This is where I grew up. A home filled with so much love, memory, support. That still houses my family. A home 2100 miles away from where I live now.
I begin my journey back to reality today, after almost four weeks surrounded by so much love. Reconnecting with friends I haven't seen in decades. Watching my kids be kids... Grass stained clothes, sticky ice cream faces, playing with the deer every morning in our backyard.
It took 10 days into our trip for my sympathetic nervous system to recalibrate to a stage where then I could begin rest and recovery. 10 days.
I was never able to fully unplug - as the responsibility (and truthfully liability) of being a physician right now does not allow for total disconnect.
And I know what I'm walking back into. An overcapacity acute care system with worsening staffing challenges; more and more delayed diagnosis; and silence from our governing bodies on how to solve any of it.
So, I reflected, meditated, brainstormed. How will my return be different? How do I keep the feelings of that home, the love, the *happiness* alive when I re-enter work?
And I think the answer is a phenomenon we are already seeing amongst hcw. That we are no longer willing to go 120% effort for a system that doesn't not value or understand our commitment. We are not sinking with this ship.
Like many of my colleagues who are finding some peace this summer, getting their repreive from burn out-- I am not willing to go back to the state I was in.
4 weeks is not enough to cure burnout. Its long enough to scratch the surface to understand the problem, identify my non-negotiables, and begin a journey to find balance.
We want to be effective agents healthcare delivery for our patients. Our system is not allowing us to do this without submitting our entire souls to do so.
So for this doc, it's time to make a change.
And I hope my colleagues can too- for their sake and truly for the sake of the future of our system.
Burn out -- it's not a surprise nor uncommon amongst myself and my physician colleagues. It is always one of the topics of conversations when we meet, see each other in the hallways, at events.
Chronic burnout is a decades old problem in medicine, with alarmingly high rates of occurrence over the last 3 years within in this pandemic. With no tangible solution in sight.
Our advocacy bodies, @EZMSA2@Albertadoctors@CMA_Docs all continue the work to lobby for physician safety, and for that I am grateful. It is a bleak time for the healthcare system, and without these groups, the obstacles can seem insurmountable.
Recently, my colleagues and I at my clinic had to make a difficult decision to temporarily stop accepting new internal medicine referrals until 2023.. which is where are currently booking into.
Between the demand for Long COVID referrals, the volume of complex other internal medicine consultations, and increasing inpatient demand on our time, the situation hit a breaking point.
We could not, in good conscience, accept referrals that we know need more timely care than we can provide. At the same time, the decision to suspend referrals was gut wrenching. We want to support our family medicine colleagues who are facing the brunt of deferred, delayed care.
You've heard many HCW talking about the system at the "brink of collapse." But what does that mean and how did we get here? People and System. Let's explore.
Firstly, the system. And when I say system, I am going to speak specifically to medicine (internal medicine/hospital medicine), the literal safety net of any hospital.
These are the groups that admit 80% of any patient that comes through the ER, that takes care of undifferentiated and complex medical problems. If this group is overcapacity, it means admitted patients backlogged in the ER.
Dear patient,
I know you are scared, worried, and even frustrated. You either have a diagnosis and are waiting critical treatment, or you are still waiting for the specialist/tests/procedures that can give you those answers. The wait is excruciating. 6-12 months. Of uncertainty.
You call us...upset at us, the system, all of it. I get it.
I hear you, see you, and want to expedite everything I can... But I can't. The system is broken. I am only one human. I cannot fix this.
Dear administrator,
I know you are trying to save a crumbling system. You ask us to discharge faster, to save money where we can, to send patients home and utilize community resources.
Post call delirium is setting in, so while I'm still slightly coherent, I wanted to share my observations of the last 24-36 hrs-- much of which isn't going to be new information, but definitely underscores the ongoing slow decay of our healthcare.
Internal medicine call, especially in Edmonton, is busy. All. The. Time. We are the default admitting service 24-7, with no caps to number of patients we can accept or admit, even when our teams are overflowing with patient volumes some might consider approaching on unsafe.
Someone has to admit patients. Currently there someone is us, internal medicine.
Another Wednesday, another conference filled with misinformation.
@JasonCoppingAB says not all hospitals are overcapacity. Only some in #yyc and #yeg ... And okay, perhaps that true. But that should not be reassuring to anyone, and here's why.
#YYC and #YEG contain the main tertiary car centers for AB, where specialized surgeries, procedures and transplant medicine occurs. It's where resources such as telemetry beds, specialized equipment exists as single point access for all Albertans.
If those hospitals are overcapacity, they can no longer safely accept patients from the peripheral sites, the rural hospitals, the smaller centers that do not have all of the necessary medical tools and personnel to care for every patient.