Joy in Work. It matters for all of us, and for the people with whom we work. We have a very human need to feel that our work is meaningful, that it makes a difference.
The increasing level of burnout in the medical profession is well documented. The Canadian Medical Association did a National Physician's survey in 2018 that revealed that 30% of us are experiencing symptoms of burnout (anxiety/depression, depersonalizing, and being less effective). Similarly, in a recent CMAJ issue, there is a disturbing article about the rates of physician suicide.
We know it is not just about yoga lunches and mindfulness (but I will get back to that) as over and over again it is acknowledged that there are many system barriers to Joy in Work - and that burnout needs to be addressed at a system level. We can also do something about it in our offices and by building our own personal resilience.
Healthcare leaders have been referring to the Triple Aim of health care for a long time. The Triple Aim refers to improving the health of populations, enhancing the experience of care for individuals, and reducing the per capita cost of health care. Research has acknowledged that there is a need to add a fourth aim - attaining healthcare provider wellness - in order to fully realize the potential of the healthcare workforce. Hence the Quadruple Aim.
My last president's messages have been talking about the Patient Medical Home and the Ontario Health Teams (OHTs) - the Patient Medical Home has more to do with you and your immediate work place and the Ontario Health Teams focus is more about your healthcare "neighbourhood".
These teams will not be successful without the meaningful engagement of family physicians at the leadership, advisory and practical level. We have made the case that family physicians have been trying to be the integrators of care for our patients but that the system has not made it easy. We hope that the OHTs will make it easier for us to do our job and address the needs of our patients. For those involved in the early phases of the OHTs, please let us know how it is going. The OCFP will be relentless in sharing your feedback about the practicalities of HOW these OHTs will address the Quadruple Aim.
Shifting closer to home, and in our offices, we often find ourselves doing work that feels inefficient. At the National Health Service in England, a lot of effort has gone into looking at 10 High Impact Actions to release time for care. There are some interesting practical suggestions in these 10 Actions that can also apply to our Ontario setting, like improving appointment triage, developing your team, improving workflows and document/test management.
Have you ever asked your staff: 'What matters to you?' The Institute for Healthcare Improvement has also considered what can be done at an organizational level to address burnout. Check out this 3-minute video about Four Steps that Leaders (that's you!) Can Take to Increase Joy in Work. The message is that by identifying those factors that lead to burnout and those that are protective, you and your staff can find your own unique solutions to make the office work better for the benefit of patients and yourselves.
And then finally, the yoga lunches. Well, maybe yoga is not your thing, but to Be in the Moment is for everyone. Have you ever tried a 2- to 5-minute mindfulness break in the middle of your afternoon? Checked out one of those You Tube videos, or a mindfulness app on your phone? It has surprised me how powerful mindfulness has been for me, in clarifying the flurry of thoughts, emotions and physical symptoms on some of those more stressful days. And what about taking a few minutes at the end of the day to review the parts of it that were joyful, felt meaningful? All too often we let the negative interactions and self-criticism colour our days, and it takes a concerted effort to focus on the positive. It sounds corny, but it really has helped me.
I won't go into the importance of work/life balance here. Nurturing important relationships, exercise, getting outside, reading fiction - all great ideas. There is also an OCFP podcast with helpful suggestions available here and there are resources through the Physician Wellness Program at the OMA.
Joy in Work needs a macro, meso and micro approach. On a macro level - many of us may not be directly involved in "changing the system" - rest assured that the OCFP is trying hard to do so and to advocate for the needs of family physicians within the system.
On a meso level, work with your staff to help you do MORE of what matters to you and what matters to your staff.
And finally, be kind to yourself, feed your soul, acknowledge all the good you do.
May 19 is World Family Doctor Day, and a chance to celebrate the special contributions of family doctors globally. Happy World Family Doctor Day. I thank you for all you do.
Jennifer Young
President