Physician Burnout is Alarmingly High

The Saskatoon Farm in Foothills County, Alberta. (Dr. Noorali Bharwani)
The Saskatoon Farm in Foothills County, Alberta. (Dr. Noorali Bharwani)

Earlier this year, Canadian Medical Association (CMA) President Dr. Katharine Smart appeared before the House of Commons Standing Committee on Health to welcome a study on Canada’s health workforce. In her remarks, she explained physician burnout is at an all-time high and the health workforce is in the midst of a crisis.

Many concerned people have written about physician health and burnout over the years. I wrote a column about this on December 5, 2010 — about 12 years ago. Many medical conferences in Canada, USA and UK have discussed this subject and proposed solutions. But we are still talking about it. COVID-19 pandemic has made things worse for doctors and nurses.

More than 13,000 physicians across 29 specialties were surveyed (advisory.com) between June 29 and Sept. 26, 2021. Across all specialties, 47 per cent reported feeling burned out last year.

According to one study, there are five things causing physician major stress — caring for the chronically ill, managing mental illness, improving communication with patients and other providers, keeping up with technology and using technology to engage patients.

Burnout has become a major risk for physicians. Doctors tend to focus on patient health, often at the expense of their own. Yes, physician health matters because physicians are a valuable human resource.

In 2006, I was in Ottawa attending International Conference on Physician Health. It was organized by the CMA and the American Medical Association (AMA). The conference was attended by delegates from Canada, U.S.A., Europe, Australia, New Zealand and many other parts of the world.

This was 18th in the series since its inception in 1975. The theme was: Physician health matters: preserving a valuable human resource. After all these years we are still talking about the same thing.

The delegates at the conference heard about the latest research on physician health, about new skills to survive and thrive in their career and learned about the progress that is being made around the world to protect the health of physicians.

The organizers of the conference said by raising physician health issues at an international policy level, the conference seeks to promote a healthier culture of medicine and decrease the stigmata associated with the physician ill health, thereby decreasing barriers to physicians seeking timely personal care.

In 2003, a survey conducted by the CMA found that 46 per cent of Canadian physicians were in an advanced stage of burnout. Physicians feel they have to work harder and longer hours because there is a shortage of medical manpower. With the information overload there is a significant pressure on physicians to satisfy the public and there is constant political battle within our health care system to obtain fair share of resources to provide good patient care. All these factors do affect physicians’ personal and mental health and their capacity to deliver good patient care.

In the past doctors have been very reluctant to seek help and lived in a culture of denial. Now more stressed-out doctors are willing to seek help. Society and medical disciplinary organizations have moved to better understanding of the challenges faced by stressed out doctors and their families.

Recent studies have shown where such doctors are identified and undergo treatment, outcomes seem to be good. Such approaches both reduce the suffering of ill doctors and protect the public.

We keep talking about physician shortage, nursing shortage, ICU bed shortage, hospital bed shortage and many other medical service issues. We have hundreds of overseas qualified doctors and nurses who cannot get a license to practise in Canada. The obstacles faced by foreign medical and nursing graduates are immense. Their education and skills are wasted.

Canada should have one licensing body for doctors like they have in the United Kingdom. If you are licensed to practise in one province then you should be able to practise anywhere in Canada. But I doubt this will ever happen.

I know we will be talking about this again 20-years down the road!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Saying Hello and Goodbye to Friends

One candle - multiple lights. (Dr. Noorali Bharwani)
One candle - multiple lights. (Dr. Noorali Bharwani)

“I once heard two ladies going on and on about the pains of childbirth and how men don’t seem to know what real pain is. I asked if either of them ever got themselves caught in a zipper,” says Emo Phillips, an American entertainer and comedian.

This is just a joke so don’t get upset about it. But it also makes a point. Almost everything in life is relative. We can moan and groan about our problems but if you talk to your friend or relative they probably have a worse story which they don’t even want to talk about.

After my recent illness, my first real outing was to attend a friend’s funeral. I had known him and his wife ever since I came to Medicine Hat – about 29 years ago. They were the nicest couple I had the privilege to know. I have known his wife from her work and I knew him as a genuine dedicated golfer. Now he is gone but he has left behind wonderful memories of charm, dedication, honesty and so much love and affection for everybody.

My second story is about another friend. Last week, I was in Lethbridge for a checkup. My wife and I were rushing to find the clinic. We passed by a couple and I didn’t even look at their faces. Then I heard a voice, “Noorali, is that you?” said the man. I recognized the voice right away. It was my good friend James (not his real name). I have known him for as many years as I have been in Medicine Hat. He worked as a family doctor in a small place until he moved to Lethbridge.

We stayed in touch with our yearly golf trips to the mountains. Last year he could not make it because he was too busy. This year he could not make it because he is not well. And I could not go this year for the same reason. And how ironic that our paths should cross in a Lethbridge hospital corridor?

As a surgeon, I have seen lots of sick people. But life is different when it affects you. I ask the same questions to my doctors as my patients used to ask me. Lots of those question have no good answers. My doctors look at me and smile. There is so much in life we know and there is so much we don’t.

I gave you three examples (including mine) of people with different backgrounds, facing the same kinds of problems in life. Is there a message in there somewhere?

Talk to you again soon. Stay healthy, happy and smiling.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Funny things do happen in life!

Here I am writing my beloved column again. Six weeks ago I would not have said that. But when you feel ill you find out how much people love you. How much they care about you. For the first few days I could not help but cry… literally cry like a baby. Feeling sorry for myself, feeling sorry for my family and touched by the love and care I received from everyone who came to see me in the hospital, sent me funny, inspiring emails, phone calls, greeting cards, flowers and yummy chocolates, fruits and cakes.

The doctors, nurses and all the members of the hospital staff who looked after me or I ran into were nothing but kind and generous. I was proud to say that I used to work with these wonderful people. They hadn’t forgotten me. I love you guys! When I was under the influence of medication, I vaguely remember kissing (on the cheeks!) and hugging some doctors, nurses, x-ray technicians (male and female… made sure everybody was covered). I love them so much. But they cannot sue me because I was under the influence of medication.

What is depressing is my ill health occurred one day after I finished five-weeks full time course in photography at SAIT in Calgary. I am hopeful one day I will be able to use my skills and take beautiful pictures.

As you all know, strange things happen in life. Sometimes they are wonderful and sometimes they are not. Sometimes you get a chance to write about it and sometimes you don’t. Sometimes you get a chance to laugh about it and sometimes not. But we have to be positive although sometimes it is hard to do that. During my downtime, I decided to follow my own advice – listen to my doctors (and my wife and children) and watch funny movies and listen to music. Laughing for few hours a day helped me a lot.

Talking about laughter reminds me of my new book, “Doctor B’s Eight Steps to Wellness” published by General Store Publishing House. I have ordered copies to be sold locally and I will make an appropriate announcement in the next few days.

In life, quite often, we get a chance to make choices. But when it comes to good health, what choice do we have? Who would opt for bad health? Probably nobody. If you are one who has decided to stay in good health then you have made the right choice. That is a good start.

Remember, to stay healthy you don’t have to make a large investment of money. What you have to do is invest some time in a day to find that joy of good health and happiness. Now, don’t tell me time is money. When it comes to your health time is more than money… does that sound right?

OK let me find out what my book says. It says if I want to stay healthy then I should read my book over and over again. Find out about healthy eating, exercise, stress relief, sleep, sexual empowerment, laughter, and meditation. Then go have some fun and be healthy. Good deal. Talk to you again soon. Love you all.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Doctor, heal thyself first

There are plenty of resources across Canada to help physicians stay healthy

Yes, physician health matters because physicians are a valuable human resource.

From Nov. 30 to Dec. 2, 2006, I was in Ottawa attending the 2006 International Conference on Physician Health. It was organized by the Canadian Medical Association (CMA) and the American Medical Association (AMA) and was attended by delegates from Canada, the United States, Europe, Australia, New Zealand and many other countries.

This year’s conference was 18th in the series since its inception in 1975. This year’s theme was Physician health matters: preserving a valuable human resource.

The delegates at the conference heard about the latest research on physician health, about new skills to survive and thrive in their careers, and learned about the progress is being made around the world to protect the health of physicians.

The organizers of the conference say that by raising physician health issues at an international policy level, the conference seeks to promote a healthier culture of medicine and decrease the stigma associated with physician ill health, thereby decreasing barriers to physicians seeking timely personal care.

In 2003, a survey conducted by the CMA found 46% of Canadian physicians were in an advanced stage of burnout. Physicians feel they have to work harder and longer hours because there is a shortage of medical manpower. With information overload there is a significant pressure on physicians to satisfy the demanding public, and there is constant political battle within our health-care system to obtain a fair share of resources to provide good patient care. All these factors do affect physicians’ personal and mental health and their capacity to deliver good patient care.

In order to help physicians understand the importance of looking after their own health, the CMA set up a Centre for Physician Health and Well-being. Since then, every province in Canada has established programs to help physicians and their families cope with the stresses of work and encourage healthy behaviours within the physician population as a whole.

At the conference, I was pleased to learn that every physician in Canada has access to a physician health program. In Alberta, it is called Alberta Physician and Family Support Program. The program has a toll-free number and a physician or a family member can call this number for help 24 hours a day.

As we know, prevention is better than a cure. In the last few years, medical students, interns and residents have been in the driving seat promoting ideas on physician health and well-being. They are educating themselves at an early stage of their professional lives to look after themselves and their families. They have learned to reduce the hours they work, they have learned to say “no” when they are tired and they have learned to balance their lives.

I belong to a foolish generation of older doctors who took pride in working round the clock. Readers of my newspaper columns in Medicine Hat, Alta., and those who have read my book, A Doctor’s Journey—an emotional and humourous look at life through the eyes of a doctor—are well aware of my trials and tribulations with my own health. I learnt my lesson too late. In the last four years, I have tried to change my practice and find a better balance in life.

It is hard to break old habits. After all, work is a kind of addiction. It takes about one to two years to “detoxify” oneself. During this process, one needs an understanding health-care administration, understanding colleagues, good friends and a devoted family. Count yourself lucky if you get all four groups rooting for you during your down time.

As one door closes, another one opens. So be brave, doctor, remember to heal thyself first.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!