Changing the Face of Physician Culture

By Shelbie Huard
Social Connectedness Fellow 2017

It is widely understood that there are high demands associated with the medical profession. Recently, however, Canadian researchers have begun to expose the disturbing trend of physician burnout, a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It occurs when individuals feel overwhelmed, emotionally drained, and unable to meet constant demands.[i]

In February 2017, the Saskatchewan Medical Association (SMA) released a survey suggesting that 62 percent of doctors reported feeling at risk of burnout, or were stressed to the point of exhaustion. Meanwhile, 50% of physicians reported that high stress, sleep deprivation, and mental exhaustion negatively affect their patient care.

Health professionals experiencing burnout make more mistakes, are unable to provide adequate emotional support, and their patients are at greater risk of mistreatment.[ii] Not only is this a serious problem for physicians and patients, but it also has broader economic costs, such as early retirement and reduced clinical hours, which in Canada are estimated at $185.2 million and $27.9 million per year, respectively.[iii]

The Canadian government has viewed this troubling trend as representing a shortage of physicians. But amidst recent health care reform, the government seems to be overlooking physician testimonials that paint a different picture of the issue. 

Many medical professionals have cited fear of discrimination, work place culture, and the stigma around mental health issues, as some of the possible causes of burnout. For example, if physicians experience mental health problems, they may fear that their colleagues, patients, and the public may begin to doubt their ability to provide a high standard of care, and thus are reluctant to seek out help. Additionally, the cultural pressure to perform can lead physicians to avoid their medical problems altogether.[iv]

One of the main solutions to physician burnout was developed by the physicians themselves. They came up with a team-based approach whereby a patient’s primary care provider coordinates their other health services. This is an approach that is already being implemented informally; formal implementation would require more resources.[v]  

It is important for political actors, as well as the medical community, to recognize that alleviating this mental health concern is not simply a matter of expanding the workforce. Indeed, physicians must be given the space to speak openly about the emotional strain and difficult realities of their profession, and offered adequate support.

Fortunately, some helpful programs have been launched by the Canadian Medical Association’s provincial divisions that provide assistance to physicians and their families. These include initiatives such as hotlines and promoting strategies on how to manage stress.[vi]

However, burnout cannot only be treated at the individual level. Ultimately, we must recognize that there are common issues at play across this crucial profession, and that human connection and support must be part of the solution.[vii] 

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[i] Smith, Melinda M.A., Segal, Jeanne Ph.D., Robinson, Lawrence and Segal, Robert M.A.. Burnout Prevention and Treatment Techniques for Dealing with Overwhelming Stress. HELPGUIDE.ORG Trusted guide to mental, emotional and social health. https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm?pdf=true

[ii] Goldman, Brian. Canada’s doctors: the best, the brightest-and the burned out. Special to the Globe and Mail. Monday, Jun. 16, 2014. https://www.theglobeandmail.com/opinion/canadas-doctors-the-best-the-brightest-and-the-burned-out/article19179842/

[iii] Rheaume, Alan. Burnout and mental illness among Canadian physicians. UBCMJ. 2016: 8.1 (48-49) https://ubcmedicaljournal.files.wordpress.com/2016/08/n3-rheaume-burnout-and-mental-illness-among-canadian-physicians.pdf

[iv] Rheaume, Alan. Burnout and mental illness among Canadian physicians.

[v] CBC News. Feb 14, 2017.  High percentage of Sask. MDs at risk of burnout survey says: Governemnt says it recognizes need for work-life balance. http://www.cbc.ca/news/canada/saskatoon/saskatchewan-doctors-burnout-sma-survey-1.3982317

[vi] Rheaume, Alan. Burnout and mental illness among Canadian physicians.

[vii] Seppala, Emma and King, Marissa. Burnout at Work Isn’t just about Exhaustion. It’s Also About Loneliness. Harvard Business Review. June 29, 2017. https://hbr.org/2017/06/burnout-at-work-isnt-just-about-exhaustion-its-also-about-loneliness