'We should definitely be concerned': Survey shows physician burnout at an all-time high

A recent survey by the Canadian Medical Association shows higher levels of burnout, depression, emotional exhaustion and anxiety among Canadian doctors, especially since the start of the COVID-19 pandemic.

The survey involved 4,121 physicians, medical residents and medical students, who participated between Oct. 13 and Dec. 13, 2021. It found that:

• 53 per cent of the doctors surveyed are experiencing "high burnout"
• nearly half of those surveyed -- 48 per cent -- are "living with depression"
• 79 per cent say they have "low professional fulfillment"

The reported burnout rate among doctors was 1.7 times higher than it was in the association's previous survey in 2017.

The survey results for Nova Scotia are similar to the national numbers, with 46 per cent of doctors reporting high levels of burnout.

Dr. Leisha Hawker, the president of Doctors Nova Scotia, says she isn't surprised by the results based on conversations she's had with colleagues over the last few years.

"I know burnout is really high. Everyone is really struggling and the pandemic has made it worse," said Hawker. "If we look at the survey from four years previous, the rates for wellness in general has gone down for all categories."

Hawker says everyone should be concerned about the statistics.

"We should definitely be concerned. The health-care system is only as healthy as the folks working in it, so we really should be concerned about physician health, nurse health and all allied health professionals’ health," she said.

According to Hawker, the feeling of low professional fulfillment felt among doctors is at a level never seen before. She says more doctors are also thinking about cutting back their hours, or in some cases, leaving the profession altogether.

"So, that's worrisome because we already have such a staff shortage, and in Nova Scotia in particular, about a quarter of our physicians are over 60, so we have a lot of retirements coming up and we really can't afford to lose more people," said Hawker. "We really need to try and retain as many Nova Scotia doctors as we can."

Hawker says Doctors Nova Scotia does provide a professional support program for any employees looking to speak with someone. She says another important factor in correcting the morale is looking at ways to improve professional fulfillment.

"We went into the profession to talk to patients and we love seeing patients face-to-face, but we're getting more administrative burden, and we're spending more and more time on paper charts in front of the computer system, and responding to emails and going to meetings, than actually spending time with the patients."

The survey also showed that women, younger physicians and at-home caregivers in general are suffering the most. Hawker says it's a problem seen country-wide.

"We also see a generation where their parents are starting to have more health problems, and then they also have young children, so they're kind of taking care of two generations, while trying to still work fulltime," Hawker said. "It's particularly challenging for my colleagues who are a two-physician couple, because they're both under that similar strain and a lot of them had to get outside support from family members, or a nanny or caretaker to help."

Hawker says, throughout the pandemic, she's only seen things get worse.

"People working longer hours. And also just the moral injury," she explained. "When we see our patients needing things, that because of staff shortages or wait times, that they can't get them. So, in my family practice, I've seen more and more patients who need special care or surgeries, and I'm having to try and keep taking care of them while they're waiting for longer than they used to have to."

Hawker says she does see some hope when speaking with medical students currently working towards becoming a member of the medical field.

"I was talking to first-year medical students about a week ago, and they're really excited, and their energy and excitement was great, kind of a renewal for me. Because I find working with medical students, it helps with my professional fulfillment because their energy kind of rubs off," she said.  

Hawker suggests a number of ways to help with the high levels of burnout.

"One thing that we could do is look at ways to improve physician flexibility," she said. "A lot of the younger physicians might want to do practice shares, or work only part-time in family medicine but then part-time outside of the usual clinic. And we need to make it so that everyone comes to Nova Scotia and they want to stay, and not just recruitment but also retention."