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Doctors are burning out

A majority of doctors report having good mental health overall, but a significant proportion report experiencing burnout, depression and even thoughts of suicide, a survey by the Canadian Medical Association suggests.

Results of the national online survey completed by 2,547 physicians and 400 medical residents found reported rates of burnout and depression were higher among residents than practising physicians and more prevalent among female doctors than their male counterparts.

"Poor physician health not only affects physicians individually, but studies have shown it can have an impact on patient care," said CMA president Dr. Gigi Osler, a Winnipeg ear, nose and throat surgeon.

While 82 per cent of physicians and residents indicated they had high resilience, more than one in four reported elevated levels of burnout and one in three screened positive for depression, the report released Wednesday found.

Medical residents were 48 per cent more likely to report burnout and 95 per cent more likely to screen positive for depression than all other physician groups, the survey showed. Doctors in practice for 31 years or longer reported the highest sense of emotional, social and psychological well-being.

Female physicians were more likely to report burnout and screen positive for depression, compared to their male colleagues. But women doctors also reported having higher emotional and psychological well-being than men in the profession.

"For years we have been focusing on the individual physicians," Osler said in an interview Wednesday. "Eat well. Exercise. Sleep well. Do some mindfulness training. You've got to make yourself more resilient.

"And they have been doing that, but we're still seeing these high levels of burnout. So I think that means the issues and the drivers are deeper than just individuals."

Dr. Murray Erlich, a retired Toronto psychiatrist who now works with doctors and others as a life coach, said he was alarmed to learn that 19 per cent of respondents had experienced thoughts of suicide at some point.

"That's shocking. That's a very high number," said Erlich, who has provided counselling services to doctors, residents and medical students through the Ontario Medical Association's physician health program.

He said burnout causes a person to feel emotionally exhausted; experience depersonalization, as if they aren't fully present; and to have a decreased sense of accomplishment. The condition can lead in some cases to depression, he added.

Typically hard-working and often perfectionistic, medical students, residents and doctors are driven to be high achievers in their field, which can mean giving up life balance and time for self-care, Erlich suggested.

"It helps build this veneer in which we are trained to look healthy and good and on top of things," he said. But at the same time, he's heard many doctors he's counselled say they feel like impostors, no matter how capable or competent they are.

In part, that can arise from the demands of their job or clinical curriculum, including heavy patient loads, decreasing resources, and an overwhelming mushrooming of medical information that few physicians and trainees can keep up with, Erlich said.



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