TORONTO – A majority of doctors in the country say they have a good mental health overall, but a significant proportion of them say they are exhausted, depressed and even suicidal, reveals a survey by the canadian medical Association.
The national survey conducted online with 2547 physicians and 400 medical residents demonstrates that the reported rates of burnout and depression were higher among residents than among physicians in practice more common among female physicians than among their male counterparts.
“The poor physician health affects not only the physicians individually, but studies have shown that it could have an impact on the care provided to patients,” said the CMA president, dr. Gigi Osler.
While 82 percent of physicians and residents indicated that they had high resiliency, more than one in four reported high levels of burnout and one in three have had a positive screen for depression, ” says the report released on Wednesday.
The resident physicians were 48 percent more likely to report burnout and 95 percent more likely to have a positive screen of depression than all other groups of physicians, reveals the survey. Physicians in practice for 31 years or more reported the highest sense of emotional well-being, social and psychological.
Women physicians were more likely to report a burnout, and a positive screen of depression than their male colleagues. But women physicians also reported a greater emotional well-being and psychological than men in the profession.
“For years, we have focused on the different doctors, said Ms. Osler during an interview. Eat well. Exercise. Sleep well. Train yourself to full consciousness. You need to make it more resistant. And they have done it. But we continue to see these high levels of burnout. So I think this means that the problems and factors (…) are deeper than mere individuals.”
Dr. Murray Erlich, a retired psychiatrist from Toronto who now works with doctors and other as a coach-of-life, says he is alarmed to learn that 19 percent of the participants had already had suicidal thoughts during their life.
“It’s shocking. It is a very high number,” said Mr. Erlich, who has provided consulting services to physicians, residents and medical students through the health programme of the doctors of the Ontario medical Association.
He adds that burnout leads a person to feel emotionally exhausted; to depersonalize the experience, as if she was not fully present; and to have a sense of accomplishment decreased. The problem can sometimes lead to depression, he added.
Generally, hard-working and often perfectionists, medical students, residents and physicians are driven to be highly successful in their field, which can mean to renounce the balance between the life and the time devoted to personal care, ” says Dr. Erlich.
“This helps us to build this varnish (…) to have a healthy look, good, and above all,” he said. But at the same time, he has heard many doctors say that they felt like imposters, regardless of their ability or competence.
In part, this may be a result of the requirements of their work or their clinical program, including heavy loads of patients, a decrease in resources and increasing overwhelming of the medical information that few doctors and trainees can assimilate, ” said Mr. Erlich.
“So, I think it nourishes this feeling that no matter how good I am, maybe I’m not good enough.”
However, the survey revealed that while 81 percent of the participants stated that they were aware of the availability of health services for doctors, only 15 percent indicated that there have been access during the previous five years.
Trivialization and shame
Among the reasons most cited for not using such services, there was the conviction that their situation was not serious enough and the shame of asking for help.
“The stigma exists, explained Mr. Erlich. And I think that there is also a fear of shame and embarrassment”.
He added that the problems of mental health could also have an impact on the professional level, including potential interventions to a provincial college of physicians and surgeons that may affect the ability of a physician to exercise.
Dr. Osler said that the systemic problems in the health system – for example, patients with mental health problems, but having too few resources for their care; and a growing number of older people with multiple health problems, but a shortage of beds for long-term care – are beyond the control of the physician, but may contribute to burnout and depression.
“If you’re a doctor full of compassion and empathy and want to help these people, it wears you out. It becomes really exhausting, she explained. It is easy to tell people to harden off. It is more difficult to make the big systemic changes.”
In a policy on physician health, adopted in December, the AMC makes a number of recommendations, including that the individual physicians to “undertake to create supportive environments in work and education” and that governments adopt for the doctors ‘standards of well-being from the point of view of health at work similar to those of other canadian workers”.
The CMA, which represents about 85 000 physicians, residents, and medical students of Canada, has also hired a vice-president to the health and well-being of doctors.