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Confessions Of A Doctor On The Brink Of Burnout

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Dread and despair, uncertainty and panic ebb and flow around thoughts of my medical career.

Most days clamour with stories of clinics closing, physicians leaving and patients dying on waitlists -- all flatly ignored by provincial leaders.

Some days, I even want to quit. After only six years of independent practice, I'm burning out.

The thing is, I love being a doctor. Serving my patients and my community fills my life with joy, fulfillment and meaning. Medicine is my calling.

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That's why I don't think twice about devoting hours of personal time to medicine at the expense of myself, my family and other commitments. Add politics though and I'm barely treading water.

On average, 35 per cent of Canadian physicians suffer burnout.

In Ontario, this has skyrocketed: alarmingly, 78 per cent of nearly 1000 physicians self-reported burnout in a recent survey. Why? From those nearing retirement to bright-eyed newbies pledging the Hippocratic oath, physicians blame the Ontario Liberals for unprecedented levels of occupational stress.

Why should anyone care? From a health policy perspective, burnout is a symptom of a health-care system drowning under "burdening demands and insufficient resources."

On a health human resource level, burnout leads to absenteeism, apathy, workplace conflict and high personnel turnover. At an individual level, burnout precipitates compassion fatigue in those who have "nothing more to give." Left unchecked, it escalates to hostility towards coworkers, patients and family; substance abuse; poor decision-making; medical error, and at end-stage, self-harm and physician suicide.

Politics is decimating morale and trust among Ontario's physicians.

Unfortunately, this comes at a critical juncture. The government is fast-tracking health-care reform. Hot off the presses and devoid of detail, the proposed changes to primary care and CCAC sparkle with buzzwords: Universal digital records! Guaranteed family doctors! Appointments within two days! Actual home-care services! Quality improvement!

With clinics closing, waitlists ballooning, and patients desperate for care, this press release is a fantasy we all crave.

But front-line doctors like myself view these hollow promises with cynicism and disbelief. Years of mounting evidence prove that the Liberals have no clue how to manage health care. Attempts at holding them accountable are met with smirks and subterfuge. They spin rhetoric without conscience and play semantics when we need candor.

Physicians should be not be political puppets.

How exactly will the cash-strapped Liberals deliver this expensive wish-list when they won't even fund basic care? How exactly will they reform a health-care system affecting 13.7 million people when they have vilified and alienated front-line doctors, field experts in that very system? Why are they super-sizing "inefficient" and "ineffectual" LHINs, criticized not just by the Auditor General but by high-level industry insiders?

The proposed legislation, Bill 210 reads like Orwell's nightmare: layers of bureaucracy; intrusive government control; non-medical experts dictating medical standards of care; health service providers denied the right to reject unsafe and unsustainable contracts; removal of independent oversight by Ontario's Ombudsman... the list goes on.

Not that long ago, hospital CEOs characterized Ontario's Ministry of Health as "bullying." Bill 210 will grant them absolute power, empowering the Ministry to unilaterally impose contracts on everyone and anyone -- not just physicians -- once negotiations fail. The word "comply" lurks everywhere: providers must comply with LHINs, who must comply with Ministry mandate -- even at the risk of patient welfare.

Physicians should be not be political puppets. But I fear that if this legislation is passed -- and it will, given that the Liberals are a majority -- gone will be the days where the doctor-patient relationship could be safeguarded against political interference.

I feel helpless, unable to bail out the sinking life raft that is our health-care system.

Physician burnout is defined by emotional exhaustion, lack of professional autonomy and efficacy, and depersonalization. Check, check and, on really bad days, check.

Ontario's health-care system is about to face the devastating consequences of a workforce in crisis. The very people holding this broken system together are about to sink under.

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