Canadian Medical Association

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Physician Wellness: The Time Is Now
A discussion with Well Doc Alberta

We've known for decades that because of the work physicians do, they are vulnerable to being unwell. The study of physician wellness has come to the forefront in the last number of years due to an increased recognition of the physical and mental health threats to physicians, along with a growing appreciation that when physicians are unwell, patient care – in fact, the entire health care system – suffers.

In addition, the COVID-19 pandemic has amplified the gaps in supports for physician wellness and reinforced the importance of building foundational support programs within health care systems.

Occupational distress is common in the practice of medicine because the job of a physician is to help people be well, even when at times it comes at a personal cost to themselves. In addition, the culture of medicine tends to perpetuate the ideal of the superhuman doctor, impervious to any type of distress. In the early days, there was a focus on individual resilience for physicians — the notion that if a doctor was just a bit grittier or tougher, they could successfully weather the challenges inherent to the job. But physicians are human, like everyone else.

While we are witnessing the impact of COVID-19 on health care workers first-hand, the science related to their risk of being unwell has also evolved; there's more emphasis on teasing out what those occupational risks are and articulating the occupational distress syndromes that physicians might be exposed to. We now know that the main causes of  physician burnout are due to system factors – related to excessive workload, lack of resources, lack of control and flexibility over their work, and challenges with social support, among others.

To fundamentally shift the culture that views physicians as impervious to distress, we need system-level interventions aimed at improving physicians’ work environments, work structures and the toxic aspects of the culture of medicine.

Physician looking at an ipad

We also know we need to focus upstream. To illustrate, we can use the example of cardiovascular disease. We treat heart attacks, we stent blocked arteries, we perform angioplasty and we administer thrombolytics, but the real answer to treating cardiovascular disease is risk reduction. And so, over time, our approach has evolved to address the factors that initially put these patients at risk.

The same is true with physician wellness. It’s time for us to go upstream and implement those risk reduction strategies.

At Well Doc Alberta we are working with 45 formal collaborators – most of whom are physicians – who want to help support physician wellness within the system. We are working together to develop and deliver education sessions and other real-time supports that are helping shift the culture of physician wellness and promote positive and productive system-level interventions.

And we find that our efforts are most effective when we do work at both the grassroots and leadership levels, ensuring that there’s support and engagement from everybody who's involved.

Increasingly, there is more awareness about the need for physician wellness strategies and we are seeing more work happening in the field.

Ultimately, our goal at Well Doc Alberta is to help all health care stakeholders understand how important physician wellness is and help organizations implement strategies that have been shown to be effective. This critical evolution will help organizations support their physicians, both in terms of reducing the risk of occupational distress syndromes and promoting mental health.

As a result, we know we can bring about significant change at the system level. It’s time to take our commitment to physician wellness to the next level, taking care of ourselves and each other.

The time is now. The profession of medicine and health care systems are poised to take physician wellness to the next level. Physicians deserve to be protected from occupational distress syndromes and supported in their mental health, and well physicians fundamentally contribute to quality patient care and quality health care systems.

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.

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