Hope, healing and physician families

By Hayley Harlock MSW, RSW

The COVID-19 pandemic continues to affect the mental and physical health and well-being of Canadians. Physicians and their families continue to be highly affected in unique ways. To date, there has been considerable discussion regarding the threat that increased workloads, anxiety, moral injury, compassion fatigue and exhaustion pose to physicians. This threat is extended to the health of our health care systems and to the delivery of quality, compassionate and sustainable patient care.

A thriving physician family acts as a protective buffer to the ongoing stressors physicians experience by helping to cultivate and support their physical health and psychosocial well-being. However, to date, the impact of the COVID-19 pandemic on the families of health care workers has not been adequately considered or discussed. Early in the pandemic, the authors of an article published in The Lancet acknowledged that support and solidarity for health care workers should “also mitigate the burden on their families,” recognizing that the families of health care workers are also “subjected to stress, isolation and emotional distress of exceptional intensity.”

As the wife of a Canadian physician, a social worker and someone who interacts daily with physician families in my role as founder of The Flipside Life (TFSL), I agree. Not enough attention has been paid to the significant stressors that the families of physicians (and all health care workers) have been experiencing throughout the pandemic. The spouses and partners of physicians provide essential and ongoing support from behind the scenes, a role they take on instinctively and often out of necessity. What affects one affects all.

We can all agree that “you cannot pour from an empty cup.” As the pandemic lingers on, many physician partners (including partners in dual-physician relationships) describe finding it more difficult to provide support to the doctors they love, as they too are experiencing increased feelings of isolation, frustration and emotional and physical exhaustion. Although the COVID-19 pandemic has shed light on the importance of prioritizing the physical and mental health of physicians, the shame and stigma associated with seeking help remains a significant barrier for many physicians and their families. Being unaware of available programs and services may also limit individuals’ motivation to pursue support. Physicians may also be reluctant to seek assistance because they have limited time and energy to do so and they may be skeptical about providing highly confidential and potentially career-limiting information to service providers. Within our community we hear worrisome anecdotal reports and research-based statistics describing the mental health struggles of health care workers, including post-traumatic stress disorder and suicide. While struggles with mental health have increased significantly among physicians, the number of individuals seeking help has not.

From heroes to villains

The need to support and protect Canadian physicians and their families is greater than ever before. The prolonged and ongoing battle against COVID-19 has seen a major shift in the public perception of physicians from heroes early in the pandemic to villains when restrictions and vaccine mandates were introduced by governments. Physician families have experienced this shift too, which unfortunately is continuing to intensify as the pandemic lingers on.

Countless Canadian physicians have endured online bullying and harassment. Hate mail that threatens their safety and well-being has been sent to their places of employment, to their regulatory colleges and in some cases to their homes too. The ongoing abuse of physicians, nurses and other health care workers poses a legitimate threat not only to their individual and family safety and well-being but also to the sustainability of our health care systems and the delivery of patient care. It needs to stop.

Help for the helpers

The role reversal required for the helper to seek help does not come easily for most physicians; the same can be said for the partners of physicians. Perhaps this is the by-product of many years of toxic medical culture where the concealment of emotions became the price of entry during the training years, and an unspoken expectation throughout practice. Or maybe it’s the inhumane and unrealistic expectations that have long been bestowed upon physicians, and until very recently have remained unchallenged. The altruistic nature of physician families is a characteristic deeply ingrained early on and is often a barrier to accessing help when needed. Physicians and their families are also quick to acknowledge their privilege — and in doing so often minimize their own challenges regardless of the severity, with an assumption that others are worse off and more deserving of assistance.

Healing forward

It’s now time to consider how we move forward through the current pandemic challenges that remain and make plans for what our physician families will look like in a post-COVID world. It’s unlikely that our pre-pandemic selves will ever entirely return — as a community we have been changed forever. The first step in our community’s healing journey will require us to come together to work through and normalize our individual and collective experiences. There are opportunities for our community to come together to support one another through weekly TFSL Connect Calls for spouses and partners of medical students and physicians, CMA peer support and other events curated for physicians and their families. These interactions help to foster a sense of belonging and understanding and instill hope for a return to normalcy and better days ahead. Moving forward, our capacity to remain hopeful will be essential to healing our community and rebuilding our health care system.

The cracks that existed in the health care system and the culture of medicine before COVID have been smashed wide open. We have been provided with the opportunity to reinvent what the system looks like and who it includes. It’s an opportunity for our health care system and participants within the system to do better. The pandemic has seen physicians go from revered heroes to villains — it’s time to take the final step to truly see physicians as human too.

Moving forward, a non-negotiable systematic change is required to create and nurture a culture within medicine and our health care systems that supports the psychological safety, mental health and well-being of all health care workers and their families. As physician families, community partners and stakeholders in the health care system, we all have a part to play to ensure meaningful change finally occurs. The Flipside Life is doing its part by continuing to provide much-needed ongoing support and connection to the spouses and partners of medical students and physicians, while working with community partners. The Canadian Medical Association offers many valuable wellness resources for physicians and medical students including the Wellness Hub and the Pandemic Wellness Toolkit.

To say that our community has been through a lot since the beginning of the pandemic is an understatement. As we begin our healing journey, may we remember the importance of extending compassion, grace and kindness to ourselves, and to our families.

Here’s to our community of physician families healing and moving forward together.

Topics

Physicians and their families COVID-19 wellness resources Conflict management and prevention