One year into the pandemic, Canadian physicians continue to feel high levels of stress and fatigue, according to a recent survey commissioned by the Canadian Medical Association. The survey found physicians’ fatigue has increased by 69% over the last year and 64% experienced anxiety around the pandemic.

“Like all health care professionals, physicians are feeling the stress of the last 365 days. And while they’re suffering, very few are seeking help. Suffering in silence is so detrimental; we have more work to do to break down the barriers preventing physicians and other health care workers from seeking support when they need it,” Dr. Ann Collins, CMA president, said in a news release.

Respondents in the survey of 1,648 practising physicians, conducted between Feb. 18 and 22, cited longer time with social restrictions (64%), continued uncertainty about the future (63%) and concerns about vaccine rollout (62%) as factors contributing negatively to their mental health.

Not surprisingly, physicians viewed the rollout of vaccines as a key priority, and more than half gave relatively poor marks to governments’ efforts on that score so far. They pointed to key challenges in vaccine rollout, including supply (93%), clear direction on priority groups that should be prioritized for vaccination (52%), and engagement of physicians in vaccine rollout and delivery (39%).

“The vaccine rollout is the light at the end of the tunnel for Canadians, including doctors, whose mental health has been battered by this pandemic,” Dr. Collins said in the release. “Despite the heroic efforts and guidance from our public health colleagues and health workers, we’re off to a rocky start with the rollout — not getting this right is not an option.”

The issue of physician burnout isn’t new. In a survey the CMA conducted among its members in 2018, well before COVID, 30 to 35% of respondents said they had experienced some degree of burnout in their career.

“I don't think it's a stretch to say that we would expect that to continue and to be even higher as a result of the pandemic,” Dr. Collins said in an interview with Perspectives.

“I think post-pandemic we're very likely to see far reaching effects, including such things as psychological trauma. Those physicians that are dealing with patients in the ICU settings, with the very sick who are isolated from family, and where the care team including physicians become like family - we’ve all heard the gut-wrenching stories of them having to make calls to family and trying to connect family with patients through iPads and electronic means.”

Add to that the concern around getting COVID themselves, taking it home to their families, and even in non hotspots, the need to practise with PPE, physical distancing and increased sanitization.

“It just goes on and on and on,” Dr. Collins says.

MD Financial Management Inc. (MD) - the only national financial services firm dedicated to Canada’s physicians and their families - and Scotiabank have partnered with the Canadian Medical Association to support physicians and the communities they serve across Canada. Among the programs the partnership has supported was the creation last year of the Physician Wellness+ Initiative, with $15 million targeted to address the urgent and ongoing health and wellness needs of physicians and medical learners, as well as an additional $4.6 million to support physicians during the COVID-19 pandemic. The CMA also launched a Wellness Support Line, which provides 24/7 mental health support and counselling to physicians, residents, medical students and their immediate families.

Like many Canadians, physicians have also faced financial challenges during the pandemic. Many operate what is essentially a small business. They have overhead costs – staff, supplies, rent, etc. – and must plan for their own and their families’ financial future. They depend on seeing patients in order to generate income. When the lockdowns came, much of that income disappeared.

“It's been an emotional journey for many, family and financial stress all boiled into one,” says Carol Fensom, a senior portfolio manager with MD. “Healthcare workers that I work with are the ones walking into the danger, not walking away from the danger.”

Fensom has been helping doctors plan their finances and investments for 12 years. The chaos of the early days of the pandemic – with lockdowns, PPE shortages, many unknowns about the disease, not to mention an early stock market plunge – was like nothing she’d seen in her job before.

“Picture this group of people who are watching a historic market drop of 30, 35% over that one-month period in early 2020, and their practice may be shut down, and they are reluctant to visit their elderly parents because they are at risk of contracting COVID from patients,” she said. “Emotions were running high.”

Fensom and her colleagues at MD began calling their clients rather than waiting for worried physicians to call them.

“I have many longstanding relationships, and I can generally predict what worries my clients most. So it’s crucial to have something reassuring to say, such as, ‘let me take one worry off your plate. I know your financial situation from top to bottom and side to side, you will weather this storm – just look after yourself right now.’

“Those calls were difficult, but they ended up deepening relationships. That is where my meaning and purpose come from, is serving the people who are serving Canadians, working for people who are doing so much good.”