Doctor burnout impacts everyone’s health
Doctor burnout is one of the primary issues facing our health-care system, according to the Canadian Medical Association. When the CMA surveyed more than 4,000 physicians and medical learners in 2021, it found high rates of burnout (53 per cent) and depression (48 per cent) and low professional fulfillment (79 per cent).
Those findings were especially common among female doctors, residents, physicians practising in rural and remote areas, and physicians with disabilities. Even worse, nearly half the National Physician Health Survey respondents said they were considering reducing or modifying their clinical work hours within the next two years.
That would have a devastating impact on an already struggling healthcare system, according to Dr. Andrew Park, outgoing president of the Ontario Medical Association. As of 2022, he points out, 2.2 million Ontarians were already without a family doctor, and by 2026 the OMA expects that number could almost double.
What’s driving the problem?
The reasons for doctor burnout are many, according to Leanne Son Hing, a psychology professor at the University of Guelph and lead author of a study on work-life balance among doctors. Although Son Hing’s study focused on doctors at an elite teaching hospital in Ontario, she says that doctors in general tend to be overachievers who can often be hard on themselves.
Compounding the effect of those inherent personality traits, she says, is a medical culture that promotes the idea that doctors should always “put the profession and their patients first.” Doctors are socialized from medical school on “not to prioritize taking care of themselves and to never say ‘no’ or set boundaries,” says Son Hing.
That has increasingly become a problem in the face of a health-care system that is stretched past its limits, says Park. The system has been dealing with underfunding for the past 10 years, he contends, but if it was operating on the edge before COVID-19, the virus pushed it over a cliff.
Doctors focused on acute care “because we had people dying all around us,” explains Park. But with the postponement of regular doctors’ appointments and routine surgeries, “people were sicker” post-pandemic, and mental health and addiction issues ballooned.
“Physicians are extraordinarily resilient and we’ll stretch ourselves physically, mentally and emotionally to care for our patients,” says Park. “But it became very clear that no matter how hard we worked, we just couldn’t keep up with the volume of people we had to take care of.” That created an immense amount of moral distress, he says, because “at the root of our profession is the desire to help people. And when you’re trying to help as many people as possible and you still can’t stem the tide, that’s crushing.”
Rx for healthy patients and doctors
National Physicians’ Day takes place on May 1 this year. “If you’re seeing your doctor that day,” suggests Park, “say a simple ‘thank you’ and tell them about the impact they’ve had on you and your community. It always lifts our spirits.”
But ultimately, he contends, the best way to show appreciation for doctors’ unstinting care is by supporting meaningful action. To that end, the OMA’s Prescription for Ontario: Doctors’ Solutions for Immediate Action (2023) offers three main recommendations for healing an ailing healthcare system and stemming the tide of doctor burnout.
First among them? The government should invest more in team-based primary care for patients. Teams would include a physician, as well as a nurse, administrator and at least two other inter-professional care providers. Patients would get timely, seamless treatment for things like nutrition counselling or the removal of stitches, and doctors would be freed up to treat more serious medical problems.
The OMA’s second recommendation focuses on reducing the increasing demands of paperwork and administrative duties. “The OMA found the average family physician spends 19 hours a week on administrative tasks that take them away from patients,” says Park. To enable doctors to focus on patient care, it proposes creating a centralized intake and referral system, streamlining forms, reducing sick notes and referral letters, and funding the use of artificial intelligence scribes.
Lastly, the OMA urges the government to build “a rural and northern workforce strategy” aimed at attracting and retaining physicians in underserved areas of the province.
If you want to help, Park suggests, write an email or letter, or make a phone call to your member of provincial parliament to let them know you support our right to a wellfunctioning health-care system. Ontario’s health-care system “needs a significant shot of investment,” he says. “It’s up to all of us to demand that our politicians be accountable. Healthy doctors make healthy communities, and healthy communities support doctors being healthy.”