Taking its Toll

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Dr. Janet Van Vlymen

Recently, I had the opportunity to chat with Dr. Jillian Horton, the award-winning medical educator, writer and physician about an issue she knows only too well — physician burnout. During the “In Dialogue” podcast, which is now available, we discussed the systemic drivers that continue to challenge physicians.

“We so often set ourselves up in medicine to do things that are quite literally impossible,” Dr. Horton said. “We think that furthering science would be the hard part, but it’s actually the rest of what we’re doing … [it’s following the] big lofty goal that sets you up unequivocally to crash and burn, and then think you were the problem. We are not the problem. The problem is the system that we’re born into was broken to begin with and we never really understood that.”

When we immerse physicians in a culture where the stakes are very high, pressures are enormous and emotions are suppressed, we create an environment that generates a lot of suffering, she said.

And, of course, adding a pandemic to this toxic mix creates a health care environment that is even more punishing.

She identified the importance of compassion and noted how willing we are to give it to others, but withhold it so easily from ourselves.

Indeed, findings from CMA’s National Physician Health Survey demonstrate the toll being taken on the profession. The results show a physician workforce struggling under the weight of an under-resourced health system and pandemic challenges. 

Key findings include: 

  • Nearly half of respondents (48 percent) screened positive for depression, up significantly since the CMA’s 2017 survey (33 percent). 
  • One-quarter (25 percent) of physicians and residents experience severe (10 percent) or moderate (15 percent) anxiety. 
  • Eight in 10 physicians and medical learners scored low on professional fulfillment, and less than six in 10 physicians and medical learners indicated being satisfied with their career in medicine. 

With more than half of physicians and medical learners experiencing high levels of burnout, it is not surprising 49 percent of respondents report they are considering reducing their clinical work in the next 24 months. 

This does not bode well for our emergency departments, which are already facing challenges finding enough health care professionals to keep them open, and it is an unsettling statistic for the growing number of Ontarians unable to find a family physician.

“I am so proud of the work we accomplished in the face of ongoing system challenges”

Faced with this growing stress on an already straining system, the Ontario government asked CPSO to help mitigate this crisis. To that end, Dr. Nancy Whitmore, the College Registrar/CEO, and her leadership team have committed to working with the government to find solutions to increase our registration numbers.

This is my last letter to the profession as CPSO Council President as I will be passing the torch to Dr. Rob Gratton, who served as Vice-President over the past year. I am grateful for the support of College staff, Council members and my family for their help. I am so proud of the work we accomplished in the face of ongoing system challenges, including the approval of policies on virtual care and social media, and the development of a culturally-sensitive draft policy on human rights in the provision of health services.

In closing, I would like to end my message by highlighting one of the recurring themes of my podcast conversation with Dr. Horton. She identified the importance of compassion and noted how willing we are to give it to others, but withhold it so easily from ourselves. It does not serve us well to be unrelentingly harsh in our self-appraisal. In fact, a growing body of literature on self-compassion highlights its benefits not only in enhancing our well-being, but also its potential in improving the care we provide to our patients. So, for many reasons, I would ask that you extend to yourself the same kindness and encouragement that you so readily extend to others.

Thank you,