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Economic issues still rule the roost in
contract negotiations between physicians and governments, but they
are starting to face a challenge from the lifestyle concerns raised
by Canada’s youngest doctors.
This became clear in November during
the CMA’s Health Policy and Negotiations Conference, when a session
was devoted to the need to give greater priority to issues such as
physician burnout and maternity leave during contract talks. It was
the first time this type of discussion has been held since the
conferences, which bring together contract negotiators from all CMA
divisions, began 13 years ago.
CMA Past President Dr. Dana Hanson said
growing stress is behind the new emphasis on lifestyle issues.
“Increased patient volume and acuity mean longer working hours,
which mean less time with family and pursuing leisure, and
potentially poorer patient outcomes,” he said. “What can be done to
reverse this trend?”
Plenty, says Ottawa psychiatrist Dr.
Derek Puddester.
His Top 10 list of negotiation issues
includes flexible models of work, career flexibility, family support
programs and full implementation of the CMA’s Policy on Physician
Health and Well-Being.
Dr. Puddester, a 1995 graduate of
Memorial University, maintains that contract bargaining is beginning
to change because of the arrival of Generation X, which accounts for
roughly one-third of today’s workforce. He described the new
generation of doctors as “yuppies with a conscience but without fat
pay cheques” who were raised in an era of high divorce rates, the
need for dual incomes and separation from extended family.
With Gen X, the pendulum has swung
back. “What we are seeing is a strong desire for close family ties,
parental leave, flexible work hours and integration of the roles of
parent and professional.”
All of the issues strike a chord with
Dr. Puddester because not only did he and his partner recently adopt
a baby, but he also heads the Faculty Wellness Program at the
University of Ottawa medical school, which opened about 200 new case
files within the past year.
Dr. Mamta Gautam, an Ottawa
psychiatrist whose practice is restricted to the care of physicians,
blamed burnout for many of the problems Dr. Puddester sees in his
program. She said that burnout occurs when “demands exceed the
available resources,” and is exacerbated in the medical profession
because of the stigma attached to any type of mental illness,
including stress-related problems.
Dr. Gautam, whose negotiation wish list
includes improvements in workload limits and fewer on-call hours,
says medicine’s human resource issues are responsible for many
burnout problems because many physicians are afraid to take time off
because of concern about their patients. “The feeling is, ‘If I’m
sick, who looks after my patients?’ ”
Lynda Buske, the CMA’s associate
director of research, said the human resource issues won’t be solved
any time soon. For instance, Canada is producing 300 fewer doctors
than the annual goal of 2,500 proposed by the CMA, and the fact
women physicians practice seven to eight fewer hours per week than
men is taking added significance because women now account for 50%
of new graduates. “At some point, demographics will catch up with
us,” she said.
Dr. Hanson is pleased that lifestyle
issues are gaining attention at the negotiating table. He said it is
ironic that physicians “deal with issues of exhaustion, anxiety and
depression every day when we see our patients, but we don’t like to
talk about it among ourselves.” |
