I was post-call at home with my husband. Tradespeople were in the house measuring for new windows. I was sitting on the couch when months of work-related stress overwhelmed me. I was distraught and sobbing uncontrollably. I could not get myself together enough to even make the call to the AMA’s Physician and Family Support Program (PFSP), so my frightened husband did. A physician called us back and promptly organized the support and professional help I needed. That was 20 years ago, and I still remember that day very clearly.

Fast forward a few years and again the PFSP was my lifeline. An increasingly toxic work environment threatened to destroy my mental health, my marriage and my career in anesthesia. My PFSP intake physician compassionately assessed my situation and reassured me. Through the service provider, I was matched to an experienced, compatible therapist who I continued seeing for two years. Without her support, I have no doubt that I would have abandoned medicine.

Today, I take an antidepressant and have the great good fortune to work with supportive colleagues. And Tim and I are still married! I am a passionate advocate for physician health and for the unique and essential role of the PFSP within the AMA. I share my story because the stigma and shame around mental health prevents many physicians from seeking help, and I believe that the culture of medicine will change only when more physicians feel safe to share their own struggles with mental health. 

The pandemic has created intense personal and professional stress. Everyone is dealing with fear, uncertainty, isolation and grief, but Alberta physicians are also enduring the stress of a sustained attack on our profession. 

The 2020 PFSP utilization data clearly show the negative impacts of our current health care environment on physician health. Never has the demand for AMA’s PFSP been so high. Here are some examples: 

  • 2,200 distinct callers contacted the assistance line in 2020 – an 18% increase over the previous year
  • calls due to occupational burnout/stress increased 59% 
  • calls due to anxiety, stress and depression increased 27% 
  • 1,144 counselling hours were used – 934 in November 2020 alone

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There is a high level of stress among Alberta's physicians

We know that a supportive work environment offers the greatest protection against work-related stress and burnout. Unfortunately, the current health care and political environment in Alberta can, at best, be described as unsupportive. 

Although a vaccine will ease the impact of the pandemic, there is no vaccine to protect us if government that does not view physicians as critical partners within our health care system. The uncertainty and stress that physicians have faced since the government unilaterally terminated our agreement in February 2020 has been overwhelming for many of us. I believe that the AMA and the PFSP will continue to face increasing demand for physician mental health resources.

Since 1998, Alberta Health has funded the PFSP as part of the benefits stream in the master agreement with the AMA. Government has indicated that PFSP will be due for a review before March 31, 2021. 

I want to be absolutely clear: funding for those benefits will not only be maintained but increased. We will do so by streamlining the administration of these dollars, making sure that every dollar available reaches Albertas physicians.” 

(July 15, 2020, statement by Health Minister, Tyler Shandro in reference to maternity and paternity benefits and physician health programming)

AMA funding for our PFSP may not continue beyond March 2021. The government may also place the program under the direction of another organization, e.g., AHS. If either (or both) of these outcomes occur, there will be predictable and significant negative impacts that should concern us all. 

The AMA is the official representative body for physicians in Alberta. It is physician centric and as such, physicians trust the AMA to act on their behalf and in their best interest. Understandably, many physicians do not trust other organizations to maintain confidentiality or provide equivalent access and quality of care. The following physicians’ quotes are shared with permission.

Right now – more than ever – physicians need access to safe, trusted and effective psychological supports with minimal barriers. Luckily, we already have the PFSP to provide this support. Please do not take that away.”

Being confident in anonymity is so important to me.”

Without the confidential nature of this program, run by the AMA, I never would have called. As a resident with significant debt, their financial assistance has meant I can see a psychologist regularly.”

The PFSP is invaluable. I would absolutely not trust any program run by the government. Losing it would be a tragedy.”

The PFSP has been crucial to my ability to provide expert care. The support of a superb therapist through the PFSP helps me keep perspective and take care of myself, so I can take care of others.”

Without the PFSP I would have struggled to complete my residency.”

Having the program administered by doctors for doctors challenges the stigma around asking for help.”

The PFSP saved my life, my career and my marriage. If the AMA loses this program, physicians will die – I firmly believe this.”

We all know that professionally sourced PPE is essential to protect the physical health of all health care professionals and their patients. I believe we should consider psychological PPE to be equally essential to protect our mental health. 

The AMA’s PFSP provides trusted, professional, personalized psychological services to protect and support the mental health and well-being of physicians, thereby protecting the health and safety of their patients.

The PFSP is an essential program which must remain within the AMA. I sincerely hope that the government comes to an agreement with the AMA that maintains the current model and funding for our physician health program. But, if that is not the case, we must be prepared to assist the AMA in their advocacy. 

I’m ready – AMA’s PFSP provides PPE!

Note: A supportive community of friends and colleagues is also important for our mental health and well-being. Particularly if you’ve recently said “no problem!” to a request to write an article for Alberta Doctors’ Digest and are now completely out of your depth. I want to say a sincere thank you to all the physicians who responded to my distress signal on Twitter and generously shared their experiences with me. 

And, in my honest opinion, AMA’s PFSP is living proof that “a small group of very determined people can indeed change the world.” 

Banner image credit: Omni Matryx, Pixabay.com

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