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doctors are not choosing to do lower
risk procedures for fear of retribution
from the College. We need to convey
that we understand that the very nature
of complex care means that there will be a
greater likelihood of adverse outcomes.
Q&A
Q: Do you think physician burnout is
becoming more pervasive?
A: Definitely. I think there are higher expecta-
tions for physicians. Providing medicine in a
digital world presents huge opportunity but it
also creates huge burden. One simple example
of this is that you can face a public flogging
on an anonymous rating site if a patient is
unhappy with your care on a particular day.
Q: Is burnout a regulatory issue?
A: Fallout from burnout is definitely a
regulatory issue. If a doctor feels disengaged
from her/his practice or is not able to be
in the moment with a patient because he is
overwhelmed by the eight other things that
he needs to be doing right then, that is a
concern. And it’s a concern for a whole host
of reasons, not least of which is that patient
care will be adversely affected. We need to be
cognizant about the prevalence of physician
burnout and be a partner in ensuring that
resources are available for help. A healthier
physician workforce will provide better
health care to their patients.
Q: Are you going to continue your clinical
practice?
A: Yes. I appreciate now, having taken this
role, that understanding the real day-to-day
concerns of front-line clinicians will inform
my work at the College in important ways. I
think it is essential to stay grounded in
the issues that affect physicians and their
work.
Q: What led to the development of a
learning module for physicians about
domestic abuse?
A: In my role at WCH, I had a conversa-
tion with other medical leaders after the
murder of Dr. Elana Fric. We realized
that we needed to be more knowledgeable
about recognizing when health-care provid-
ers are experiencing domestic violence,
and how to safely provide them the sup-
port they need. In doing this, we realized
that we had an opportunity to train other
physicians and health professionals. The
module will be utilized by several thousand
physicians in Ontario, and we hope it will
prevent future cases of domestic violence.
One thing we didn’t really anticipate was
that we would also be able to use what we
had learned to help our patients. In the
face of terrible tragedy, we hope to bring
some meaning, and positive change to our
health system.
Q: Are you comfortable in the role of
advocate?
A: Yes. I think, for physicians, not only is it
okay to be an advocate, but it is often im-
perative. The CanMEDS health advocate role
anticipates that physicians will use their posi-
tion of privilege to improve the health not only
of their patients, but of their health system.
To me, the keys in advocating for change are
to take a principled approach, use the scien-
tific evidence, and advocate for greater public
benefit.
MD
ISSUE 1, 2019 DIALOGUE
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