■ Physician wellness:

Coping with the stress of medical practice

Physician health: Putting yourself first

Many elements of physician life can result in poor health

A tired-looking doctor wearing full personal protective equipment

5 minutes

Published: September 2015 /
Revised: April 2022

The information in this article was correct at the time of publishing
P1504-1-E

Physicians have the knowledge and skills to be healthy. Yet, while they care for their patients, their own physical and mental well-being may suffer. The medical community recognizes that physicians are at their best when healthy, and encourages physicians to look after themselves and ask for help when they need it.

What puts physician health at risk?

The very nature of medical practice can contribute to physicians’ stress. A regular work day can be emotionally draining as doctors witness suffering, fear, pain, tragedy, and death. Physicians may also experience mental stress from dealing with increasing patient care demands, constrained resources, mounting paperwork, demanding work hours and schedules, challenges with work-life balance, and frustration in trying to meet the conflicting needs of patients and healthcare organizations. The COVID-19 pandemic has also been associated with increased mental health visits among physicians.1

Physicians’ intrinsic personality traits often make it easy for them to ignore their own health needs. Typically doctors are high achievers, independent, and self-sufficient.2 They can be perfectionists, with a tendency to overwork. These characteristics allow them to let work become their priority, neglecting their own care and personal lives.

The culture of medicine may deter physicians from caring for their health. From the beginning of their medical career, students and residents are exposed to long hours and heavy workloads. This is often seen as the only way to achieve success.3 Doctors report feeling pressure from colleagues and patients to prove their medical competence by always appearing well and able to cope. Many are reluctant to take sick leave or sufficient vacation. Some fear that asking for help may be seen as a sign of weakness and so hesitate to discuss their health concerns with others.

These factors — the nature of medical practice, the personality traits of physicians, and the culture of the profession — can make doctors vulnerable to stress, fatigue, depression, anxiety, substance abuse, burnout, and impairment. In addition, physicians face the same stresses and difficulties as any other individual. They may, for example, experience family difficulties, financial problems, relationship issues, workplace challenges, or social isolation, all of which can erode their ability to cope.

The focus shifts to prevention

Increasingly, the approach for supporting physicians has focused on self-care and preventing illness, starting in medical schools and clinical training. According to a survey conducted by Resident Doctors of Canada, over half of residents experience “definitive symptoms of burnout ranging from physical and emotional exhaustion to feeling completely burned out and in need of help or change.”4 Many universities and residency programs have developed wellness resources and revamped medical curricula to help students and residents practise good self-care in their daily lives.5

Medical associations and organizations are also promoting good health habits. Several provincial physician health programs and other groups offer resources to help physicians incorporate self-care into their lives. For example, the CanMEDS Physician Health Guide, by The Royal College of Physicians and Surgeons of Canada, offers advice specific to physicians for maintaining relationships, parenting, using emotional intelligence, managing stress through mindfulness, coping with an adverse event, and making financial plans.6 The CMPA website also contains resources on physician wellness that help physicians practise safely and respond appropriately to medico-legal difficulties if and when they arise.

The courage to ask for help

Even physicians who normally cope well may need help at times. Some, for instance, may find it difficult to carry on if they become overextended in their everyday work or if they face traumatic events either at work or in their personal life. Doctors should try to be self-aware, recognizing when their health requires care. They should consider their care options, such as taking time away from work, adjusting how they work, or seeking outside help and advice including treatment.

Physicians must allow themselves to reach out for help. This might take the form of speaking with a trusted colleague, institution administrator, life or practice partner, friend, or religious advisor. Other options might include contacting the local provincial physician health program, or obtaining professional treatment from a family physician, psychologist, psychiatrist, or other healthcare provider.

Some doctors must overcome barriers before seeking help. Many may have trouble accepting the patient role and being away from work. Others may think they will prevail over their difficulties with time and will consequently delay seeking help. Many must overcome fears that their problems will become public, damage their reputation, and result in the loss of their medical licence.

Medical students and residents should also get help when experiencing challenges with their physical or mental health. They can contact their faculty advisor, the dean’s office at their faculty of medicine, or the wellness program at their institution. Many physician health programs specifically serve students and residents.

The CMPA can help, too

The CMPA has more than 100 years of experience assisting physicians with medico-legal difficulties. We know that these matters can create undue stress, impair health, and affect physicians’ ability to practise. Members have told us that simply calling the Association and speaking to one of our physician advisors reduced their stress and improved their well-being. By getting information and support from our specially-trained experts, members can see their situation in the proper perspective.


References

  1. Myran D, Cantor, N, Rhodes, E et al., “Physician health care visits for mental health and substance use during the COVID-19 pandemic in Ontario, Canada,” Journal of the American Medical Association, Vol. 5, No. 1. Accessed February 25, 2022 from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788289
  2. Wiskar, K., "Physician health: A review of lifestyle behaviors and preventive health care among physicians," British Columbia Medical Journal, 2012, Vol. 54, No.8. Accessed March 24, 2022 from: http://www.bcmj.org/mds-be/physician-health-review-lifestyle-behaviors-and-preventive-health-care-among-physicians
  3. Ibid.
  4. Resident Doctors of Canada, National Resident Survey 2020, Summary of Findings. 2020. Accessed February 25, 2022 from: https://residentdoctors.ca/publications/national-resident-survey/2020-national-resident-survey/
  5. For an example, see Student Wellness, University of Ottawa, Faculty of Medicine, Student Affairs Office: http://www.med.uottawa.ca/Students/StudentAffairs/eng/wellness_sw.html
  6. Puddester, D., Flynn, L., Cohen, J. eds. Royal College of Physicians and Surgeons of Canada, CanMEDS physician health guide: A practical handbook for physician health and well-being. 2009. Accessed February 25, 2022 from: https://www.royalcollege.ca/rcsite/documents/canmeds/physician-health-guide-full-e.pdf

DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.