Physician health and well-being comes "out of the dark corners"
CMA News 2000;10(8): 4-5
As physicians struggle with increasing stress brought on by demanding on-call schedules and ridiculously long work weeks, the doctors who look after doctors sounded the alarm bells that physician health programs must unite so colleagues don't slip through the cracks.
Last month 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.
"I didn't come here to talk about physician health in broad strokes," said Dr. Michael Kaufmann, medical director of the Ontario Medical Association Physician Health Program. "I'm here to ask the CMA to help us get together and to meet more regularly so that we can better respond to the needs of our colleagues."
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.
Most of those attending the meeting agreed that a visible national clearinghouse of physician health information would help raise awareness of the problem of physician health, which historically has been an issue that is raised only in whispers, if at all.
"Right now physicians who have a problem turn to [BC psychiatrist] Michael Myers because he's a name they recognize, but we really need a national network to help those who need it," said Robin Robertson, of the Alberta Medical Association's Physician and Family Support Program.
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| Robin Robertston (right) manager of the Alberta Medical Association's Physician & Family Support Program talks with Dr. Marjorie Smith of Charlottetown and Rosemary Lahey of the Professionals' Assistance Program in St. John's | Dr. Douglas Graham, shown here (left) with Dr. Dan MacCarthy of Burnaby, BC, has been helping physicians with his Victoria-based support program since 1978. |
Although many physicians struggle in silence with stress or other factors that can ultimately lead to bigger problems, the president of the Canadian Association of Internes and Residents says residents are much more willing to seek out help.
"Residents feel that it is OK to talk about work stress or other emotional issues," said Dr. Derek Puddester. "CAIR has a committee that deals with well-being and we feel it is important to get the whole issue out of the dark corners."
 | Dr. Derek Puddester, president of the Canadian Association of Internes and Residents |
The business of providing health or other support services to physicians in need has developed into a kind of cottage industry, with programs growing to meet particular needs and to survive in particular political circumstances. 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.
"We need to learn from each other, to have people develop unique competencies and share them with each other," added Robertson.
While developing better ways to communicate with each other would be a major advantage of a national clearinghouse, it would also help foster better research on how programs are used and what services are lacking.
"I have the feeling that the number of calls is growing and that they are more serious, but we have no frame of reference," said Kaufmann. "We desperately need some science about where we stand and whether we are growing or not."
 | Drs. Derek Fewer of Winnipeg and Gisele Microys of Calgary |
Dr. Andre Lapierre, director of a Quebec physician support program that has just moved from under the auspices of the province's College des médecins, said recently that figures from his program show that burnout is one of the biggest factors facing doctors today. He added that more doctors contacted the program as the number of reforms taking place in the provincial health care system increased.
Attendees of the meeting developed a short list of items that need to be improved to foster the concept of physician health in Canada. It will now be developed into a document that will present several different models for discussion by the provincial/territorial divisions and the CMA Board of Directors.
Some of the priorities identified
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© 2000 Association médicale canadienne
