Tag Archives: physician health

Kirsten Patrick is Deputy Editor at CMAJ

 

In the last two weeks I’ve attended three very different scientific conferences on behalf of the CMAJ Group. In fact you couldn’t get more different than the 33rd International Conference on Pharmacoepidemiology and Therapeutic Risk Management (ICPE - all Big Data and massive record linkage aimed at finding out more about the benefits and harms of medicines and devices) and the 5th Canadian Conference on Physician Health (mainly focusing on the major problem of physician burnout and what we should do about it). And yet the same study was mentioned by plenary speakers at both conferences to support the same message: that physicians are overburdened by administrative and data-capture demands. Across four medical specialties, “for every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day,” ...continue reading

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JTepperJoshua Tepper is a family physician and the President and Chief Executive Officer of Health Quality Ontario

 

Often when we talk about improving health care, we turn to the Triple Aim. Developed in 2007 by the Institute for Healthcare Improvement (IHI) in the United States, the Triple Aim captures three objectives for a better quality health system: Improving a patient’s experience of care, improving population health and doing this at a reasonable cost. It has become a way of thinking embraced by many health care systems around the world.

The Triple Aim takes a big-picture, system-wide approach that can be applied to any part of the health care system, as well as across all levels of an organization. The ultimate endgame is a sustainable health care system that patients trust and that contributes to healthier populations.

All great ideas get improved upon over time. ...continue reading

Magbule Doko Magbule Doko is a family physician in Windsor, Ontario, and an adjunct professor at The University of Western Ontario

 

School. Career. Children. Partner. Parents. Siblings. Being a Doctor. Getting Older. Turning 30. Teaching the next generation of doctors. Next step in my career. In-laws. Body. Health. Meditation. Having another baby. Trying to make the world a better place. Trying to understand who I am. Vacation time. Couple time. Debt. Income. Work. People living. People dying. Crying. New life. ...continue reading

DMacA_3Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Throwing surgical instruments across a theatre, idiosyncratic single handed practice, refusing to see patients in clinic without notes. I didn’t think physicians could get away with this sort of practice anymore. While these were hypothetical examples explored in a recent seminar discussing doctors’ disruptive and unprofessional behaviour, the audience clearly recognised that it still happens. Dr Kevin Stewart, Clinical Director of the Clinical Effectiveness and Evaluation Unit at the Royal College of Physicians in London and a geriatrician in Winchester, England, facilitated discussions on how to manage doctors who display difficult behaviour. His approach was to focus more on patients than doctors and to recognise how such behaviour affects patient safety. ...continue reading

amy gajariaAmy Gajaria is a third year resident in the Department of Psychiatry at the University of Toronto

 

Last week was the first snowfall of the season in Toronto. Usually, the first sight of fluffy white flakes collecting on city streets would have me dreaming of strapping on my cross-country skis. This, year, however, the first snow left me huddled inside, frightened of slipping on ice.

Towards the end of September I badly damaged my ankle when attending a charity event. In a few moments I went from an active 30-something to someone unable to stand independently. After the paramedics got me to the nearest hospital, the first thing that popped out of my mouth was not “pain medication STAT” (that was the second thing), but instead “I’m a doctor. I hate being a patient.”

I later told myself that this was because I wanted to speed up communication and avoid unnecessary explanations. ...continue reading

Dr_Ziegler_picDr. Sabine Ziegler is a general practitioner with an interest in palliative care, practising in Ettlingen, Germany

 

For readers from Canada, a "mother land" of physician health, my reflections on physician health in Germany may surprise; the structures in Germany are not nearly as well developed as in the USA, Canada or Great Britain.

Doctors in Germany can prescribe and self medicate without any consultation or assessment by a colleague- which means drug misuse, including benzodiazepines, is possible. Long working hours, high professional responsibility and little recreational time lead to a large percentage of doctors feeling physically and psychologically affected. On top of that is the constant confrontation with suffering, fear and death. Doctors also often crumple under the high demands they create for themselves. It doesn't fit with a doctor’s self-perception to seek help for their own problems. Yet when a sick healer tries to cure himself most of the time it doesn't work. Every year around 150 German physicians end their lives. ...continue reading

profDameCarolBlackProfessor Dame Carol Black is Principal of Newnham College Cambridge, Expert Adviser on Health and Work to the Department of Health, England, Chair of the Nuffield Trust, and Chair of the Governance Board of the Centre for Workforce Intelligence. She was a keynote speaker at the recent International Conference on Physician Health

 

Whatever the nature of their work, whatever skills they bring to bear, however strong their calling and dedication, employees come under the influences of their workplace and of those who employ them. It is as true for doctors as it is for the drivers of tube trains, the builders of Olympic stadia or civil servants in Whitehall. The evidence, gathered painstakingly over many years, in such different arenas of work, is consistent and strong.   It leaves no doubt about the characteristics that we look for in identifying good work and a good workplace.

The effects of workplace influences are felt and measured to varying degrees in ways that are clear. First is the personal health and wellbeing of employees – their physical health and their mental health, the former often measurable declared, the latter often masked and hidden.

Second is the performance of the group, the team, and ultimately the institution for which they work. In health care such performance is measured in terms of the quality of patient experience, the safety of care and health outcome.

These measures correlate with features common to organisations which have achieved success in promoting staff physical and mental health and well-being. ...continue reading

Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

“It was the loneliest I’ve ever felt,” said my consultant surgeon colleague as he described lying in his hospital bed the night before cardiac surgery. Even with all his surgical experience, familiarity of the surroundings, knowledge of his own hospital, and utmost confidence in his cardiac surgical colleagues and anaesthetist, he was scared. Despite what our patients might think, being a doctor is no defence against illness and doesn’t make coping with illness any easier.

But, we are our own worst enemies. We put immense pressure on ourselves and don’t want to let our medical colleagues or patients down. I once listened to a single-handed rural GP who had recent chest pain and was awaiting an angiogram. His greatest worry was that he could not get a locum to cover his patients ...continue reading

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Jim_Lucey2_2010Prof Jim Lucey is Clinical Professor of Psychiatry and Medical Director at St. Patrick's University Hospital, Dublin, Ireland. He is a keynote speaker at this week's International Conference on Physicians' Health #ICPH2014

People sometimes ask me whether doctors are any different from other people when it comes to their mental health. Do they suffer more or less? Do they have different disorders and distress? The truthful answer (as with so many human questions) is a bit like, “Yes and No”.

Of course doctors can have physical and mental health issues, but this fact is often hidden from public view. Mental suffering in particular is a clandestine experience, and disclosure is especially hazardous for doctors, since it adds professional jeopardy to their burden of shame and guilt.

Awareness of doctors as human beings with real personal problems and stresses is not widespread ...continue reading

TGreenhalgh_picTrisha Greenhalgh is Professor of Primary Health Care and Dean for Research Impact at Barts and the London School of Medicine and Dentistry, London, UK

The Professor of Trauma Surgery texted me: “Can I come and see you today please?”

I had started work at 8 am and it was already 4.30 pm. I had four more meetings in my diary. But he had never asked before, so I decided it must be important. I texted back: “6.30 in my office, if you’re still around.”

He was early. I buzzed him in, and asked wearily, “How can I help?”. We overlapped on a committee so I assumed he wanted to talk business.

“Actually, I came to ask about you,” he said

“Huh? I’m fine.”

“I had a tip-off that you weren’t fine.”

“Who told you that?” ...continue reading