Many factors contribute to physician burnout. Dr. Gautam says the risk of burnout is directly related to the amount of work physicians do.
Physician burnout
Burnout is a system-level issue that impacts many physicians in Ontario and was exacerbated by the pandemic. System-level solutions are needed to address it. And if doctors, nurses and others providing care burn out, this impedes access to care for patients. The OMA’s top policy recommendations, identified in Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care, will help to address burnout and support the well-being of physicians.
As a group, physicians have higher than average rates of burnout than the general population. Almost three-quarters (72.9 per cent) of physicians surveyed by the OMA said they experienced some level of burnout in 2021, up from 66 per cent the previous year. Just over one-third (34.6 per cent) reported either persistent symptoms of burnout or feeling completely burned out in 2021, up from 29 per cent in 2020.
This percentage was likely higher with the COVID-19 pandemic increasing demands on physicians. Stress, burnout and post-traumatic stress among health-care workers rise significantly during disease outbreaks, and for two years afterwards.
Despite being burned out, Ontario’s doctors have provided the best possible care to their patients throughout the pandemic and beyond.
72.9 per cent of physicians experienced some level of burnout in 2021, up from 66 per cent the previous year
Advocacy
The OMA advocates to the Ontario government to address burnout as a system-wide issue through the OMA Burnout Task Force and the Bilateral Burnout Task Force with the Ministry of Health.
We’ve sent a letter to the federal government to share our concerns about added administrative burden related to new funding in the federal budget to help Canadians with disabilities. For a patient to qualify for the subsidy in the Canada Disability Benefit program, a physician has to fill out a lengthy and time-consuming form, which adds more paperwork and unnecessary administrative burden. The federal government did not consult with us or our Forms Committee to understand the impact this change will have on your workload. We’ve sent a letter to Kamal Khera, minister of diversity, inclusion, and persons with disabilities, about this issue. Read the full letter to Kamal Khera.
OMA Burnout Task Force initiatives
The OMA’s Burnout Task Force was struck in 2019 to identify the contributors to burnout, advocate to the Ontario government, co-ordinate with stakeholders to address and inform issues related to burnout and develop system-level recommendations on burnout prevention.
To support this work, the task force surveyed physicians in 2020 and 2021. Both surveys have allowed the task force to hear directly from members on potential solutions and what you believe are the factors contributing to burnout. The survey results culminated in the task force’s white paper that provides system-level solutions to address this critical issue for the profession and recommendations to achieve them, and a peer-reviewed publication in BMJ Open.
The OMA Burnout Task Force has also developed individual-level supports for physicians like the burnout toolkit and the series of burnout podcasts, recognizing that short-term support is important while we work toward long-term system-level changes.
Bilateral Burnout Task Force
One of the OMA Burnout Task Force’s recommendations in its 2021 white paper was the creation of a bilateral table with the Ministry of Health as a mechanism to drive system-level change. This Bilateral Burnout Task Force is now up and running, and has been meeting regularly since June 2022, with its top priority to address administrative burden and establish a standard measure of burnout for the system.
The task force is also engaging system stakeholders to work together on these issues, and working with the Forms Committee to learn from its longstanding work to reduce administrative burden from Ministry of Health forms.
Ministry of Red Tape Reduction
Through the work of the OMA Forms Committee and its consultations with members, several problematic government forms contributing to increased administrative burden for physicians have been identified. The Bilateral Burnout Task Force has obtained the support of the Ministry of Red Tape Reduction to scope out a project to address burden from forms such as these. In addition, the OMA submitted recommendations to reduce red tape to the Ministry of Red Tape Reduction. Topics in this submission include forms, centralized referral, regional credentialling, integration of electronic medical records and care co-ordinators.
Burnout at all-time high
OMA papers on burnout
The OMA Task Force, based on consultations with members and key system stakeholders, has developed a series of white papers outlining recommendations to address burnout in the medical profession.
Through the Ministry of Health-OMA bilateral Burnout Task Force, the OMA has had the valuable opportunity to reinforce the potential to improve the efficiency and effectiveness of Ontario’s health-care system through reduction of administrative burden for physicians.
Ontario physicians identify administrative burden as one of the leading causes of burnout, which affects the vast majority of doctors. The Canadian Medical Association’s 2021 National Physician Health Survey found that physicians spend more than one extra working day – 10 hours a week – on administrative tasks. Further, burned out doctors are decreasing their workloads and retiring earlier, leaving the sustainability of the health-care system at risk.
The OMA’s results from the 2020 and 2021 member burnout surveys were published in the prestigious journal BMJ Open. Findings show that following one year of the pandemic, high levels of burnout among Ontario physicians had increased from 28 per cent in March 2020 to 34.7 per cent in March 2021, with female physicians and physicians under 35 more likely to experience burnout in 2021. This publication supports the findings of the OMA Burnout Task Force’s 2021 white paper.
The OMA’s Burnout Task Force was struck in 2019 to identify the contributors to burnout, advocate to the Ontario government, co-ordinate with stakeholders to address and inform issues related to burnout and develop system-level recommendations on burnout prevention.
To support this work, the task force surveyed physicians in 2020 and 2021. According to the surveys, just prior to the pandemic, 29 per cent of Ontario physicians had high levels of burnout with two-thirds experiencing some level of burnout. By March 2021, these rates had increased, with 34.6 per cent of Ontario physicians reporting high levels of burnout and almost three-quarters reporting some level of burnout.
The OMA released a white paper calling on the Ontario government to address burnout, recommending the top five solutions:
- Reducing and streamlining documentation
- More work-life balance through flexible work arrangements
- Making digital health tools a seamless part of physicians’ workflow, including by ensuring different systems can speak to each other
- Support for physician wellness at their workplaces
- Fair and equitable compensation for all work, including administrative work that cannot be reduced
Read the full white paper and the executive summary.
Access the infographic outlining the top five system-level solutions to burnout.
Practical OMD resources
- OMD Advisory Service: Members are assigned an OMD Advisor who provides support to maximize the value from their EMRs and other practice technologies
- OMD Peer Leaders: A network of physicians, nurses and clinic managers who are expert users of EMRs and other digital health and virtual care tools who can share advice and answer questions
- OMDEducates.com: A website dedicated to providing practical advice, time-saving tips, education, events and training on EMRs, digital health tools and privacy and security
Dr.Bill donation funds research grants addressing burnout
What is burnout?
Burnout is a work-related syndrome characterized as a state of mental exhaustion caused by one’s professional life. While individual factors can influence burnout (for example, high stress combined with high ideals, perfectionism and a sense of responsibility), burnout in physicians is driven primarily by system-level factors, such as:
- Long work hours (especially more than 80 hours per week)
- Caring for sicker patients with more complex needs
- Pressure to learn new technology
- Greater expectations from patients
- Increased pressure to produce
- More time spent on administrative tasks rather than patient care
- Constantly changing rules and roles (office-based health care transitioning to population-based care)
- Micromanagement of medical practice by administration and government agencies
This can leave physicians feeling a lack of:
- Control (personal and professional)
- Connection (toward work and others)
- Competence (decreased confidence)
Get support
Pre-budget submissions
In its current and past pre-budget submissions to the Ontario government, the OMA has proposed the following recommendations to help bring the issue of physician burnout to the forefront and address key challenges in administrative burden:
- Stronger research, specifically Ontario-specific data to better understand the system-level causes and effects of physician burnout to guide system improvements that support physicians
- System-level solutions to enable a supportive system that promotes physician wellness and prevents physician burnout
- Partnership with the OMA on implementing recommendations and solutions developed by the OMA Burnout Task Force
- We need dedicated investment to prioritize the review and streamlining of government forms to reduce administrative burden. Given the urgency, the government should follow the lead of Nova Scotia and set a target for how many government forms can be reduced and complete this work within the next year
- Stop building portals. Doctors have long called for the integration of digital health tools that can be seamlessly accessed from their electronic medical records. More focus needs to be put on integration
OMA in the news
Read the latest articles on how the OMA is bringing awareness and offering solutions to address burnout.
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Survey shows doctors are quitting
Reducing paperwork key to improving health care in Canada
OMA videos
Physicians are reporting higher levels of burnout. Watch as four physicians describe the causes of burnout, the effect it is having and how they are coping.
Dr. Mamta Gautam
OMA Burnout Task Force chair and psychiatrist
Dr. Chandi Chandrasena
Chief medical officer, OntarioMD
Dr. Adam Kassam
OMA president and physiatrist
Dr. Carolyn Snider
Chief of emergency medicine, St. Michael’s Hospital
Related articles from the Ontario Medical Review
OMR has featured stories on physician mental health, administrative burden and the use of digital tools to highlight the issue of burnout in the medical profession.Related episodes from the Spotlight on Health podcast
The OMA Spotlight on Health podcast features doctors from across the province. Listen as they discuss how burnout affects them and possible solutions.