logo
Canadian Physicians Report Happiness, Acknowledge Challenges

Canadian Physicians Report Happiness, Acknowledge Challenges

Medscape5 hours ago

Canadian physicians reported a high rate of happiness at work and in their home life in a new physician wellness survey conducted by Medscape Medical News . At the same time, many physicians acknowledged experiencing work-related burnout and depression.
The national survey included information submitted by 744 respondents (66% specialists, 34% general practitioners [GPs]). Most respondents lived in Manitoba (42%), followed by Alberta (17%), Prince Edward Island (13%), and Newfoundland/Labrador (12%). Smaller proportions came from Ontario and Quebec, the country's most populated provinces.
While 37% of respondents reported working in hospitals, 24% were based in GP groups or private practice settings, 19% were based in clinics, 15% were based in other settings (including virtually, working from home, and long-term care), and 5% were in academic settings.
More than half (57%) of respondents identified as men and 41% as women. The majority (91%) were aged 45 years or older, including 24% who were aged 70 years or older.
Widespread Happiness
While most respondents reported being very or somewhat happy with their work life (68%) and personal life (74%), 24% reported experiencing burnout, 3% reported depression, and 11% reported both. The remaining 62% reported experiencing neither condition.
Burnout was more commonly reported by respondents younger than 45 years (about 40%) compared with older respondents (23%). Women reported a higher rate of burnout than men (35% vs 17%), and respondents based in an office practice were more likely to report burnout than those working in a hospital setting (33% vs 23%).
While 57% of physicians who reported burnout or depression attributed some of it to personal life, 73% attributed all or most of it to work. About 69% said that work burnout had negatively affected their personal relationships. This effect on personal relationships was most evident in respondents younger than 45 years (90%), compared with those aged 45 years or older (65%).
Health and wellness were a priority or somewhat of a priority for 91% of respondents, with exercise being a commonly reported activity to achieve them (72%). Exercise was a daily activity for 17% of respondents. About 30% reported engaging in it two or three times a week, and 26% reported exercising four to five times weekly.
Slightly more respondents (73%) reported spending time with family and friends and pursuing hobbies as their way to stay well. Healthy eating was reported by 64%, and 58% reported getting enough sleep.
Yearly vacation time totals of 3-4 weeks were common (36%), and many respondents (42%) had more weeks of vacation than that.
Almost half (48%) of respondents said that they would take a salary reduction to achieve better work-life balance, while 27% said that they would not, and 25% said that they were not sure. Respondents younger than 45 years were more likely to endorse this option than older respondents (61% vs 47%).
A desire to spend less personal time online was reported by 49% of respondents, with 56% reporting spending 2-4 hours a day online for personal reasons, including social media, texting, movies, news, and other interests.
Poor Self-Assessment?
Commenting on the survey results for Medscape Medical News , Catherine Pound, MD, director of Physician Support and Wellness at the Canadian Medical Protective Association (CMPA), said the rate of burnout and depression in the survey is likely an underestimate.
The CMPA recently launched the Physician Well-Being Index, a validated tool that has found higher rates of physician depression and burnout, said Pound. 'The level of distress we are seeing is about two thirds of physicians who are struggling or in distress, and that level was a bit lower in the Medscape survey.
'What was super interesting to me is that the Medscape survey asked people to self-assess, as opposed to the Well-Being Index, which gives you a result of well-being based on the questions they ask,' Pound added. Physicians are not good at assessing their own mental states, she said. 'If I ask a physician if they're distressed, they may say no, but if I give them a validated tool, the result may be different.'
The Well-Being Index has thus far collected almost 4000 responses from 117,000 CMPA members. While those responses might reflect a self-selection bias of respondents who are feeling higher than average levels of distress, Pound said that the findings dovetail with the results of the Medscape survey.
'All across Canada, there's a human resource crisis. We know that physicians are working really hard. They're working long hours, and we know that there's a lot of emotional distress and burnout. Physician wellness is a pillar of the healthcare system. If you don't have physician well-being, then we know there's an increased risk of patient dissatisfaction, there's an increased risk of patient safety events, and there's an increased risk of burnout, and the more physicians who leave the system because they're burnt out. It's a vicious cycle.'
Small Numbers
Margot Burnell, MD, president of the Canadian Medical Association, said the Medscape survey provides more information on this area and is consistent with research underway by her organization, but it includes a relatively small sample size.
'We will be releasing our national physician health survey results in the fall, so seeing something a little more robust will be good to add to all of these data points on this important topic,' she told Medscape Medical News.
Burnell identified four main opportunities to alleviate physician burnout and improve well-being, including facilitating physician autonomy, easing administrative burden, streamlining team-based care models, and improving access to patient health data through electronic medical health records.
'There were several bills that died when government was prorogued, and one was on connected care and data interoperability,' she explained. 'There is an imperative to get that back onto the legislative table. We will be working with all parties to identify solutions that we can move through with our stakeholders — federal, provincial, and territorial medical societies and governments — to keep healthcare at the forefront.'
Pound and Burnell reported having no relevant financial relationships.

Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Sclerosing Mesenteritis: Update on Rare GI Disease
Sclerosing Mesenteritis: Update on Rare GI Disease

Medscape

time3 hours ago

  • Medscape

Sclerosing Mesenteritis: Update on Rare GI Disease

The American Gastroenterological Association (AGA) has issued an updated pragmatic review on sclerosing mesenteritis (SM). Published in Clinical Gastroenterology and Hepatology, the update evaluates available evidence for diagnosis and treatment and examines opportunities for future research in SM, previously known by such names as misty mesentery, mesenteric panniculitis, and inflammatory pseudotumor. Led by Mark T. Worthington, MD, a professor of medicine in the Division of Gastroenterology and Hepatology at the University of Virginia in Charlottesville, Virginia, an expert AGA panel described SM as an uncommon benign idiopathic autoimmune disease of the mesenteric fat. Although of poorly understood etiology, gastroenterologists need to be prepared to diagnose it. 'CT radiologists increasingly are reporting SM and related lesions, such as misty mesentery,' Worthington told Medscape Medical News . 'We are also seeing new SM cases caused by immune checkpoint inhibitors in cancer treatment, and the oncologists ask us to manage this because it interferes with the treatment of the underlying malignancy. Those are often readily treated because we catch them so early.' Metabolic syndrome and associated conditions increase the risk for SM, as does aging. The recent changes are intended to help clinicians predict disease activity and the need for other testing or treatment. 'For instance, most cases are indolent and do not require aggressive treatment — often no treatment at all — but for those that are aggressive, we want the clinician to be able to identify those and make sure the treatment is appropriate. The aggressive cases may warrant tertiary referral,' Worthington said. 'A secondary cancer is a possibility in this condition, so drawing from the SM radiology studies, we try to help the clinician decide who needs other testing, such as PET-CT or biopsy, and who can be monitored.' As many as 60% of cases are asymptomatic, requiring no treatment. Abdominal pain is the most frequent symptom and its location on clinical examination should correspond to the SM lesion on imaging. Treatment involves anti-inflammatory medications tailored to disease severity and clinical response. No biopsy is not necessary if the lesion meets three of the five CT criteria reported by B. Coulier and has no features of more aggressive disease or malignancy. Although some have suggested that SM may be a paraneoplastic syndrome, current evidence does not support this. SM needs to be differentiated from other diagnoses such as non-Hodgkin's lymphoma, peritoneal carcinomatosis, and mesenteric fibromatosis. 'There are now CT guidelines for who actually has SM, who needs a biopsy or a PET-CT to rule-out malignancy, and who doesn't,' said Worthington. 'Radiologists do not always use the Coulier criteria for diagnosis, but often they will with encouragement. From this review, a GI clinician should be able to identify SM on CT.' Epidemiologically, retrospective CT studies have reported a frequency of 0.6%-1.1%, the panelists noted. And while demographic data are limited, a large early case series reported that SM patients had a mean age of 55 years and more likely to be men and of White race. Patients with SM do not have a higher prevalence of autoimmunity in general, but may have increased rates of metabolic syndrome, obesity, coronary artery disease, and urolithiasis, the panelists noted. The update allows room for differences in clinical judgment. 'For instance, a longer or more frequent CT surveillance interval can be justified depending on the patient's findings, and no one should feel locked in by these recommendations,' Worthington said. Medical Therapy Although there is no surgical cure, pharmacologic options are many. These include prednisone, tamoxifen, colchicine, azathioprine, thalidomide, cyclophosphamide, and methotrexate, as well as the biologics rituximab, infliximab and ustekinumab. Current corticosteroid-based therapies often require months to achieve a clinical response, however. Bowel obstruction is managed nonoperatively when feasible, but medically refractory disease may require surgical bypass. Offering his perspective on the guidance but not involved in its formulation, Gastroenterologist Stephen B. Hanauer, MD, a professor of medicine at Northwestern Medicine in Chicago, said, 'The most useful component of the practical review is the algorithm for diagnosis and determination when biopsy or follow-up imaging is reasonable in the absence of evidence.' He stressed that the recommendations are pragmatic rather than evidence-based 'as there are no controlled trials and the presentation is heterogeneous.' Hanauer added that none of the recommended treatments have been shown to impact reduction on imaging. 'Hence, all of the treatments are empiric without biological or imaging endpoints.' In his experience, patients with inflammatory features are the best candidates for immune-directed therapies as reduction in inflammatory markers is a potential endpoint, although no therapies have demonstrated an effect on imaging or progression. 'As an IBD doctor, I favor steroids and azathioprine or anti-TNF directed therapy, but again, there is no evidence beyond reports of symptomatic improvement.' Worthington and colleagues agreed that treatment protocols have developed empirically. 'Future investigation for symptomatic SM should focus on the nature of the inflammatory response, including causative cytokines and other proinflammatory mediators, the goal being targeted therapy with fewer side effects and a more rapid clinical response,' they wrote. Currently, said Worthington, the biggest gaps remain in treatment. 'Even the best studies are small and anecdotal, and we do not know the cytokine or other proinflammatory mediators.' In other comments, Gastroenterologist Eli D. Ehrenpreis, MD, research director, Internal Medicine Residency, at Advocate Lutheran General Hospital in Park Ridge, Illinois, and not involved in the update, found it fell short in several ways, including nomenclature. 'The appropriate term for this condition is mesenteric panniculitis, meaning inflammation of the mesenteric fat, seen histologically on biopsy. The term sclerosing mesenteritis introduces the idea of fibrosis, which is seen in a smaller number of patients, not all,' he told Medscape Medical News . Ehrenpreis also took issue with the inclusion of the cancer drug tamoxifen as the most common treatment used. 'Mesenteric panniculitis, when it does not represent a malignancy, is a benign disease,' he said. 'However, many patients on tamoxifen will experience hormone-related adverse effects such as breast tenderness and hot flashes.' He noted the drug has an FDA Black Box warning for uterine malignancies, pulmonary embolism, and other thromboembolic events, including stroke. Another significant gap, in his view, is the lack of recognition of the psychological effects on patients of the diagnosis. According to Ehrenpreis, more prospective analyses of treatments are needed with objective measures of success including symptom scoring and laboratory testing with erythrocyte sedimentation rate and C-reactive protein. 'And as with many rare diseases, a better understanding of the psychological effects of having a poorly understood disease and management of this challenge is vital to the comprehensive care of the patient with mesenteric panniculitis.' This guidance was supported by the AGA. Worthington reported renumeration from TriCity Surgery Center, Prescott, Ariz. The coauthor Wolf has received renumeration from AbbVie, Align Technology, Alnylam Pharmaceuticals, CVS Health ORP, Dexcom, Exact Sciences, HCA Healthcare, Johnson & Johnson, Eli Lilly, McKesson, Moderna, Regeneron Pharmaceuticals, Sarepta Therapeutics, Seagen, Stryker, and Thermo Fisher Scientific. Crockett has served as a consultant for IngenioRx. Pardi has served as a consultant for Boehringer Ingelheim and received research support from Atlantic, ExeGI Pharma, Rise Therapeutics, Janssen, Pfizer, Seres, Applied Molecular Transport, Takeda Pharmaceuticals, and Vedanta Biosciences. Hanauer and Ehrenpreis had no conflicts of interest relevant to their comments.

2 cases of measles confirmed in P.E.I., with many public exposure sites listed
2 cases of measles confirmed in P.E.I., with many public exposure sites listed

Yahoo

time3 hours ago

  • Yahoo

2 cases of measles confirmed in P.E.I., with many public exposure sites listed

Two new cases of measles have been confirmed in Prince Edward Island, with the people involved unrelated to each other and linked to possible public exposure sites, the province's Chief Public Health Officer says. In a news release issued late Thursday afternoon, the CPHO said the individuals were "unvaccinated or partially vaccinated." The news release listed the following public exposure sites: R&A (RaceTrac) service station, 9967 Route 6, Stanley Bridge: Saturday, June 21, between 1 and 4 p.m. Charlottetown Bible Chapel, 35 Lincolnwood Dr., Charlottetown: Sunday, June 22, between 9 a.m. and 2 p.m.; and Sunday, June 22, between 6:30 and 9:30 p.m. HomeSense, 1-202 Buchanan Dr, Charlottetown: Sunday, June 22, between 6 and 8:30 p.m. Morell Co-op, 7690 St Peters Rd., Morell: Monday, June 23, between 10 a.m and 1 p.m. Adams Chiropractic, 100 Capital Dr., Charlottetown: Monday, June 23, between 4 and 6:30 p.m. Princess Auto, 15 Saint Dunstan St., Charlottetown: Monday, June 23, between 4:30 and 7:30 p.m. Ultramar Gas Station, 11302 St Peters Rd., Scotchfort: Monday, June 23, between 5 and 8 p.m. WestJet flight 3540 from Kamloops, B.C. to Calgary: Wednesday, June 25 (departed at 5:50 a.m.) West Jet flight 630 from Calgary to Charlottetown: Wednesday, June 25 (departed at approximately 8:50 a.m.; landed around 4 p.m.) Charlottetown Airport: Wednesday, June 25, from 4 to 6:30 p.m. Until Thursday, the Island had not recorded any new cases of measles since April. At that time, Health P.E.I. confirmed two infections — the province's first reported instances of the disease since 2013 — but said no public exposure sites had been identified. The two adults who tested positive in April had travelled together to an area in Canada where there were outbreaks, the CPHO said. Health officials ask that people reach out to the CPHO if they and/or a depedent was on June 25 flight or at one of the exposure locations during the times specified, and any of the following apply: They are not protected against measles and are pregnant; They are under one year old; They are immunocompromised (even if they are vaccinated). Islanders can reach the Chief Public Health Office by emailing outbreak@ or calling 1-800-958-6400 to arrange for post-exposure treatment. People are asked to provide their full name, date of birth, contact information and location at which they were exposed. Anyone who is not immune to the disease from a past case or vaccine, and has been at one of the identified exposure locations, must stay away from public settings during the contagious stage, the CPHO said. The exclusion period begins five days after the last known exposure to measles and ends 16 days after the start of the exclusion period. Public settings include schools, childcare facilities, post-secondary institutions, workplaces and any other public or group environment. The measles vaccine is part of the province's childhood vaccine program, administered at 12 months and again at 18 months. The CPHO's current recommendations for vaccination are as follows: Adults born before 1970 are considered to have acquired natural immunity and do not require the vaccine. Anyone travelling outside of Canada should receive one dose of measles vaccine. Adults born in or after 1970 who have neither had measles nor received two doses of vaccine should receive two doses. Regardless of age, students entering post-secondary education, health-care workers and military personnel should receive two doses if they have no evidence of having had measles and no documentation of having received two doses of the vaccine. Symptoms of measles include fever, cough, sore eyes and a red rash that begins on the head and spreads down to the trunk and limbs. Serious complications can occur, such as blindness, viral meningitis or pneumonia — or even death, as was the case recently for two unvaccinated children in Texas. The measles virus spreads through the air when a person who is infected breathes, coughs, sneezes or talks. It may also spread through direct contact with droplets from the nose and throat of a person who is infected, according to the CPHO. The measles virus can stay in the air or on surfaces for up to two hours after a person who is infected has left the space. Someone with measles is contagious for four days before the rash is noticeable, and for up to four days after the rash occurs. If you or your family members develop symptoms described above from now until 21 days after being at one of the listed exposure sites on P.E.I.: Consult a health-care provider as soon as possible. Avoid being in contact with other people, specifically people considered at high risk: children under the age of 12 months, pregnant women and immunocompromised individuals. Wear a mask if you leave your household. Avoid taking public transportation to get to your medical appointment. Inform your health-care provider and health-care facility that you have been in contact with a measles case before presenting yourself for your appointment so that appropriate measures can be taken to prevent spreading the disease to others.

Diabetic patients taking GLP-1s may face increased risk of eye disease, study suggests
Diabetic patients taking GLP-1s may face increased risk of eye disease, study suggests

Yahoo

time4 hours ago

  • Yahoo

Diabetic patients taking GLP-1s may face increased risk of eye disease, study suggests

Diabetes is the leading cause of vision loss in people between 18 and 64 years old, according to the American Diabetes Association — and the best way to prevent this is to control blood sugar levels. Glucagon-like peptide-1 receptor agonists (GLP-1s), such as Ozempic and Mounjaro, have become popular medications for controlling diabetes and treating obesity — but new Canadian research suggests they can also lead to a paradoxical side effect in the form of eye problems. Young Police Officer Dies By Suicide After 'Debilitating' Laser Eye Surgery Complications A retrospective study conducted from January 2020 to November 2023 included more than 139,000 diabetic patients, some of whom were taking GLP-1s for at least six months and some who were not taking the medications over a three-year period. The average age of the participants was 66 years old, and approximately 47% were women. Researchers found that the participants taking the weight-loss medications had twice the risk of developing neovascular age-related macular degeneration (nAMD) compared to the people not taking them. Read On The Fox News App "There have been growing reports of [eye] adverse events with GLP-1 receptor agonists, but no clear consensus regarding their impact on age-related macular degeneration (AMD) progression," study author Dr. Rajeev Muni, an ophthalmologist and vice-chair of clinical research in the Department of Ophthalmology and Vision Sciences at the University of Toronto, told Fox News Digital. 6 Simple Ways To Protect Your Hearing Now Before It's Too Late, According To Experts "In particular, we observed a dose-response relationship — the longer patients were exposed to these medications, the greater their risk appeared to be," added author Reut Shor, a researcher in the department of ophthalmology and vision sciences at the University of Toronto. The findings were published in the journal JAMA Ophthalmology. Age-related macular degeneration (AMD) is the most common cause of vision loss in those aged 50 and older in the developing world, according to the American Society of Retinal Specialists. Approximately 20 million adults in the U.S. have the condition. It mainly affects people's central vision, which means they have a challenging time seeing in front of them, but their peripheral vision is intact, according to the National Institutes of Health (NIH). There are two types of AMD – dry and wet. Dry AMD, the most common type, occurs when small yellow deposits of protein develop under the macula, but symptoms may not occur in the early stages, experts said. In about two out of every 10 cases, dry AMD develops into wet AMD — also known as neovascular age-related macular degeneration (nAMD). With this more advanced type of disease, abnormal blood vessels form under the retina and start to leak, causing damage to the central part of the retina, known as the macula, according to WebMD. "When this occurs, symptoms include loss of central vision, distortions in vision and blank areas missing in the central vision," Nishika Reddy, M.D., assistant professor of ophthalmology at Moran Eye Center's Midvalley Health Center at the University of Utah, told Fox News Digital. (She was not part of the study.) Risk factors for nAMD include chronic heart failure, chronic kidney disease and diabetes – all of which often overlap with those who take GLP-1s, experts confirmed. The study authors cautioned that their findings should be taken in the context of the overall higher risk of eye disease in older people. The incidence of nAMD in the general population is about one in 1,000, and it doubled to two in 1,000 for the group taking the GLP-1s in the study. However, the overall absolute risk is still small, according to the researchers. The study's main limitation is that it was observational in nature, meaning the researchers could not confirm that GLP-1s medications cause neovascular age-related macular degeneration. The study also could not draw conclusions about younger populations, the researchers acknowledged. "Also, our findings apply only to diabetic patients aged 66 years or older, and cannot be directly generalized to non-diabetic individuals using GLP-1 receptor agonists for weight loss," Shor told Fox News Digital. GLP-1 receptors are present in the retina regardless of age or diabetes status — so theoretically, the risk could apply to younger populations. More research is needed to better understand why diabetic people on GLP-1s have increased eye disease, Shor said. Click Here To Sign Up For Our Health Newsletter "While the risk of developing macular degeneration while on a GLP-1 drug is low, patients should be aware of the possible eye side effects related to these types of medications," Reddy said. If someone notices blurred or distorted vision, straight lines appearing wavy, or any new blind spots, they should seek medical attention, according to Muni. For more Health articles, visit Early detection of eye disease is crucial, experts agree, as timely treatment can reduce the risk of vision loss. The study authors said they hope their findings will empower patients to monitor for early article source: Diabetic patients taking GLP-1s may face increased risk of eye disease, study suggests

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store