Podcast

New Brunswick Medical Society

June 10, 2022

Listen as Anthony Knight, CEO, and Lisa LePage, COO, of the New Brunswick Medical Society discuss their Tailored Counselling Program, which provides physicians with timely, one-on-one mental health treatment in all NB communities.

Anthony and Lisa also talk about NBMS’ Professional Coaching for Physician Leaders Program, which delivers tools and skills to help physician leaders manage anxieties around interpersonal relationships and balance their leadership roles with many other responsibilities.

View transcript

This episode is available in English only

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New Brunswick Medical Society: Supporting Physician Wellness and Leadership

Anthony Knight, CEO, New Brunswick Medical Society

The New Brunswick Medical Society (NBMS) is one of the oldest medical associations in the country and represents more than 2,000 practising, future and retired physicians in the province.

Over the course of the more than 150 years we’ve been collaborating with and supporting physicians, we’ve learned a tremendous amount about the effective delivery of health care – and about the importance of effectively caring for health care professionals.

Some of these key learnings are listed below and are reflected in a number of new programs available for physicians through NBMS.

Doctor speaking to family with a child

Cookie cutter approaches don’t work. NBMS’ Tailored Counselling Program was developed to provide timely, low barrier access support for any type of mental health needs our members were seeking. And while the offering is robust, the real success of the program has been being able to adapt the support to the lifestyle of the physician. There is no one-size-fits-all solution when it comes to serving physicians. Delivering almost 1,000 session per year, we know each physician has specific, individual concerns – whether it’s about the time they have available or about privacy, for example – our program accommodates the way in which a physician lives their life and functions in the community.
Help for a physician’s family is also help for the physician. We’ve also made sure physicians’ spouses and their kids can participate in the program at no cost. As with any family, when children or a partner is struggling, it results in added stress. Our approach is to care for the whole physician, which means providing care for their families as well.
Enabling better communications can also help reduce stress. When NBMS first launched the counselling program, we noticed during the intake process that there was a tremendous amount of anxiety caused by interpersonal relationships within the workplace; many physicians didn't have a counselling need but rather required tools and skills to help them communicate more effectively.

On one hand, physicians have scope of control in their own space, but they also work in a system that's often inefficient, or not meeting their patients needs, or not moving the needle in the way they would expect. Offering them mechanisms and tools for articulating their points of view and positively influencing change can help them overcome these frustrations.

Leadership training is not just for business executives. Executive coaching can significantly contribute to building physician leadership skills and fostering personal growth. Although physicians are generally well equipped to have crucial conversations with patients, they're admittedly less so when it comes to discussions with a colleague or advocating for more system-level change. The NBMS executive coaching program was launched in 2021, resulting in physicians becoming increasingly prepared for those potentially high-impact conversations. To date, 84 physicians have been successfully matched with an executive coach and the intake continues.
Leadership is personal. Our executive coaching program has also unlocked a new understanding of leadership. More and more, we're seeing physicians rely on principles of collaboration and consensus building, rather than command and control, which can be a dominant leadership stereotype. Likewise, participants of this program are adjusting their expectations of themselves and others, allowing themselves to grow into their own style of leadership. We also see physicians applying this learning in their work and daily lives and seeing the profound difference it can make.
Partnership is key. We’re pleased and proud to work alongside partners including the Canadian Medical Association, MD Financial Management and Scotiabank. Their hand-in-hand approach to solving challenges related to physician wellness, their commitment to helping develop physician skills and their enthusiasm for promoting the unique role physicians play in the health care system allow for the development of programs that might not have existed otherwise and help make our communities stronger, healthier and better places.

The Canadian Medical Association (CMA), MD Financial Management Inc. (MD) and Scotiabank together are firmly committed to supporting the medical profession and advancing health in Canada. As proof of this commitment, Scotiabank, in collaboration with the CMA and MD, is investing $115 million over 10 years to support physicians and the communities they serve across Canada.

Physicians First Podcast Transcript | Episode 2: New Brunswick Medical Society

Welcome to Physicians First – a podcast series that explores unique and home-grown wellness initiatives that are impacting the lives – and livelihoods – of Canada’s physicians. In this series, we’ll introduce you to the people creating customized solutions that improve physician health and wellness and strengthen the medical profession – whether through coaching programs, peer support groups or leadership training sessions. And you’ll hear how these initiatives are making a difference to physicians.

The Canadian Medical Association, MD Financial Management and Scotiabank together are firmly committed to putting physicians first, supporting the medical profession and advancing health in Canada. As proof of this commitment, and in collaboration with the Canadian Medical Association, and MD Financial Management, Scotiabank is investing 115 million dollars over 10 years to support physicians and the communities they serve across Canada. This podcast is just one of many initiatives. Physicians First is hosted by Dr. Caroline Gérin-Lajoie, a psychiatrist and physician wellness expert.

Dr. Caroline Gérin-Lajoie: Welcome. I'm Dr. Caroline Gérin-Lajoie, a psychiatrist and wellness expert and the host of Physicians First, a podcast exploring important topics related to supporting physician wellness.

Today, I'm pleased to welcome Anthony Knight, Chief Executive Officer of the New Brunswick Medical Society, and Lisa LePage, the organization's Chief Operating Officer.

The New Brunswick Medical Society represents more than 2,000 practising, future and retired physicians in the province. It is physicians leading positive change for the growth and enhancement of the health care system and the improved health of New Brunswickers. Anthony and Lisa are here to explain how these leadership programs are helping achieve positive change. Welcome to you both.

Anthony Knight: Thank you.

Lisa LePage: Thank you. Great to be here.

Dr. Caroline Gérin-Lajoie: Anthony, for those listeners not familiar with the New Brunswick Medical Society, what can you tell them about the organization's day-to-day work?

Anthony Knight: We're actually one of the oldest medical associations in the country, established at Confederation, representing, as you said, over 2,000 doctors and medical learners around the province. We work really hard to advance the interests of physicians in the health care system and also to educate and support the public in making good health care decisions about themselves and their families.

We run a number of programs, including one that promotes a primary care team-based care and leveraging technology at the same time. And we work on a wide range of issues to advocate for physicians when it comes to legislation or any sort of legal or policy matters that could affect the health system. So that, as well as the fact that we negotiate fees and incomes for doctors, like most other medical associations in the country.

Dr. Caroline Gérin-Lajoie: Lisa, the New Brunswick Medical Society has many member programs underway, two of which we want to highlight here, the tailored one-on-one counselling program and the executive coaching program. Let's start with the counselling program. How does it work?

Lisa LePage: Sure thing. The Tailored Counselling Program was developed to support the mental health needs of all of our members, including medical students and retired physicians, including their spouses and their children.

And the goal of this program was really to provide timely access, low barrier access in all of our communities across the province in a physician’s language of choice for any type of mental health needs that they were seeking. We have a large list of skilled counsellors, psychologists and psychiatrists that are in the program and I guess the best part of it is there are no session limits on this program.

So, we offer the program face-to-face, video conference or telephone or whatever the needs are of the physician. And as mentioned before, in both official languages, so we've got trained counsellors providing treatment on a wide range of challenges from addictions, depression, anxiety, trauma, suicide prevention, burnout, return to work, financial counselling, you name it. We are really proud to say that we have not had a need that we have not been able to fulfill a therapy plan for. So, we are really quite excited about that.

We are really pleased to see the physicians reaching out for help in what has been unprecedented working conditions over the course of the last two years. And we're providing probably close to 1,000 sessions per year, if not more, for our physicians. So, this program really is our flagship program and our most popular program.

We're seeing new physicians each week come through the program, through the intake, very simplistic intake, and very quickly matched with a therapist.

Dr. Caroline Gérin-Lajoie: Anthony, how does your approach to physician counselling differ to the more traditional models of counselling?

Anthony Knight: Well, one of the things I've always been excited about with this program is that it's done to be tailored to the lifestyle of the doctor.

You know, we know they don't have the time to surf the Internet and find the right counsellor. They also have concerns about privacy as a health care practitioner in the community; small towns in New Brunswick talk, and so there's a need for privacy. And what we do, it's something that's tailored to their lifestyle, acknowledges they want privacy, (but) that also allows for flexibility. So, evenings, weekends. And it really accommodates the way in which a physician lives their life and functions in the community.

We've also made sure that physicians’ spouses and their kids can participate in the program at no cost. And, I think we all know, if you're a parent, that when your kids are having trouble, if your spouse is having trouble, that that's stressful, too. That affects you, affects you in your work. So, we really wanted to take a whole person, whole physician approach to this counselling solution. I know many medical associations offer similar services, but maybe they're provided by an insurance company or a health care provider agency. And sometimes there's limits on how many services, how many counselling sessions can be made available. This service has no limit.

And why can we do that? It's because of the partnership with the CMA and MD (Financial) Management and Scotiabank. That collaboration has made sure that we have the right resources and the right people in place to meet physicians at the place that they are at, whether it's their mental wellness or in their workplace. So, we are just beyond excited with the great outcomes that we're seeing and benefits to our members as a consequence of this partnership.

Dr. Caroline Gérin-Lajoie: Lisa, the New Brunswick Medical Society has also launched the executive coaching program, which I understand was inspired by the counselling program Anthony just spoke about. What kind of gap or need were you trying to fill? And can you explain what the coaching program is and what its goals are?

Lisa LePage: Sure thing. When we first launched the counselling program, what we noticed during the intake process is that there was a tremendous amount of anxiety caused by interpersonal relationships within the workplace.

You know, the systematic challenges that were going on within the medical system, and particularly as it related to physicians communicating with physicians and also with administration and so forth. So, they didn't really have a counselling need per se, but what they did require is some tools and some skills to help them better communicate effectively and so forth.

So, we started to investigate different mechanisms that we could put in place because they were coming in in larger numbers. The other thing that we noted while investigating this program and doing our research is that we were told over and over again that a number of the physicians in leadership positions didn't have any formal leadership training. So, they took on these positions, they didn't have any allocated resources in which to do that, administrative support, any time for training, and they were also maintaining clinical practices as well. And balancing that leadership role and all of their other responsibilities was becoming very challenging and overwhelming for them. So, we coupled this all together, had a couple of small focus groups around, worked with our physician health committee and from that, the Professional Coaching for Physician Leaders program was born, which is essentially the executive coaching program.

And so, we had a couple objectives to improve the physician leadership skills across the province and also help foster personal change and growth within our physician leaders. The ultimate goal, I suspect, would be at the end of all of this is to see an improvement in our medical leaders across the province. I guess what we really wanted to do throughout this is to provide a mechanism for physicians to really learn about themselves and to gain some self-awareness by going through this program and find out, you know, what it is that's blocking them from becoming their best self and to be as productive in their fields as they could be. And those were really the goals that we wanted to accomplish when we launched this program.

Dr. Caroline Gérin-Lajoie: Lisa, as a bit of a follow up. What kind of response have you had to the coaching program and how has the program evolved since it was launched in 2021?

Lisa LePage: So, what we recognized right off when launching this program is that executive coaching is more prevalent in the realm of business and business executives but it was a relatively new concept with physicians. So, we had 10 physicians go through the process of intake and matching with an executive coach in February of 2021 and our idea there was they could help us smooth out the process and also help us communicating this and the benefits of this to their physician colleagues.

And so, we did that soft launch and right away the feedback we received from the 10 physicians was just amazing. I think it was well beyond their expectations, the value that they were receiving from this coaching. So, we did not wait the six months of the pilot. What we did is we launched to our entire membership in May of 2021 and within the first 48 hours we had 60 physicians call, wanting to be matched with a coach.

And so, we have received really nothing but very positive feedback out of all of the people that have gone through the program to date and we have 84 in total that have been matched with an executive coach – and the intake continues – we've only had one physician that did not go through the entire sessions and it was because life was too busy and it's going to be tabled to the fall. So, we hope to put that physician through at that point in time.

And so, we really have had some feedback on this. One of the things that did evolve and that we noted with the initial success of the executive coaching and the leadership training is that we needed to do more as it pertains to leadership within the province.

So, we were very fortunate to be able to pull together a leadership program for physicians, a cohort of 34 physicians that launched in January of 2022 that are pursuing the leadership program and they are also matched with coaches as they are going through this. So, it's really exciting. We've been told by the facilitators in the course that New Brunswick has the most engaged physicians that they've seen in a long time in physician leadership. They're not missing the classes. They're there every evening or if it's on a weekend, depending on the module, and full of energy and eager to learn. So, I think thatthat's very telling of the programing that we're putting forward.

I'll also say that in New Brunswick, we have two health authorities. We have a Francophone health authority and an Anglophone health authority and we were able to pull physicians from both health authorities together in the same leadership courses. And so, their shared experiences and so forth, I think is very beneficial to physician leadership, and having those colleagues across the province that you can call on when faced with an issue where you might need some peer mentorship.

Dr. Caroline Gérin-Lajoie: So, Lisa, what would you see as the most important outcomes of the executive coaching program?

Lisa LePage: Well, I don't think as of yet we've seen the full effect of what the executive coaching program is going to do for our physician leaders in the province and all of the people in the health system. But what I can tell you is the physicians that have gone through the coaching program have nothing but very, very positive things to say. They are all very committed to bringing the lessons learned back to their practices and their lives in general.

I think there's a dual benefit that physicians who have taken part in that type of coaching are just more effective communicators in general. And better equipped to engage with their teams and the administration in the hospitals. So, one thing that we've anecdotally heard from all of the coaches is just the breakthroughs that they're seeing in the physicians and what they're making going through the executive coaching program.

The other benefit that we've heard quite a bit throughout this is that although physicians are equipped to have those crucial conversations with their patients, they're less so when it comes to a colleague or having one of those crucial conversations around behavior or what have you. So, we've heard that over and over again and we've heard physicians having the ability to be very well prepared for those conversations by going through this program.

Dr. Caroline Gérin-Lajoie: Anthony, what lessons are physicians learning about leadership and their roles in the workplace and at the system level?

Anthony Knight: Well, what's been interesting that we've heard from physicians is that there's this preconceived notion that a leader is someone who walks into a room and takes charge, gives orders. That comes from television and all kinds of figures you see in the world.

And I think that our participants have said, well, you know, I might be a little more introverted and that extroverted leadership quality may not be for me, but that's okay. It's okay to be a thoughtful, considered individual and still take that leadership role, which is fascinating and something I can sort of relate to as well. You want to take some time, consider your options before grabbing a hold of the situation or guiding and directing a team. So, I think our physician members have really stepped back and really reconsidered their definition of leadership and what it means to be a leader. And pulling people together, I think, is another theme that that we observe that people are really applying in their daily lives, in their work and seeing the difference that that can make of bringing people together rather than command and control, which is that dominant stereotype folks have about leaders.

I think we also need to just give physicians an opportunity to grow. I think when you think about medical school and training, there's some rigidity to that training. And some expectations of others that you're supposed to be meeting and allowing folks to grow into not only their own leadership style, but how that meshes with their personality and that of their colleagues.

I think the tools we're delivering in this program really underscore the value of those capabilities.

Dr. Caroline Gérin-Lajoie: Anthony, how has funding supported the development of these programs?

Anthony Knight: Well, they wouldn't exist if it weren't for the funding that we received from our partners at the Canadian Medical Association, MD Financial Management and Scotiabank. Just tremendous support and not just writing a cheque and walking away, but being partners and hand-in-hand trying to solve these wicked problems around wellness, developing skills and abilities in our physicians that aren't front and centre at medical school and in their training and that partnership and our collective knowledge around the unique role physicians play in our health care system and in our communities has just made the partnership so valuable to us and to our members.

Dr. Caroline Gérin-Lajoie: In terms of the overall physician wellness landscape, beyond the programs that you have developed and started piloting, what else do you feel needs to be done at the system level for us to really move the yardstick when it comes to physician wellness? How can the health system or any initiatives better support physician wellness so that can we can really achieve culture change?

Anthony Knight: I mean, I think at least in New Brunswick, we don't do enough team-based approach to care. And there's a lot of stress and strain placed on physicians. So, I think that's one piece.

I think technology and paperwork and how offices are run and managed places a lot of stress and strain on the doctor. U.S. has adopted scribes. That's a small thing. But if you're doing paperwork night after night after night charting, it wears on you and it exhausts you at the end of the year, the month, the career. So, I think it's a series of little things for sure.

The voice piece in the system I think is another unknown. The health system was run by doctors 40, 50 years ago. That swung the other way and they brought in health executives, health professionals that are not doctors, not necessarily even health practitioners who are making decisions about structure and form and design of the health system. And sometimes those people are very good at what they do and sometimes they are not. And sometimes they are influenced or driven by politicians.

So, those influences around how systems work, how decisions get made, how resources are assigned, those all compile and add to the frustration.

Dr. Caroline Gérin-Lajoie: So, for physicians or other health care professionals or organizations that are not located in New Brunswick and can't access the services directly, do you have any takeaways or advice for them?

Anthony Knight: Well, I would say the first thing that really jumped out at me and we played with some different models around how to support physicians using the health care insurance provider model, making sure it's tailored to the physician need and their family and their community is really a key takeaway. So, however you can accomplish that in your respective province, I think that's really key. Not looking for a cookie cutter solution. There really isn't one when it comes to our specific niche in the health care system space when it comes to serving physicians. So, looking for that highly-tailored approach, I think is really, really valuable.

I also think that when it comes to leadership development, physicians play such a crucial role in the health care system. The decisions they make influence the lives of their patients, influences the lives and work practices of their colleagues in the health system. And understanding that role as a leader and how to communicate effectively, or more effectively, is really just a positive impact on the physician in their teams.

And also, I think physicians have leadership and scope of control in their space, but the system is much more controlled by politicians and bureaucrats and health system CEOs. So, understanding what are the mechanisms and tools for influencing change can really, I think, give people the tools they need to overcome the frustration that I hear from on a regular basis by doctors who are seeing a system that's inefficient, that's not meeting their patients needs, that's not moving the needle in the way they would expect, at least knowing what the levers are for control and power. That makes a big difference, I think, in terms of the stresses and frustrations doctors feel each and every day.

Dr. Caroline Gérin-Lajoie: Anthony and Lisa, thank you both for sharing these key programs at the New Brunswick Medical Society. You've certainly challenged us to think more about how we approach supporting the wellness of physicians and their families, as well as how organizations and workplaces can begin to build leadership capacities that can drive positive and meaningful change.

Anthony Knight is the Chief Executive Officer of the New Brunswick Medical Society, and Lisa LePage is the Chief Operating Officer. And thank you to our listeners today for joining us for this important conversation about physician wellness. I'm Dr. Caroline Gérin-Lajoie, your host of the Physicians First Podcast.

You’ve been listening to Physicians First.

The Canadian Medical Association, MD Financial Management and Scotiabank are firmly committed to putting physicians first, supporting the medical profession and advancing health in Canada. As proof of this commitment, and in collaboration with the Canadian Medical Association and MD Financial Management, Scotiabank is investing 115 million dollars over 10 years to support physicians, including the funding for the wellness initiative discussed in today’s podcast.

For more information, visit cma.ca/physiciansfirst.

Thanks for listening. Please share the link so others can learn about important and unique programs supporting physician wellness in Canada.

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Physicians First Podcast Transcript | Episode 2: New Brunswick Medical Society