For many physicians, finding time to focus on their own health and wellness can feel unattainable. How can doctors in Manitoba prioritize their well-being and that of their colleagues?

One part of the answer may be found in the Physician Health and Wellness Communities of Practice Program. Not only does investing time and resources make a difference for physicians, it helps strengthen our entire health care system. 

According to Dr. Shelley Anderson, Medical Lead for Physician Health of Doctors Manitoba, ​“Burnout and frustration with system issues are causing roughly 40% of physicians to consider retirement, leaving Manitoba, or reducing their clinical hours over the next three years. This will have a significant impact on patient care.”

In 2019, Doctors Manitoba partnered with the Canadian Medical Association, MD Financial Management Inc., and Scotiabank to support a three-year pilot of the Physician Health and Wellness Communities of Practice Program in three regions — Northern Health Region, Interlake Eastern Regional Health Authority, and Prairie Mountain Health.

That pilot program has now wrapped up, and has demonstrated through a comprehensive evaluation it will have lasting benefits for physicians across Manitoba. Each physician and health authority leader who took part deserves to be celebrated for all they’ve done for the benefit of their colleagues and Manitoba’s entire health care system.

To understand how, it’s worth looking at the way this pilot program operated, the action plans each region developed, and the steps Doctors Manitoba is taking to sustain the good work of these communities of practice. 

This pilot program was unique in that it used the idea of communities of practice to inform thinking about wellness. A community of practice refers to a group of people brought together around a common concern to learn from one another’s experiences and expertise. Doctors Manitoba partnered with three regional health authorities, each bringing together their own community of practice hub. The hubs include a diverse range of local doctors, health system leaders, and community members.

At the heart of these hubs is a physician champion, designated with taking the group’s work and championing it with their region. The three hubs began meeting in 2020, with all meetings virtual due to the pandemic.

The hubs were asked to all keep in mind a few key things. First, physician wellness benefits the whole health care system and is a shared responsibility. For this reason, physicians, Doctors Manitoba and RHA leadership should take a collaborative, evidence-informed approach to improve physician wellness. Also, approaches to wellness that target the whole work environment have a greater impact than those targeting individual physicians. Finally, the urgency of the situation was kept top-of-mind by stressing that half of all physicians in Manitoba are experiencing burnout, in line with the rest of Canada. Through the work of each hub, a region-specific action plan was developed.

Prairie Mountain Region

Efficiency was also the priority in the Prairie Mountain Health region. They recommended the region establish navigation supports for physicians to help them better understand how to orient themselves within the broader region. Recommendations were also made to develop a strategy to promote psychological safety and prevent mistreatment, provide supports to enable physician connection and collaboration, and to create a wellness-centred physician leadership strategy.

“In PMH the collaboration with NHR to create the Physician Peer Support team has been a very rewarding experience. As a region we are also increasing our recognition of the importance of the physician voice in decision-making. There is still a lot of work to be done and our Physician Health and Wellness Committee, made up of physicians who are interested in improving physician health and wellness, are contributing and keeping us accountable, which is what we want,” said Dr. Adrian Fung, CMO, PMH.

Interlake-Eastern Region

In the Interlake-Eastern region, the community of practice recommended that the top focus be on leadership, specifically on developing a leadership training strategy for all physicians. They also recommended the region enhance physician on-boarding, orientation, and connection supports for physicians, and provide access to physician coaching services related to leadership and work-life balance. The community of practice would also like to see the region integrate ​“stoplight reports” to support physician teams and leaders in identifying and addressing inefficiencies.

Northern Region

In the Northern region, efficiency was the top concern, and the community of practice recommended that more work be done to collaborate with Digital Health to improve the workflow of Electronic Medical Records.

According to Northern Health Region’s CMO, Dr. Harsahil Singh ​“collaboratively with Digital Health/​Health Information Services and other stakeholders, we have focused on reducing administrative burden by reducing signature requirements, eliminating unnecessary discharge summaries, increasing EMR efficiency, integrating Dragon One dictation, and piloting AI scribes,” said . Progress has also been made on developing a physician peer support team and on physician and medical staff appreciation.”

Beyond that recommendation, the community of practice wants to develop and schedule more ways for leadership and physicians to have check-ins, support physicians in bringing forward collaborative workflow improvements, and enhanced supports for new and current physicians to help them connect with each other and with regional and provincial resources.

Dr. Singh adds ​“all levels of NHR leadership have a better understanding of the impact of heavy workload burden on physicians. They know physicians are human and cannot be expected to work excessive hours without rest, for example, post-call.” As CMO, he also runs every new initiative he is involved with a physician health lens to ensure they are ​“making progress and not accidentally going backwards, for example, by increasing admin burden.”

Now that the pilot is complete, the communities of practice have become permanent Physician Health and Wellness committees, working alongside their respective regions to determine how they can best enact and sustain the recommended changes. To support these efforts, Doctors Manitoba has also invested in new resources to help drive system change to support physician health, including a new permanent position to support physician health and wellness and another to help coordinate physician peer support.

New Community of Practice for Southern Region

The success of the pilots is also reflected in wider adoption. A new community of practice has been established in the Southern Health-Santé Sud region. Dr. Louw Greyling is the region’s physician champion, a role building on the work he is already doing at C.W. Wiebe to support physician and staff well-being. Work is now underway to develop a region-specific plan to help guide their regional wellness efforts.

The goal is a health care system in Manitoba where physicians feel supported and want to keep working here. This pilot project took the time to understand the day-to-day challenges physicians and communities face in delivering high-quality health care, and provided a forum for people to work together to figure out how changes can be made to create a more positive and satisfying work environment for doctors. In the end, the hope is that physicians can spend more time caring for patients, and feel supported in their roles — something that will pay off big for patients, their families, and our entire health care system.

Learn more and review the Action Plans.

Scotiabank, MD Financial Management and the Canadian Medical Association proudly support the Physician Health & Wellness Community of Practice Project, one of several initiatives that comprise our 10 year, $115 million commitment to supporting the medical profession and advancing health in Canada.