Doctors demoralized, tired and considering quitting, survey finds
Almost one-in-five Saskatchewan doctors is thinking of retirement.
Most plan to reduce their clinical hours, and a majority say the COVID-19 pandemic has worsened their health, their finances and how they feel about their careers.
Medical leaders say those findings from a February survey of Saskatchewan's doctors paint a picture of a demoralized, exhausted profession. They say the consequence could be more doctors cutting hours, retiring early or quitting entirely, further narrowing patients' access to care as the province hopes to tackle backlogs of delayed surgeries and routine care.
“Those numbers do not surprise me,” Saskatchewan College of Family Physicians president Dr. Myles Deutscher said.
“We're overworked, we're burning out and we're frustrated. That's essentially how I would say we feel.”
Nearly 400 doctors responded to the survey conducted by the Saskatchewan Medical Association, more than half of whom were family doctors. The rest were medical specialists, such as cardiologists.
More than six-in-10 family doctors who responded said they were “likely” or “very likely” to cut clinical hours in the next two years.
More than seven-in-10 said they have not had adequate time to rest during the pandemic. A majority said their mental health was “worse” or “much worse” compared with the start of 2020.
Overall, 57 per cent of respondents said their workloads had increased during the pandemic. Nearly three-quarters said their practice was “less satisfying ” than before, and 19 per cent said they plan to retire, compared with five per cent who reported the same in a similar survey in 2020.
SMA president Dr. Eben Strydom said the survey's results are a red flag, given the demand for doctors in Saskatchewan.
The province struggles to recruit physicians in rural and remote areas and is short on several specialists, such as child psychiatrists. Strydom noted doctors are also central to the province's plan to climb a mountain of delayed surgeries and clear a backlog of patients who could not or did not access routine health services earlier in the pandemic.
“We have excellent doctors in this province. We need every single one of them,” Strydom said.
He and Deutscher said they believe the survey reflects a range of problems as the province juggles managing COVID -19 while resuming other routine medical services.
Deutscher said family doctors are on the front line of efforts to “catch up” on medical care that was missed or delayed over the past two years.
“As far as concerns about patient health, daily now, we're seeing patients suffering because of the burden of illness that they are carrying,” Deutscher said.
Many of the same doctors worked throughout the pandemic in emergency rooms or in other settings like vaccination hubs or COVID -19 assessment centres and adapted to see patients remotely through virtual visits or phone calls — important tools that have nevertheless added to their workloads.
Those assessment centres have since closed, which Deutscher said leaves much of the work of treating patients with COVID -19 to family physicians.
They were already overworked before the pandemic began.
“The pandemic has just made it so much worse,” he said. “It's exacerbated the problem, in my opinion, where it just can't be ignored anymore.”
Dr. Hein de Klerk, a family doctor who serves as the Saskatchewan Health Authority's area chief of staff for the province's southwest, said more physicians are “presenting with concerns in their personal lives reflective of an unhealthy work-life balance.
“Increased burnout creates safety and quality of care risks,” he told doctors at an SHA town hall last week.
A slide from his presentation noted doctors will likely pivot to roles where they have fixed hours in an effort to recuperate, which in turn could affect access to care.
“This puts more strain on family physician who provide full-service family practice,” de Klerk said.
Strydom says the association received a clear signal to double down on promoting physician wellness, which could include securing additional funding. He also suggested it creates a case for the government to explore different models of pay for physicians.
Most respondents who are paid under a fee for service model — where the province pays a set amount for a given task — said they feel more negatively about that system after the pandemic. The percentage was even higher for family doctors and doctors who began their practice within the last 10 years.
“It's not a unanimous feeling here,” Deutscher acknowledged, but he said it does establish good reason to consider expanding a salary model as a way of attracting and retaining doctors.
Strydom said the big risk is that physician burnout hamstrings the recovery of the health-care system.
“At this stage, we need ... healthy physicians. We need energized physicians. We need all hands to deal with the challenges ahead.”