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Physician Wellness

Physician Wellness. A Public Heath Perspective. Take Home Messages. Physician health should be a high priority Physicians are surprisingly unhealthy considering our finances, our education, and sense of the importance of good health Public health interventions can work.

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Physician Wellness

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  1. Physician Wellness A Public Heath Perspective

  2. Take Home Messages • Physician health should be a high priority • Physicians are surprisingly unhealthy considering our finances, our education, and sense of the importance of good health • Public health interventions can work

  3. Physician Health: a High Priority • Individual Impacts (morbidity and mortality) • Patient Impacts (capacity, attitude, modeling) • Physician satisfaction with life correlates highly with patient satisfaction with service and with following recommendations • Colleague Impacts (teamwork) • Community Impacts (resources, leadership)

  4. Current Health Status • Smoking—Our best index, but still not zero • Preventive Interventions—Needs Work • Obesity/Nutrition—Needs work • Exercise—Limited and Conflicting data • Mood Disorders--Unknown • Substance Use—Unknown

  5. Smoking • Current research on smoking habits of American physicians is not available • Nurses’ Study showed smoking rates of about 8% in the US in 2003 • 3% of a big survey of Canadian Physicians in 2009 reported smoking (Erica Frank, MD, MPH) • The low smoking rates are likely a huge factor in the better survival rates of physicians over the general population

  6. Prevention Interventions • Once again data on most interventions is limited on American physicians • But we do know that the health care worker rate of vaccination for seasonal flu has been abysmal until very recently, with rates dropping into the 30-40% range. What does this say about other interventions—mammograms, pap smears, colonoscopies, update on tetanus ????

  7. Obesity and Nutrition • A 2004 study of male physicians demonstrated that 44% of male physicians were overweight and 6% obese • Nurses Study demonstrated 28% overweight and 11% obese • 8% of Canadian physicians reported being obese in 2009 • While this is not as bad as the general population, it is disappointing.

  8. Exercise • Again, no solid data for the US and contradictory data elsewhere • A 2011 study published in the British Journal of Sports Medicine found only 21% of those physicians surveyed got 30 minutes of moderate exercise 5 days a week—in other words 8/10 physicians failed this modest test of good health in Great Britain • The 2009 Canadian study found an average of 4.7 hours exercise per week, or more than expected

  9. Physician survey 2006 • 1200 practicing physicians surveyed • 6 in 10 doctors have considered leaving medicine • 77% experience fatigue • 67% experience burnout • 33% depression & family discord • NOVEMBER • DECEMBER 2006 THE PHYSICIAN EXECUTIVE

  10. Working when ill • The 2009 Canadian study reported that 11% of the total respondents disagreed with the statement: “If I can, I work when I am ill”. In other words, 89% agreed that they would work while ill.

  11. What is Wrong? • High Stress work environment—long hours, important decisions, limited support, constantly changing rules, lack of control • Trying to find balance between family and work • High expectations of self and Type A Personality • Denial • Difficulty accessing health care (no time, embarrassment, confidentiality concers)

  12. Physicians and Pilots • Pilots are required to have medical examinations on annual or even semi-annual basis, many physicians don’t have a PCP • There are long lists of exclusionary conditions that must be dealt with before pilots can fly • New “pilot-fatigue” rules were issued this year. Their new rest requirements would be the envy of many physicians

  13. Canaries in a Coal Mine • Physicians with vulnerabilities will be unable to maintain healthy habits or seek care • This may manifest as smoking, obesity, lack of exercise, use of alcohol or drugs, disruptive behavior in the workplace or even death

  14. Public Health Interventions Can Work • Better data collection on an on-going basis • Screening early in training and organized interventions • Education about the risks of the profession, and tools for protection • Development of Evaluation and Treatment Plan when needed (MPHP model) • On-going Careful Follow-up Contract when needed (MPHP model)

  15. Medical Professionals Health program • Case management program for medical professionals affected by substance abuse or dependency • January 2012—Launch pilot project in case management for pure behavioral contracts • Success rate is high nationally—75-85% • Problems include—no health insurance support for testing, confidentiality issues, late identification of illness

  16. International Conference on Physician Health • “From Awareness to Action” • October 25-27, 2012 • Le Westin Montreal Hotel, Montreal, Quebec, Canada • Visit cma.ca/physicianhealth or email physicianhealthconference@cma.ca • Call for Proposals deadline is May 7, 2012

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