B07 – What’s up Doc? Systemic Denial of Burnout

Summary

Burnout is a normal response to abnormal amounts of stress. 70% of Canadian physicians reported burnout in the 2019 according to the CFPC. The rates of ASD and PTSD are rising exponentially during the pandemic in both Canada and the US. The CMA 2018 survey described the problem as “beyond any individual’s ability to cope” and yet measures to combat it are largely directed at individual physicians with a prescription for more “self-care”. Burnout is a symptom of the systems we work in. It is epidemic and well established in physicians by mid residency. Burnout knows no boundaries, no one is immune. Systemic factors contribute more to burnout than individual ones. Doctor ” heal thyself ” and “self-care better” have become added responsibilities that are systemically unsupported and yet fueled by institutional expectations, limited resources and the culture of training. The effects of burnout are pervasive and lasting. Burnout is bad for patient health, provider health, for professional satisfaction and sustainability. It is bad for our institutions, system and society. The number one cause of medical disability and long term sick leave amongst health care providers are mental health diagnoses and this is more pronounced in those providing mental health care. Socio cultural processes around power, privilege, Inclusion, exclusion and racism are strong and implicitly part of the system we work in. Health care providers are not exempt from the effects of these processes. Research during the pandemic has demonstrated increased susceptability to ASD and PTSD among some racial and minority health care providers. How do we reduce unconscious bias so that we create an explicit understanding and share the responsibility to address these issues and solicit support at every level. This is how we heal, we create a culture of compassion, one that acknowledges the harm done while creating solutions rooted in safe, fair, equitable practices and policies. What has historically been implemented has not worked and is only worsening the rate of burnout as the pandemic demands more of health care providers, with fewer resources under higher levels of stress and threat. Mental health providers treating those with burnout are themselves burnt out while denial and avoidance of an ever expanding crisis in care grows to what one could argue it is a parallel epidemic for which there is no vaccine. We need immediate action that aids self-help, treatment, increases patient engagement in their own care, fosters stronger integrative and collaborative models of care that are supported by systemic cultural change.