Entering the medical profession as a physician, often considered a calling, can be both gratifying and stressful, and for many will take a toll on their health and well-being. The pressure often begins in medical school and is compounded by heavy workloads and demanding standards of training and practice.
Recognizing the range of challenges physicians face and how that might affect their patients, Scotiabank, in partnership with the CMA, and MD Financial Management Inc. (MD) has made a 10-year, $115-million commitment to support physician health and wellness, targeting individual and systemic factors that negatively affect physician health.
Recently $4.6 million was committed to support physicians during the COVID-19 pandemic. A Physician Wellness Hub and a Physician Wellness Hotline were also launched to enable physicians to find resources in their communities that can help them better manage the stress and burnout.
“COVID-19 has impacted our communities from coast to coast, and physicians stand at the centre of our country’s ability to respond,” says Glen Gowland, Group Head, Global Wealth Management at Scotiabank. “We have supported physicians during this challenging period – but we also recognize additional longer-term funding is needed to support the health and wellness of the medical profession over the longer term.”
On October 1, Scotiabank, in partnership with the CMA, and MD launched the Physician Wellness+ Initiative, which will distribute $15 million to provincial and territorial medical associations and key medical organizations across Canada that are best attuned to the needs of physicians and are already established, allowing funds to get where they are most needed more efficiently.
The fight against COVID-19 has compounded issues that physicians, residents and medical students were already reporting — burnout, depression and other health concerns — while countless others, according to the CMA, stay silent out of fear of stigma.
CMA’s National Physician Health Survey in 2017, the first of its kind in Canada, highlighted key factors affecting health and wellness, such as average 48-hour work weeks, not including the monthly on-call average of 111 hours, and failing to get the optimal amount of sleep and physical activity were common and contributed to nearly one-third of respondents experiencing burnout.
It seems that many Canadians are also worried about their doctors: A recent online survey done by Scotiabank, CMA and MD found that 93% are concerned about the long-term effects of the pandemic on the health care system, and 95% believe the health and wellness of physicians impacts the health of all Canadians. “Physicians’ critical commitment to Canadians’ health and wellness has not faltered even during the most trying times,” says Daniel Labonté, President and CEO, MD. “We are proud to have been by their side for more than half a century and to contribute to a brighter and healthier future for all physicians.”
Being a physician today comes with a great many stressors – diminishing resources, heavy workloads, not to mention the risks associated with COVID-19
— Dr. Ann Collins, CMA President
The Canadian Federation of Medical Students, which represents more than 8,000 medical students from 15 student societies across Canada, plans to use an investment from the Physician Wellness+ Initiative to expand its National Wellness program to influence change in the culture of medical education. Three years into the program, its goal is to improve all aspects of the students’ experience.
“Clearly, there are things in our training environments that contribute to the issues we’re seeing with physician health and wellness,” says Victor Do, past President and Board Chair of the CFMS, who notes that stress-related health issues are documented early in a physician’s training, and compared with other professions medical schools have a much higher burnout rate.
One key challenge Dr. Do sees is removing the stigma attached to seeking help. “It’s very difficult for students and physicians to talk about mental health struggles or burnout because we see ourselves as having to be totally on to take care of patients. As trainees, we’re really trying to change that narrative early on,” he says.
Contributions from Scotiabank, in partnership with the CMA and MD Management 18 months ago are allowing Well Doc Alberta to continue what Dr. Jane Lemaire, Physician Lead of Well Doc Alberta, calls “a really unique pilot project,” focusing on prevention and recognizing physician wellness as a system-level responsibility. The money is the program’s sole funding for three years.
Building on initial funding in 2018 from the College of Physicians and Surgeons of Alberta, the Alberta Medical Association, and the Cumming School of Medicine at the University of Calgary, Well Doc Alberta creates educational opportunities to enhance literacy around physician wellness, allow self-reflection for physicians, and coach towards positive change.
“There’s a whole body of science that demonstrates that physician wellness is necessary to enable healthy health care systems and good patient care. We think that what we’ve learned will lay the foundation for other jurisdictions,” Dr. Lemaire says. “Ultimately, there will be less distressed physicians who need to be cared for.”
Doctors Manitoba is taking a similar collaborative approach to physician wellness, framing it at the individual level, the team, the organization and the system. Its priority is to ensure learning and work environments are positive starting in medical school. The funding from the Physician Wellness+ Initiative will be used to build on existing programs, and in particular the mentorship and leadership development programs.
“More than ever it’s clearly been demonstrated that leadership is needed to have engaging healthcare system change, so investing in leadership education programs as well as partnering with the University through the Office of Leadership Education at Rady Faculty of Health Sciences will be important to focus on,” says Dr. Ming-Ka Chan, Vice-Chair, Physician Health & Wellness Committee, Doctors Manitoba and Co-Director, Office of Leadership Education, Rady Faculty of Health Sciences, University of Manitoba.
“Being a physician today comes with a great many stressors – diminishing resources, heavy workloads, not to mention the risks associated with COVID-19,” says Dr. Ann Collins, CMA President. “We need to take care of our medical community in order for them to take care of patients. This funding will address the needs of physicians and medical learners by leveraging and bolstering existing health and wellness infrastructure while also extending support in new ways.”