Physician Health and Well-being

Canada’s MDs most pessimistic in five-country survey

Canadian doctors are more pessimistic about the state of medicine than physicians in four other industrialized countries. The 2000 International Health Policy Survey of Physicians, conducted by the Harvard University School of Public Health and the Commonwealth Fund, found that Canadian physicians believe their ability to provide care has not only deteriorated in the past five years but also is bound to slide further. CMAJ 2000;163(11):1496.

Canadian Medical Hall of Fame

The CMA added its support to the Canadian Medical Hall of Fame to help raise Canadians’ awareness of the accomplishments of their physicians. "The CMA is delighted to do this," said President Hugh Scully. "Our collaboration and funding commitment recognize the importance of the hall’s mission to celebrate discovery and innovation in medical science in Canada."

The CMA will provide $150 000 a year for five years to fund educational and promotional programs. The Canadian Medical Hall of Fame was founded in 1993 to recognize remarkable accomplishments by Canadians. The laureates include Sir William Osler; Frederick Banting, Michael Smith and Roberta Bondar. Six new inductees were announced last year. CMA News 2000;10(1):1.

Healing the healers

The term Neighbourhood Watch has taken on a whole new meaning in the University of Ottawa’s Faculty of Medicine, where the program is used to emphasize the importance of watching for signs of distress in physicians. The program is considered important, because even though physicians are generally suspected of being at higher risk for suicide, alcohol abuse and marital discord than the general population, at least in part as a result of workplace stress, they have historically been among the least likely segment of population to seek or receive help. Two physicians state that concerned colleagues are often reluctant to help because of a lack of knowledge and privacy concerns. On the other side of the equation, affected physicians are torn between the desire to maintain confidentiality by seeking help outside of their own professional circle and uncertainty about the competence of experts they do not know.

In this review article, the authors report on the work of the Task Force on Faculty Stress at the University of Ottawa, which was created to address these problems among academic physicians and develop an early detection, outreach and intervention program that faculty would use. The main stressors include family breakdown, hospital cutbacks and conflicts between research, clinical and family responsibilities. CMAJ 2000;163(6):735-8.

Health programs offer important safety net

In June the CMA hosted a meeting of the CMA’s provincial/territorial divisions and representatives from physician support programs to discuss whether a national organization could be formed to coordinate and improve physician health programs from coast to coast. The CMA has supported work in the area of physician health for some time, most notably through collaboration with the American Medical Association on the International Conference on Physician Health, which is held every two years, and through the CMA Policy on Physician Health and Well-being that was released in 1998. The association also regularly deals with issues that touch on areas of physician health — physician workforce or on-call restrictions, for example — but these efforts can suffer from a lack of visibility since they often become part of larger awareness or lobbying campaigns.

The problem of creating a national amalgamation of programs is made more difficult by the fact that each province has its own college of physicians and surgeons. How well each particular college interacts and works with physician support programs also varies widely. However, physician health experts say that if there was a national linking of programs, they could build on each other’s strengths, add support for smaller programs and begin to conduct much needed research in the area of physician health. CMA News 2000;10(8):4-5.

Poor quality of life among final-year med students

The quality of life of medical students deteriorates during their clerkship year, a new study indicates. Students spend their clerkship year in the hospital instead of the classroom, learning to treat patients. They are not allowed to prescribe drugs and their orders must be countersigned by a physician. The authors measured the self-reported quality of life of final-year medical students four times over 10 months and found significant deterioration in the students’ vitality and ability to conduct work activities due to physical and emotional problems. The authors say their findings suggest that the decline in health status may begin in the clerkship year or even earlier, and steps should be taken to find out why. CMAJ 2000;162(4):509-10.

A related article, cautions that today’s medical students must deal with issues earlier students did not have to consider, including rising tuition fees, accumulated debt during training, return-of-service requirements and more competition for residencies. The author speculates that these issues may combine to drive some would-be medical students away from the profession. CMAJ 2000;162(4):515-6.

Rural family physicians score as well as those trained in urban settings

Recent measures aimed at increasing the number of physicians practising in underserviced areas have included the establishment of family medicine residency training programs in Sudbury and Thunder Bay, Ont., both of which are far removed from the province’s medical schools. In contrast to their urban counterparts, rural residents train primarily in community medical practices and rural hospitals and there is often only one trainee at each site. Researchers set out to determine whether the two types of training are equivalent by analysing the exam results of 1,013 Ontario family medicine residents (922 in urban programs, 91 in remote programs). The authors reported they found no consistent, significant differences in examination performance between the two groups. The finding is important, because residency training is shifting away from tertiary care teaching hospitals to community centres in smaller communities. CMAJ 2000;163(6):708-11.

World’s first association for disabled doctors

The inaugural meeting of the 30-member Canadian Association of Physicians with Disabilities was held in August 2000 in Saskatoon, Sask. The meeting was the culmination of four years of work by a visually impaired Charlottetown physiatrist, Dr. Ashok Muzumdar. He thought it would be useful for disabled physicians to get together to compare notes on how they manage clinical practice and legal issues, and to share technology, offer emotional support and lobby for changes to improve their treatment and well-being. CMAJ 2000;163(10):1330.

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