The Current

Doctors call for systemic change to tackle burnout among health-care workers

As health-care workers feel the exhaustion of the pandemic setting in, some doctors say medical organizations must do more to prevent burnout among front-line employees.

Nearly a year into pandemic, 'we're absolutely in crisis,’ says Dr. Rod Lim

In the Canadian Medical Association's 2017 National Physician Health Survey, 30 per cent of physicians and medical residents reported high levels of burnout. But one doctor who focuses on burnout and resilience estimates that number is even higher, especially because of the pandemic. (Massimo Pinca/Reuters)

As health-care workers feel the exhaustion of the pandemic setting in, some doctors say medical organizations must do more to prevent burnout among front-line employees.

"During the early phases [of the pandemic], we actually had a little bit of a galvanization and a calling that was very inspiring," said Dr. Rod Lim, director and section chief of the pediatric emergency department at the Children's Hospital in London, Ont.

"But through this period of time now into the second wave, almost a year into this, absolute fatigue has set in, and … we're absolutely in crisis."

It's no secret that the COVID-19 crisis has placed unprecedented pressure on health-care professionals. And although people are no longer taking to the streets or their balconies to cheer them on, emergency workers are still heading to the front lines day in and day out.

Now the medical community is sounding the alarm about the pandemic's impact on mental well-being, after a Quebec doctor died by suicide last month.

Lim told The Current's Matt Galloway the tragedy of Dr. Karine Dion's death has hit emergency doctors hard.

"Unfortunately, this is not surprising in the fact that, you know, we've been dealing with … quite a bit of unhealthiness within our profession, even prior to the pandemic," he said.

According to the Canadian Medical Association, burnout is characterized by emotional exhaustion, a reduced sense of accomplishment, and depersonalization — the feeling that you're an outside observer to your own thoughts or emotions.

In the association's 2017 National Physician Health Survey, 30 per cent of physicians and medical residents reported high levels of burnout.

Left to right: Dr. Rod Lim, Dr. Jillian Horton and Dr. Ajmal Razmy say organizations need to make changes to help protect health-care workers from burnout. (Submitted by Dr. Rod Lim; Leif Norman; Submitted by Dr. Ajmal Razmy)

But Dr. Ajmal Razmy, who focuses on burnout and resilience, says that number is likely closer to 50 per cent, at the least. He said he believes most health-care providers are feeling some form of burnout right now because of the pandemic.

"As health-care providers in general, it's omnipresent," said the psychiatrist and head of service for mental health and addictions at Joseph Brant Hospital in Burlington, Ont.

While physicians are generally pretty good at taking care of their medical well-being and fitness, "we do a lousy job of promoting psychological PPE," he told Galloway.

'Wholesome' solutions needed: Razmy

Dr. Jillian Horton, an internal medicine specialist and medical educator in Winnipeg, believes workplace culture is part of the problem.

"We have a long history in our profession of suppressing our physiologic needs in the name of training," she told Galloway.

When she was an intern and resident, for example, she often worked 36-hour shifts, something she said is still common today.

"We also have a real culture of, you know, that heroism has a dark side too," she said, referring to the stress and guilt health-care workers face when something bad happens to a patient. 

"If you are responsible for the good things, then you're also responsible for the bad things."

Horton said health-care organizations could better support their workers' mental well-being by changing how long, and how frequently, employees are expected to work. Employees would also benefit from programs that help them develop skills to deal with workplace stressors, she said.

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Razmy agrees that a systemic solution is needed. But he says those changes must be "wholesome" rather than paying "lip service to wellness."

He suggested organizations consider appointing chief wellness officers, and create committees that can address the issues of burnout, stress and depression.

In the meantime, Lim said it's important for health-care professionals to look out for one another, and to work as a team through these difficult times.

"It's just so important … to find things that are going to fill your bucket up and allow you and your team to keep doing the work that you know is so important for the community," he said. 

"We're doing the best that we can, but this has been pretty tough."


Written by Kirsten Fenn. Produced by Joana Draghici.

Where to get help

Canada Suicide Prevention Service

1-833-456-4566 (Phone) | 45645 (Text, 4 p.m. to midnight ET only) | crisisservicescanada.ca 

In French: Association québécoise de prévention du suicide: 1-866-APPELLE (1-866-277-3553) 

Kids Help Phone: 

Phone: 1-800-668-6868

Text: TALK to 686868 (English) or TEXTO to 686868 (French)

Live Chat counselling at www.kidshelpphone.ca 

Post-Secondary Student Helpline:

Phone: 1-866-925-5454 

Good2talk.ca 

Canadian Association for Suicide Prevention: Find a 24-hour crisis centre

If you're worried someone you know may be at risk of suicide, you should talk to them, says the Canadian Association for Suicide Prevention. Here are some warning signs:

  • Suicidal thoughts.
  • Substance abuse.
  • Purposelessness.
  • Anxiety.
  • Feeling trapped.
  • Hopelessness and helplessness.
  • Withdrawal.
  • Anger.
  • Recklessness.
  • Mood changes.

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