Physician Health Program a vital source of support
“Physician, heal thyself.” This Biblical proverb—meaning “Look after your own shortcomings before trying to correct others”— has been taken to heart by far too many medical doctors for far too long. In the traditional medical culture, doctors were expected to suffer in silence, to somehow treat themselves, to show no weakness. “That stoicism, that autonomy, was applauded, without realizing that under that white coat these are human beings, too,” explains Brenda Senger, director of Physician Support Programs, including the Physician Health Program, for the Saskatchewan Medical Association (SMA).
Simply put, the program provides doctors for doctors. More specifically, medical students, residents, physicians and their families all have access to professional help to diagnose and treat mental and physical health issues. That includes consultation for personal and professional relationships, work or family disharmony, and substance abuse and addiction. According to the SMA’S website, one out of every 10 physicians trying to cope with the strains of their profession will become dependent on psychoactive drugs or alcohol “sufficient to impair the practice of medicine at some time during their career.”
Fortunately, the old “suffer in silence” medical culture is diminishing, and the program has made significant strides in providing help before matters get out of hand. The initial peer support program, called SPARC —The Saskatchewan Physician at Risk Committee—began in 1976. It was a grassroots movement from several well-intentioned physicians who wanted to reach out to physicians with addiction issues. In 1987, it became a joint committee of the College of Physicians and Surgeons and the Saskatchewan Medical Association. Having the College involved, however, as a licensing and disciplinary body, made physicians hesitant to reach out, for fear of the consequences, so in 1993 the College stepped off the committee. In 2003, the SMA took over the program, renamed it, and hired Senger as a clinical person to be the case manager.
Today, the program emphasizes that, “It’s okay to have problems. You have permission for help-seeking behaviour,” says Senger. This has led to a significant increase in students, residents, physicians and their families reaching out, as opposed to those whose situations worsened to the point of where they had no choice but to get the treatment they needed.
“What we have found, especially in our younger generation, is that they are accessing support and help long before they crash and burn,” explains Senger. “It used to be that over 80 per cent of all referrals to the program came from the College. Now, 80 per cent are self-referrals, with College referrals amounting to only two to three per cent.”
Ironically, the characteristics we often admire in doctors, and what makes them succeed in the intense process to become doctors, can be the same traits to cause problems. “Medicine selects for people with certain characteristics,” says Senger. “People who have a need to be in control. People who have perfectionist tendencies. People who can sacrifice their needs to meet the needs of others. People who have a high emotional investment. People who are competitive. That’s what medicine selects for. They need those characteristics to a degree, but if those are your only go-to things, if they’re over-used, then they will create difficulties.”
The pressures and risks of the work itself are far beyond what most people experience daily. Occupational factors include sleep deprivation; excessive workload and demands; the potential for complaints and litigation; general job dissatisfaction; and the constant witnessing of trauma and human suffering. For residents and medical students, debt is also among the top stressors.
Among all the issues facing physicians, though, mental health is at the top of the list. “That far outweighs the other issues,” says Senger. “You cannot take the stress out of medicine. It is a stressful occupation – absolutely.” For doctors who might begin to feel overwhelmed, her message is clear: “Stress is inevitable. Struggling is optional. Let’s make sure you have all the tools in your toolkit to function well, given the pressures of this job. The Physician Health Program has a wonderful committee of physicians who are addiction medicine specialists, psychiatrists and recovery doctors. They oversee the philosophy and the program, but they are also a working committee— they understand these issues and provide treatment for their colleagues in a non-judgmental, supportive way.”
Under the white coat, these are human beings, too.”