Doctors around the province are constantly working to balance patient care, office management, and an increasing volume of paperwork, with their personal lives and family obligations. It’s become more important than ever to ensure that physicians feel connected, and that they are armed with skills to deal with difficult situations.
Recognizing this, the Kootenay Boundary Division of Family Practice initiated the KB Wellness Project in 2018—a program that focuses on ensuring division members have access to peer-to-peer connections in their communities. Organizing space for physician connection and arming members with skills to deal with difficult situations means doctors feel supported in maintaining their mental health as they manage their busy workloads.
Dr Todd Kettner, Project Manager, explains how the program, called “Unplugged for Wellness,” works towards two fundamental goals. “The first [goal] is to reduce stigma around mental health issues for physicians by opening up conversations,” he says. “And the second is to facilitate meaningful connections between doctors.”
It can be difficult to try and squeeze these events into doctors’ already full calendars. But as the Kootenay Boundary Wellness team has found through their evaluation research, even just knowing that these events are available is a source of encouragement to physicians.
“Though some doctors may not be able or want to attend a certain event, they still feel the positive effects that these events represent,” says Dr Kettner. “And the fact that these events are brought to smaller communities across the division makes doctors feel that there is a real effort to accommodate everyone regardless of their location.”
Events have included informal coffee meet-ups, outdoor excursions, guest speakers, and guided weekend retreats. The events that have garnered the most positive feedback are the focused learning events. But as Dr Kettner points out, the success of these events lies in the combination of practical advice and open discussion space.
“We’ve found that the purely ‘for fun’ events don’t have the same interest and impact as the learning events,” he says. “It works to draw participants in with a cerebral objective and then give space for the natural cross-talk and bonding to happen.”
Other considerations that are key to successful events include scheduling 3-4 months in advance, providing iterative feedback to members, and not overscheduling events (which can cause additional stress to the already overloaded physician).
Transforming Our Work retreats: Creating space for open dialogue
As physicians, Drs Tandi Wilkinson and Lee-Anne Laverty are passionate about physician mental health and wellness. As certified yoga teachers, they have seen the positive effects that yoga, meditation, and open discussion can have on maintaining good mental health. Combining their unique skill sets, Drs Wilkinson and Laverty host Transforming Our Work, a series of wellness retreats for specialist and family physicians across the Kootenay Boundary region.
To date, Drs Wilkinson and Laverty have received positive feedback about the retreats. Using principles of transformation from yoga, and coupled with inquiry, participants are empowered to focus on difficult issues in a safe, supportive atmosphere. The philosophy is simple: create a safe space for dialogue to arise naturally.
“We don’t need more evidence,” Dr Wilkinson says. “We need to move past talking about the facts and the data, or even talking about the solutions.”
And doctors who participated in the retreats are echoing this desire for less time spent listening and more time sharing. As one physician writes, “I’ve listened to a lot of talks about physician wellness, and it’s so fundamentally different to listen to someone talk compared to actually having to practice these things. Having these hard conversations, sharing things, and crying in front of people; all of those things are so much more powerful than just listening.”
As a way to extend this philosophy beyond the two-day sanctuary of the retreat, Drs Wilkinson and Laverty introduce the doctors to the idea of “failure friends.” A failure friend is a concept that Dr Wilkinson was inspired to explore after learning about it from Dr Sarah Grey, internist and medical educator from Toronto. During the vulnerable period of time after experiencing a perceived failure, it’s pivotal for doctors to have peer support. A failure friend is a fellow physician to whom another physician can reach out to express feelings of failure, frustration, or disappointment. The failure friend’s role is to listen without fixing, normalize the experience, and provide empathic support.
“In our workshop we practice the roles in a failure friends relationship,” says Dr Wilkinson. “The focus of our workshop is not to talk about things but to put them into action.”
The failure friends concept is an actionable takeaway from the retreat that doctors can use in their day-to-day life. And many participants do. “Failure friends help illuminate what you’re thinking and how to be self-emphatic and work forward from there,” reports a physician. “I think the failure friend concept is an essential part of doing the work.”
Continuing the research
Dr Wilkinson’s work in rural family practice and emergency medicine is coupled with her research into physician wellness. She was recently awarded a Rural Scholar Research Grant through UBC’s Department of Family Practice, and is currently involved in a qualitative study on physician peer support. Having discovered that doctors first look to their peers for support during difficult times, Dr Wilkinson believes that giving and receiving support is a win-win situation for doctors.
“When you take away the stress of having to ‘fix’ your colleague, and just recognize that it’s normal to feel pain in response to difficult situations, it is quite liberating to just listen and provide support,” she says. “It is actually one of the reasons most of us go into medicine – to make a difference.” Her early research suggests that simply hearing that these difficult experiences are normal, and that we may be doing better than we think, plays a significant role in retention.
Through member feedback and research, the iterative process that Kootenay Boundary Division applies will ensure that the events they host will make a positive impact on their physician members, and the community at large.