professor in the Department of Psychiatry at Washington University in St Louis School of Medicine where she specializes in college mental health, medical education, and physician wellness. Jessi also writes regularly for the popular press about mental health, stigma, and medical training.

The following conversation was edited for brevity and clarity.

Todd Goldman, Vice President (8x8): Hi Jessi, could you tell us a little bit about yourself?

Jessi Gold, Assistant Professor, Department of Psychiatry, Washington University in St Louis School of Medicine: I am primarily an outpatient psychiatrist. That means ( pre-COVID-19) I would see patients in a clinic for thirty minutes or one-hour appointments for a wide variety of things. I see primarily college students and graduate students and then other healthcare providers, people who work in the hospital and people who are staff in the hospital, those are the people that I see in my clinic. All of that has transitioned to being virtual since March for me.

Todd: That’s a perfect lead-in to what we're here to talk about today which is the fact that lots of knowledge workers have been moving to video conferencing to do their jobs. I’ve done a lot of video conferences in my career, but it hasn’t been 100% video conferencing 100% of the time. But recently, that has changed, and I am on the computer and phone all the time and I find it exhausting. I know people are talking about video fatigue, so I am glad I’m not the only one. What are your thoughts?

Jessi: I think it's definitely common, so I can talk about my own experience and then I'll talk about what I know. In my own experience, I didn't have a lot of practice doing virtual anything. I had a little bit of experience through the Veterans Affairs, they were pretty ahead of the time in terms of Telehealth platforms. We did a little bit during residency, but other than that, psychiatry, just like all forms of therapy, is very human-centric, so everything's in person. I was never used to doing anything over the screen nor did I think that I would.

But, all of a sudden, the students weren't coming back from spring break and we were going to be at home and all of a sudden we decided it was in the best interest of the clinicians and the patients for us to stay at home. Then we just started seeing patients through virtual platforms.

And for me, that is just back-to-back meetings. I'm in back-to-back patients just sitting in a virtual waiting room and taking people in. In a normal environment, I see patients all day a lot of the time in my job, sitting in chairs talking to them face to face while I write on a legal pad taking notes, and then I go back on the computer and write notes.

But with telehealth, I can feel myself being much more exhausted physically doing this kind of work than I did previously. I think that we have much less time for breaks because your current appointment bumps up right into the next appointment. You almost feel that because you don't have to go get the other person, they are right there waiting, and you can see them waiting. And even though they can't see you, it almost feels like you have to keep going. I think we have this constant back-to-back feeling like you have to keep just seeing the next person for hours on end. And that's hard.

And that’s a strain on your eyes. It’s a strain on what you're doing… I'm very used to looking for nuances in people, like body behavior, things that are unspoken communication is a lot of what I do in my job and so if I'm looking at you [over a video platform] I can't see your hands, I can't see much of your body except for your eyes. I'm going to be trying really hard to figure out what I can learn from your eyes right now and that's hard. I think I'm overly focused on that and I will find myself being exhausted by just trying to figure out what facial expressions are telling me.

By the end of the day, you don’t leave the screen. For healthcare professionals, you also write notes online. When you think about that, I think nobody's ever spent this much time on a computer. Perhaps people in tech are the closest. But people in tech probably didn’t previously choose to do a lot of their meetings virtually either.

If you're working in an office, you might as well see the people that are in your office. It's nice. We don't have data on what it looks like. But I think we do know that it is fatiguing and there are hypotheses as to why, but I don't think that there are conclusions.

Todd: You're really focused on reading physically what people do as part of your job. But we all read those cues and now those cues are gone. I guess psychologically we're working so much harder to figure out what that person really meant. Based on what you just said, a conversation is a lot more work now.

Jessi: Yes, it is a lot of work. I think what you're saying makes sense. The data that I have seen has to do with human-human interaction and how your brain works. And your brain does try to take cues from more than just someone's facial expressions to understand what's going on with the person. I’m maybe trained in that but you're right, everybody talks like that. So if you're in a big 8x8 video meeting and there are 10-15 people all with cameras up and one person is talking and someone else is talking to someone else and someone else's dog is there and someone else's kids are there… your brain is pulled in all directions and you're not sure what you're supposed to really be looking at.

I think that part, especially big group meetings, is really, really, exhausting because you're not just thinking, “What are you saying, Todd?” You are thinking, “What is every single person in this entire world saying to me right now in this meeting?” Your brain is just firing on all cylinders trying to make sense of it and that's just really exhausting. If anything, that’s what the data would tell us.

Turning off the camera sometimes is one of the things that I've seen people do. You can use the voice part of video conferencing apps; you don't have to assume that everybody needs to be on video at all times when you're in those big meetings.

We have to consider that we still need breaks. I've been very much forcing myself to do that so I get up even if there's nothing for me to do, I need to go get a glass of water I need to walk around my kitchen, I need to do something before I go into another meeting because it is an absolutely horrible idea for me to just keep going right now because I need to close my eyes for a second. I need to just change my mindset for a second. That’s helped me a little and the patient can wait two minutes. If it's the difference between feeling a little mentally better and then I'm more present and I'm a better doctor, then it's really worth getting up for 2 minutes. Even if you don't have something to do you can just walk on your apartment or your house or something just to get give yourself up like some stretching.

Todd: I found I did this purely by accident. I would just move rooms between meetings. I, fortunately, live in California in an area where it is sunny and 75 degrees, so I can just work outside which is not a strategy that will work in a lot of places.

Jessi: I live in St Louis and it’s pretty hot here. I do think though, giving yourself time to go outside, even if it's for a quick meeting even if you carry it for part of the meeting and go back in. It’s definitely worthwhile. You can do some of it on your phone, that’s nice.

Moving rooms does give you a sense of change which is nice. I think part of it is that it gets repetitive. Our brain is just sort of, that again, and that again and that again. And we socialize like this right now too. So, then its, I have to socialize like this too. Or if you’re a writer or you're a social media person are you doing anything else on the computer. Like for me, I have to write patient notes so that also on the computer so it's like the computer again?! You have to find ways to not hate your computer.

If moving rooms is helpful... if taking breaks is helpful… being thoughtful about planning your schedule and your meetings are something you need to think about. I think that's something we aren't very good. I think we see that if I have 10 a.m. free, that's great but if you add 10 a.m., 11 a.m., early 12 p.m. that are all meetings I think you might need to think perhaps being on a video is not as good for something. Maybe I need to take a break like I would have if someone came and knocked on my door and gave me the five minutes that would have been them being late to my office.

Consider staggering your meetings. Don't start on the hour or maybe you start on 5 minutes after… just give yourself a little leeway

Todd: There has been discussion online where a lot of companies were saying well maybe we don't come back and see each other in the office, or at least not as much. What do you think about that?

Jessi: I really do think that organizations need to have some overall thoughts about the person and the individual and their wellness. I see a wide range of patients and I have some patients that absolutely hate everything about right now and I have some patients who love it. And the patients that love it may have social anxiety and maybe don't really want to be around people all the time. Maybe they are more of a fan of having the ability to control their schedule themselves. Maybe they want to go work out in the middle of the day and not have anyone know they did that.

Maybe there are nice things about that for some people. I definitely have patients who are not struggling and who are fine. And I think there are people who are in-between, and I would probably fit in there. And I very much understand the value of Telehealth and the value of it to patients. I had patients who would drive 3 hours to see me for 30 minutes like that's outrageous

That’s a 6-hour commute for talking to me to say “Hi” and I think that doesn't make any sense. So I think for people like that, they deserve the option of getting to continue to see me virtually. But if you break it down, could I handle that a hundred percent? No. Could I handle that a couple of half days a week? Yes.

I think that there are probably people who are also in between. You could have an office where some of the people come in some days and some of the people come on other days and then you don't have a full office any day, but you get interaction with humans in between. I think we have to think where do we fall on the spectrum and I think that you can't assume this is a one-size-fits-all model and if you choose to do that I think you have to understand that you're going to lose employees. It’s not a one size fits all model assuming everyone wants to work from home all the time.

It’s impossible that it would suit every personality type. It’s as if the company culture changed completely overnight you wouldn't have picked it upfront. Organizations just need to be aware that this is definitely a wellness issue and it's definitely not a one size fits all solution.