Dr Matthew Chow

I made a private commitment to myself as I took on the Doctors of BC presidency in the middle of the pandemic: I wanted to do everything in my power to make sure that every one of us saw it through safely to the end. My main fear was not casualties from COVID-19; instead, I feared burnout, fatigue, mental health issues, and substance use would take their toll.

Even before the COVID-19 pandemic, physician wellness was an issue requiring attention and support. With the added stressors on physicians and their families during the past 18 months, the need has increased exponentially. Since 2019, BC’s Physician Health Program (PHP) has seen a 58% increase in the number of physicians seeking help and a 37% increase in case complexity. In a recent sample of acute care physicians in BC, colleague Dr Nadia Khan found burnout rates as high as 71% in women and 64% in men. And a recent Ontario Medical Association survey found that 74% of physicians and trainees are experiencing at least some degree of burnout.

In October 2020, the Canadian Medical Association announced the Physician Wellness+ Initiative, which directs funds to address the health and wellness needs of physicians and medical trainees across the country. Included in this distribution of funds, Doctors of BC’s PHP was allocated $1 million over 4 years to identify gaps in existing wellness services, to enhance or develop new services and programs to address those gaps, and to ensure future needs are met. The PHP, in partnership with and with additional funding from the Joint Collaborative Committees, will focus on physician health and wellness and develop a number of programs to assist BC’s doctors at local, regional, and provincial levels.

Physician wellness network

We know that reducing burnout and supporting physician wellness are essential, so the physician wellness network will offer ongoing opportunities for communication, networking, and collaborative gatherings for doctors involved with MSAs, divisions, public health, and UBC’s resident doctors, among others, to share ideas, successes, and challenges, and to strategically align activities that support physician wellness.

Cognitive-behavioral therapy (CBT) skills training

So that physicians can better support their patients with mild to moderate mental health issues and use CBT skills for self-care and to communicate with colleagues and within teams, the Shared Care Committee will be offering a CBT skills training program over a period of 8 weeks plus 2 half-days. When the PHP piloted a physician-specific cohort in the fall of 2020, it was so popular that more than 170 physicians expressed interest, despite there being only 15 spots available.

Physician peer support network

Given the abundance of literature that shows the effectiveness of physician peer support to foster a caring medical community and culture where physicians feel at ease seeking and offering help, the PHP will be training physicians across the province to deliver one-to-one emotional peer support. A consultation with local divisions, MSAs, and other physician organizations is taking place to help determine the best approach.

Expansion of PHP family doctor connection service

It’s not just our patients who deserve their own family doctor; physicians do as well. The PHP will be engaging with divisions of family practice to increase the capacity to attach physicians to their own personal primary care doctor.

The CBT and peer support programs are in the early stages of planning and development, and prototyping is intended to start this fall.

I will not pretend that these initiatives on their own will restore our health and wellness. I have heard from many colleagues about the systemic problems, under-resourcing, understaffing, increasing complexity, and heavy burdens placed upon you. I experience these too.

However, by making physician health and wellness a top priority, we shine a light on an important issue, we make systemic changes possible, and we start to tackle intangibles such as toxic workplace cultures that contribute to burnout, fatigue, and distress. By putting a greater emphasis on our own wellness needs, we also set an example for our patients and society.

And what of my commitment that we all make it through to the end? We have indeed lost some colleagues along the way, though none were physicians who contracted COVID-19 in the line of duty. The factors contributing to these losses are complex, but I would like to think they also galvanize us to make things better. I am bolstered by the news that we have welcomed many new colleagues into our profession; the number of BC doctors has actually grown during the pandemic. People have joined us from different provinces and different countries; they are from different backgrounds and have many different experiences. They bring with them valuable ideas, innovations, and an abundance of energy that can only contribute to the value of our BC physician community.
—Matthew C. Chow, MD
Doctors of BC President