Life has changed dramatically since a global pandemic was declared in March 2020. As a result, an already overburdened health care system has been pushed to new extremes, profoundly changing how physicians live and work. Findings from the 2021 National Physician Health Survey (NPHS) conducted by the Canadian Medical Association (CMA) reveal key insights on the current status of physician wellness in Canada, including the negative impact the COVID-19 pandemic has had on the profession. The 2021 NPHS results demonstrate a drastic decline in physician wellness compared with pre-pandemic levels. This is concerning as decreased wellness impacts not only the individual physician but also patient care and health system performance. As such, it is crucial to understand the factors contributing to the decline in physician wellness to inform future efforts to support medical professionals.
The NPHS, which was first conducted in 2017 and then again in 2021 (on a three- to four-year cycle), provides Canada’s most comprehensive data set of physician wellness indicators. The recent survey highlights key challenges caused or exacerbated by the COVID-19 pandemic. For example, the 2021 findings reveal high rates of burnout (53%), low professional fulfillment (eight in 10 respondents) and career dissatisfaction (nearly one-quarter of respondents), which probably have contributed to the current shortage of physicians across Canada.
In fall 2021, the NPHS was completed by 4,121 physicians, medical residents and medical students. Read on to learn more about the survey and download the full report to explore the current and future state of physician health and wellness in Canada.
Pre-pandemic, physicians were already suffering
While the 2021 NPHS reveals some very concerning statistics about physician health and wellness throughout the pandemic, it is critical to compare these results with those of the previous survey when discussing the pandemic’s ripple effects. For example, although 53% of physicians reported feeling burned out in 2021, just four years earlier, that number was 31%. Although this 22% increase is significant, it is notable that physicians were already under strain before the pandemic pushed the health care system to the brink.
Today, burnout rates are at least 1.5 times higher for physicians and medical residents than in 2017. The message is clear — physicians and medical learners are overburdened and need better support to treat and prevent burnout.
The pandemic magnified existing cracks
The 2021 NPHS also uncovers a significant deterioration in mental health in the medical community. Sixty percent of respondents said their mental health was worse than before the pandemic. The top reasons reported for worsened mental health during the pandemic included increased workload and/or lack of work–life integration; social isolation; and rapidly changing policies and processes.
While most respondents mentioned taking part in some form of self-care or wellness activity, many also noted barriers to consistently maintaining their health and wellness. The top barriers included a lack of time (64%), a heavy workload and/or stressful work environment (60%) or challenges arising from scheduling (56%). Only one in 10 respondents said they do not face barriers to maintaining a healthy lifestyle, which shows that most medical professionals are not thriving.
The 2021 NPHS also noted disparities among rural and remote physicians. As hospitals and health care centres outside of urban and suburban areas struggle to manage health human resourcing, the absence of even one physician can result in an emergency department having to shut its doors. Unfortunately, physicians in rural and remote areas are more likely to encounter insufficient health human resources, contributing to worsened mental health.
In addition to physicians working in rural and remote settings, several other at-risk subgroups who are experiencing more negative wellness outcomes were identified (e.g., women, residents, physicians living with disabilities, caregivers of a child and/or parent). Refer to the full report to learn more about these at-risk subgroups.
Looking to the future and reimagining physician wellness
The findings in the 2021 NPHS may provide an indication of what’s to come. A clear consequence of poor physician health and wellness is attrition, which has subsequent effects on communities.
In 2021, nearly half of the respondents (49%) indicated that they were considering reducing or modifying their clinical work hours within the next two years. Again, it seems that wellness is playing a role in this decision-making: those who are burned out and who lack professional fulfillment were more likely to say they will reduce their clinical hours than those who are not experiencing burnout and who feel professionally fulfilled. Early retirements, part-time schedules and reduced workloads are some of the mechanisms physicians are exploring to manage overwhelming demands and exhaustion.
As the corporate world navigates the “quiet quitting” and “great resignation” movements brought on by the pandemic, the possibility that physicians will follow suit will have detrimental effects on the population’s health outcomes. Already shouldering the burdens associated with a physician shortage, doctors today are adopting a more modern view of a typical workload to protect their health better. Such adaptations are timely and are proving to have positive impacts on the next generation of medical learners. In striving for realistic workloads, younger physicians are trying to adjust their approach by prioritizing wellness to ensure longevity in their medical careers. As a result, administrators and policy-makers have an opportunity to reimagine health human resource planning to meet evolving realities and restore a healthy system.
The 2021 NPHS provides a comprehensive look at the state of physician health and wellness in today’s quickly evolving reality and opens the door for discussion and advocacy with an eye to the future. Key factors like demographic characteristics and psychological, behavioural and environmental attributes are determinants of wellness outcomes. In continuing to survey and report on physician health and wellness, the CMA aims to identify physician wellness challenges and help build a case for support, drive advocacy and advance programming. Research demonstrates that investing in physician health and wellness helps to protect physicians, patients and the health care system.
The CMA published a follow-up report on causative factors associated with some of the poor wellness outcomes identified in the 2021 NPHS study. Download the regression analyses titled From data to action: Understanding the drivers of physician wellness to read more. Visit the physician health and wellness data topic page for more information and resources.
Physician health and wellness data COVID-19 wellness resources Burnout Leadership and professional development Building a case for support Measurement and outcomes Organizational wellness Self-care Stress
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