Q & A with Dr. Michael Kidd on his New Book, Every Doctor, a Guide on how to Thrive as Medical Professionals
Doctors, residents, medical students and other health professionals can become so busy with work and life demands and pressures that often it’s their own health and well-being that suffers. The College of Family Physicians of Canada recently estimated that as much as 50% of physicians and one-third of medical students are experiencing “burnout” – extreme emotional exhaustion and overwhelming stress. Partly at fault is the culture of medicine itself: workplaces that demand more with fewer resources, where staff face physical, mental and emotional challenges in environments that often reward perfectionism and competition. Research has shown burnout can negatively impact the quality of care patients receive, workplace morale, career advancement and more.
In recent years there have been more discussions about how to protect the mental, physical and emotional well-being of physicians and trainees and create more supportive work and educational environments for medical professionals and students.
Dr. Michael Kidd, Chair of the University of Toronto Department of Family and Community Medicine (DFCM), has spent much of his career as a family physician leader focusing on the health and well-being of physicians. Most recently he has written a new book with co-author, Dr. Leanne Rowe, Every Doctor: Healthier Doctors = Healthier Patients, that provides advice on how to thrive in medicine at a time of massive advances and changes in global health systems and medical services.
How would you describe the book and who you wrote it for?
We wrote this book for every doctor and doctor-in-training in the world – no matter their experience level. It provides advice on how doctors can look after their own physical and mental well-being. If we’re not healthy as doctors, we’re less able to be as effective as we can with patients.
It also looks at the health of workplaces and medical culture overall. Many books and articles focus on the personal physical and mental health and wellbeing of physicians; however, we’ve taken that further to say that if you work in a toxic environment or somewhere where colleagues are not respectful of one another, this affects our capacity to deliver high-quality care to our patients as well. Quite often, the culture of medicine can be harmful to many people: we’re not as supportive to each other as we should be and medical organizations aren’t always as constructive and effective as they could be. So we need to challenge the medical culture as a whole.
The book contains inspirational material from doctors who are authors and leaders from different parts of the world – people who have been willing to share their views, wisdom and experiences. And it contains advice that I wish I had when I was a medical student, rather than learning these things by trial and error or feeling bullied or harassed in the workplace.
Why was it important to include patients as part of the title?
If as doctors we don’t look after our own health and well-being, it’s going to be more of a challenge to look after our patients. We need to set an example for our patients: we expect our patients to eat healthy food, be physically active, not overuse alcohol, not smoke and so forth. It doesn’t go down very well, for example, if they see us smoking a cigarette while telling them to quit.
Also, the health of our institutions, hospitals and clinics impacts the health of our patients. Patients don’t want to enter a health system that is going to make them unhealthy, they want a system that is going to look after them, and hopefully, they’ll leave healthier than when they arrived.
The personal health and well-being of physicians and the culture of medicine seem to be larger topics of conversation. Why do you think that is? Is today’s world of medicine more challenging or are we just talking about it more?
I think it’s always been challenging. In the past, there was the attitude of, “I had it tough when I was a medical student or resident and you should have it tough too,” and people ended up working unsafe hours, making mistakes and having intolerably high levels of stress. At its worst extreme, this can result in doctors harming themselves or even committing suicide. Thankfully there’s been an increased awareness of suicide amongst healthcare professionals in recent years. This has made us take a hard look at ourselves and the culture that we live and work in and ask, “Is this healthy?” and “Are we supporting each other?” We need to support each other as professionals and peers but we often don’t. Instead there’s been a culture of bullying, harassment and occasionally of discrimination, sexism and stigma. In the 21st century, this isn’t acceptable and we need to call it out, reflect on our own behaviour, and support each other.
How is this changing for the better?
I think young people in our profession are driving many of the changes. And that’s a good thing because it reflects societal changes and expectations.
I also think we’ve had decades of opening our eyes to past human rights abuses which have occurred in medicine that we’re now confronting and tackling. The Truth and Reconciliation Commission of Canada process and report is a significant step forward. It’s pushed us at the Department of Family and Community Medicine to ask how we can contribute to that process and ensure that our faculty members and residents are culturally aware, sensitive and acting appropriately with Indigenous colleagues and patients, as well as with anyone who comes from a different background than their own. All these changes are signs of a healthier community and a healthier Canada.
I often advise students to have a five and ten-year plan. And include in that plan how they will continue working on their spiritual, physical and mental health as well. I also advise students to look at the values of teachers they respect and admire and adopt those values and behaviours for themselves.
Students and residents must also recognize that even though they’re at the very start of their medical career, the population and community still regard them as doctors. People are watching them, and it’s imperative as a medical practitioner to uphold your integrity in everything that you do and not to breach trust. I also advise them to spend time reflecting on what they’ve seen and learned each day and to celebrate the great joy of being a doctor and the great privilege it is to do what we do.