A great deal has happened in Alberta since my last Medical Matters and I would like to share a few thoughts with everyone. I recognize these are very difficult times for physicians, as they are for many Albertans. I admit I’m no longer on the front lines of clinical practice and therefore can’t directly relate to the stress people are feeling right now, but that doesn’t mean I’ve forgotten what it’s like to care for patients and work in a health system. I also have a relatively unique perspective because of my background and I would like to share some of my thoughts with you.
We have a Council Position Statement and our standards of practice to help guide you. What I’m about to share is not an official CPSA position, nor is it direction to physicians on how they must act in the months to come. These are thoughts shared from someone who has lived and worked in several different provinces and countries, and practised medicine in different jurisdictions during times of peace and times of conflict.
No easy solutions to complex problems
During my time with the Canadian Armed Forces (CAF), I was very fortunate to have a year of strategic leadership training. One of the key components of that training was understanding how to manage complex problems. During that time, we heard from many brilliant leaders but one statement has really stuck with me. The CAF Chief of Defence Staff, Gen. Jonathan Vance, reminded us that in today’s world conflicts, there are no winners, because complex problems don’t have simple solutions and what is a “win” to one person is a “loss” to another. Changes applied to one part of the problem just create problems in other parts of the problem. All you can hope for is continuous gradual improvements over time. I would like everyone to consider that in Alberta’s current context.
None of us have easy answers to the problems that exist today, especially in health care. My experience from working in several other health systems is there is no one perfect system—each one has good and bad within it. I’ve also learned there are many ways to provide care and a “standard of care” is a very relative thing. I’ve heard that some doctors are thinking about leaving Alberta and for those who are considering this, I would recommend you take some time before making that decision. I can assure you the grass is not always greener.
Whenever I see success in a health care system, no matter how well funded it is, I see people working together for a common purpose, with good leadership in place. In fact, some of the best care I’ve ever seen has come from people working in some of the most adverse condition imaginable. That is because medicine is founded on people caring for others, which also means caring for each other. This is a time to look after your personal health and the health of your colleagues.
Remembering our values
I recognize there’s a great deal of anger in our profession right now, at a time when many physicians were already burning out. It’s times like this when bad decisions are made that have long-term impacts. Emotions are valuable in making decisions, but we must recognize how those emotions are influencing our decisions and not let them take us down the wrong road. This is especially true at a time where comments made on social media will be there forever. From my experience, complex problems become worse when anger is the emotion that drives decision-making and actions.
"Despite how you may feel at the moment,
you are respected and valued."
Those who rely on their values and ethics to guide them will more often than not do better in the long run. We run into problems when we start justifying reasons to deviate from those values and ethics because of anger. I can assure you that never works out for the best, especially for patients. It’s actually very fortunate that CMA recently renewed their Code of Ethics & Professionalism. I believe it can be the foundation for physicians to fall back on at times like this and I encourage everyone to take a look at this document and use it as a guide moving forward—look after not just the best interests of your patients and the profession, but also your own personal health.
Putting our patients first
In any conflict I’ve seen, there are always innocent bystanders that end up becoming trapped in the middle. In health care, those are the patients. We, as a profession, cannot put our patients in the middle. We must recognize they are struggling with their own concerns and they’re coming to physicians for help with their problems. They don’t need to worry about the medical profession’s problems on top of their own. Clinical encounters need to focus on the patient, not the profession.
I understand most of the anger today is about feeling respected as a core member of the health care team. I would argue that the most important respect needs to come from ourselves, family, patients and colleagues. That is, and always will be, essential to the long-term success of the medical profession. As physicians, we can’t lose sight of that.
I know these are challenging times, but let me leave you with just a couple thoughts: There are no easy solutions to complex problems. Do your best to not make decisions driven by anger. Use values and ethics to guide you through challenging times. And last but certainly not least, look after your own personal health and wellness, in addition to the health and wellness of those around you.
Despite how you may feel at the moment, you are respected and valued.
As always, I appreciate your thoughts.