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New doctors want better work-life balance: study

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Canada AM: Federation of Medical Students
Canada AM: Dr. Ruth Wilson and Dr. Jonathan Kerr

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CTV.ca News Staff

Date: Mon. Apr. 28 2008 11:53 AM ET

TORONTO — More medical students want a better work-life balance when they become practisng physicians, a new survey reports.

In the 2007 National Physician Survey, released Monday, 60 per cent of medical students and 52 per cent of residents said achieving a balance between their work and professional lives will be the most important factor when establishing a fulfilling career in medicine.

"I think the medical students, the medical residents and doctors alike will tell you that a good life-work balance is important in not only maintaining a healthy family, maintaining a healthy physical ability and maintaining a healthy mind, but it's also important in the work you do and the quality of care you deliver to patients," Shaheed Merani, president of the Canadian Federation of Medical Students, told CTV's Canada AM on Monday.

"So I think that the focus that medical students and residents are taking towards their own work-life balance is very important and will result in better care offered to patients across Canada."

Dr. Ruth Wilson, president of the College of Family Physicians of Canada, conceded that historically, the medical community has accepted long hours as part of a doctor's life.

"I think one of the mistakes we've made as a medical profession is defining a 60-hour work week as normal and defining 'on-call' as not being work," Wilson said.

"The flip side is there are important demands and important health needs from patients, and those of us who go into medicine to try and make a difference to individuals see those needs and try to work as hard as we can to meet them."

The survey's findings could have an impact on how government, medical schools and professional organizations address current crises in the Canadian health-care sector, including family doctor shortages, particularly in rural areas, and long wait times for various medical procedures.

"Wait times will be further influenced by changing patterns of physician practice," Canadian Medical Association President, Dr. Brian Day, said in a statement.

"While future physicians are part of the solution, the way they want to practice and their priorities must be considered in ongoing efforts to improve timely access."

New doctors themselves will be keen to find ways to streamline their practices so they can spend more time away from work. Technology will help new doctors do this.

According to the survey, 75 per cent of second-year residents want to use electronic medical records (EMRs) as part of their practice. Currently, only one quarter of Canadian physicians use EMRs.

"Electronic medical records, for example, reduce the amount of paperwork and give patients and physicians more time to interact on a one-on-one basis," Merani said.

As well, financial incentives may play an important role in recruiting physicians to underserved rural communities because of the debt load that many new doctors carry as they start their careers.

About 36 per cent of medical students who completed the survey said they anticipate their medical-school-related debt to exceed $80,000. One quarter of residents said they left medical school more than $80,000 in debt.

However, medical students don't start paying off their loans until after they have completed the required two to six years of residency training, which they must do in order to become a practicing physician, said Merani.

"By the time these medical students are paying back their student debts, of almost $100,000 and in some cases even more, they're almost 40 years old, they've started young families, and it is quite burdensome and it is definitely a source of stress to students," Merani said.

The National Physician Survey is the largest survey of physicians and medical students in Canada. It is a joint effort of The College of Family Physicians of Canada, the Canadian Medical Association and The Royal College of Physicians and Surgeons of Canada.

For the 2007 edition, 2,800 medical students and 730 second-year residents completed the survey.

Comments are now closed for this story

Roch
said

If doctors want more work-life balance, then they should move to the USA since they are not going to get it with Canada's antiquated, broken, heavily bureaucractic government-run health care system.


joe
said

If the medical professionals want a 40 hour week and a month vacation time then they should all go on a yearly salary like those that have those little perks. There are considerably more people around than doctors who have to work long hours to get paid the big bucks. You can't have your cake and eat it too.


Dean
said

I don't have a problem with doctors wanting more time with family or whatever. However, if this comes with a demand for more money, then I would have a big problem with it. I'm sure my boss wouldn't take kindly to me asking for more money so I can have time off.


Sahib Reginawale
said

Well, the amount of money they make can easily allow them to work less and deepen the crisis. On a similar note, nobody talks about the shortage of veterinarians. My cows are mooing in pain.


Its Socialism Stupid!
said

Its the single payer health care system that we have.

One payer pays for all essential and elective health coverage, finances and maintains some medical facilities, pays the physicians and ..... foots the entire bill for the cost of medical training (well excluding tuition which is not alot in Canada).

They can't do it all as they (governments who strongly support single payer single tier health care) would have you believe. So they have to limit or cut back on some spending. Sometimes the cutbacks come in the form of a limit on the number of folks in medical schools and the various residencies. This naturally means fewer doctors out there practicing.

If the system were more market driven, there'd be more physicians out there meeting increased demand. This could happen if the CHA was ammended to allow private practitioners to operate outside of the government. But we love the system that we share with Cuba!


Steve in Fredericton
said

I don't even have to read this whole story to make a valid comment... Want to work less hours, then you better be prepared to take less pay. And since I don't think these young doctors are quite ready to make less money, they should simply shut up and work for their (considerable) wage. I see this as yet another example of our deteriorating youth wanting more and more for less and less.


dwigget
said

Truck drivers work 70 hrs a week legally, and most transport support staff work long hours as well. I worked over 100hrs a week when I was concert touring (technician). Most trades I know work in excess of 80 hrs per week in peak season. I don't know a single senior manager that doesn't work less than 60 (in numerous lines of work).

40 hrs is NOT the norm for everyone. It's a western-world concept, actually - most of the world people work 6 (or more) days a week, sunrise to sunset. I've sure neer had the luxery. Not that I'm complaining - I chose my lines of work.

This will only get 'worse' as labour market (skilled & otherwise) continues to tighten. Get used to it - & learn to organize & prioritize your 'off' time well - especially if you are married/children/whatever.


John
said

I cannot blame the new generation of doctor's for practicing what they preach, however, with our already stressed system when are we going to realize that the only sustainable approach is to deal with the immigrant doctor issue? The world is full of doctor's from other countries who would love to come and practice here.


Catharine
said

I've been long frustrated how physicians think they are the only people who work long hard hours.

We all do. Some are better paid than others.




Karmen
said

I am so fed up with doctors these days.They do not listen.Theyre reluctant to order tests.If you tell them what you think your problems is,they will brush you off.I have a relative who had hypothyroidism undiagnosed for 10 years because the doctor was too arrogant to accept that just mabe the person was right.I'm amazed at how much these guys get paid to remember lists of symptoms.Then if your symptoms dont line up with what their books say,well youre just insane.If people could get a hold of their medical file they would be amazed at what their "nice" doctor says about them.Most of what you say and do is written down and left open to interprettion.Its a violation of privacy.I made the mistake of telling my doctor about post partum panic attacks 15 years ago.Well now I'm tagged for life.It doesnt matter what I go in for,its always blamed on anxiety.Me and my children go to a naturapath now and have never felt better.Doctors have far too much power.People need to educate themselves and learn some basic first aid.


Ingrid D.
said

I am greatly saddened seeing doctors are suffering like this. I believe they should get their vacation and spend time with family. After all they are well deserved. So I would like to see them get paid like the rest of the society. They should get salary, then the health system would really work. No one will complain. Why should I example USA for health care as they are at the bottom of the list. Why, do not look at Finland, Sweden, France, Swiss? Why do we have always to look at the broken countries and say yes we are better.


Mark in Ottawa
said

Uh, Joe,

Doctors are considered self-employed which means if they take a month off they don't get paid. Similarily, bills based on patients seen which means cutting back to 40 hours means less money.

I'm sure there are doctors out there who would love to have a guaranteed salary. Then they could take time off AND get paid.

A 60+ hour a week physician is a divorce waiting to happen. Those are expensive too and the extra billable hours don't make up for that, emotionally or financially. Furthermore, a physician's kids have as much right to build memories with their father/mother as the children of their patients.


Scott Cameron
said

I have the feeling that many of the commenters here do not understand the number of hours that most medical students, residents and practicing physicians work. This article is not clear enough to about those hours. As a first year resident I am working over 100 hours a week. This means I am working the equivalent of 2.5 full time jobs. With hours like this, what time is left for my family?


Taylor
said

Canadian medical schools like to choose applicants who are well-rounded and involved in lots of extracurricular activities (sports, music, etc). They typically reject applicants who spend all their time studying/working.

When you only accept students who like to devote more time to sports and music and less time on school-work, is it really surprising when the doctors you train end up wanting to devote more time for themselves and less time working?



1st Year Medical Student
said

Talking with many of my classmates in Toronto, we are all very worried about how we are going to pay off our student debts when we finish residency. Many people don't realize that doctors don't start making a reasonable salary until they are in their mid-30s.

As residents, we have lots of debt but are only paid $50 000 a year for working 80-100 hours a week with call. It shouldn't be surprising then that we want to cut back on those hours when we're fully licensed physicians!


Albert
said

I am a physician. If someone would offer me a decent salary for 40 hours per week, no unpaid night call, with 4 weeks paid vacation, pension plan, medical-dental, and office expenses I would take it. My civil servant neighbours all have it. But so far no offers. The government keeps physicians self-employed so we can pay all our own office expenses and staff salaries out-of-pocket, and have no benefits. Why are you surprised new doctors don't want this?


Jasper
said

Yes, GP's have long work hours because there is a shortage of doctors. If they want better work-life balance we need to get more doctors in the system. If you go to rural western Canada most of the doctors are immigrants. With the vast majority from South Africa.

We need to train our own kids. Open up more spaces in the Univerity programs and train more doctors. Get rid of some of the artsy fartsy classes and shorten the length and cost of the program. Make it more affordable for the average Canadian family to send their kids to med school.

Money isn't everthing if you are over worked and stressed out and your family life is suffering. If we keep our doctors happy they are less likely to pack up and head south of the border.


Ian
said

Society has to decide what it wants from those individuals we select to train as doctors. We must select people who put the welfare of their patients ahead of everything else. There is no shortage of people out there who will function like that but perhaps they are not the people we are accepting into med school now. There's more to being a doctor than good grades and a strong sense of empathy. We need these gals and guys to be there when we need them, not 9 to 5 with the odd night on call. We should restore doctors to a position of high esteem,pay them accordingly and demand tireless service. Work them hard but make the pay so attractive that it will appeal to people who are motivated by money as well as a sense of social responsibility and empathy.


Learning to Heal
said

An important issue to myself and other medical students alike.

While this debate is likely to spark a lot of harsh words, understand that many of us sacrificed our youth to serve our communities. There's no such thing as work-life balance during medical school, so it's not strange for us to want reasonable work-life balance eventually.


Mike
said

I am surprised that this interesting article does not address the impact of gender on change in attitudes towards work. In the last 10 years medical schools across Canada have gender biased to more women being admitted into medical school and residency.

The impacts of this decision are only starting.



GH
said

As I understand it ... Doctors are self employed business people. If they only want to work 40 hours a week, then by all means do so. No increase in payments from OHIP are to be considered. Just as in any business, the owner works as hard and long as he wants to. I for one am growing tired of the Doctors and Health Care Profiessionals dictating to the rest of us. They are not Gods, nor are they any better than the kid slinging coffe at the local Tims. (We that have had to deal with Doctors in business understand just how lofty and god-like they think themselves.) Time to knock them down a peg or two. I work 60 hours per week every week and only get paid for 44. Poor me ....LOL


Shawnosporin
said

There wouldn't be such a high demand for doctors if people would stop going to the hospitals at all hours for the stupidest stuff, like a birth control pill refill or trying to get narcotics for fake pain (isn't there a triage code for stuff like that?) Plus, if doctors are overworked, then maybe other doctors should be sharing the burden more rather than bogarting all the patients to capacity and not taking hospital rounds.


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