Physicians are often a part of a complex workforce team that is very susceptible to negative factors in the work environment.  Although physicians frequently do not see themselves as employees, they are likely even more susceptible to workplace stress due to their level of responsibility.

Workplace stress is an important factor affecting the delivery of health care to our patient population. Workplace stress affects the mental and physical health of employees and their overall performance in the workplace. Also, workplace stress could impact the entire life of a worker. It is also significant in contributing to reasons for some complaints to regulatory authorities.

 “I practiced in Namibia, in Texas and Washington, however, since I started practicing here, it’s been different. The place is different, the people are different, and I am under lots of stress.”

“I had done well in my previous practice, but now I make mistakes and miss diagnoses since I got to this place.”

“In this place, I feel abandoned, disrespected, not listened to and not recognized.”

“I feel somehow that my colleagues are looking out for me to make mistakes so they could catch me at a fault.”

These statements reflect the deep psychological pain and agony these individuals are experiencing due to workplace stress and anxiety.

According to the Canadian Center for Occupational Health and Safety, workplace stress is the harmful physical and emotional response that can happen when there is a conflict between job demands on the worker and the amount of control the worker has over meeting these demands[1].

Workplace stress is prevalent among workers in Canada. According to the Mental Health Commission of Canada, seventy percent (70%) of Canadian workers are concerned about the psychological health and safety of their workplace, and 14 percent (14%) feel their workplace is unsafe.

About 30 percent of short- and long-term disability claims in Canada are attributed to mental health problems and illnesses. The total cost from mental health problems to the Canadian economy exceeds $50 billion annually.   In 2011, mental health problems and illnesses among working adults in Canada cost employers more than $6 billion in lost productivity from absenteeism, presenteeism and turnover[2].

According to the Centre for Disease Control, 

• One-fourth of workers view their jobs as the number one stressor in their lives.
• Three-fourths of workers believe the worker has more on-the-job stress than a generation ago.
• Problems at work are more strongly associated with health complaints than are any other life stressor-more so than even financial problems or family problems[3].

In a study of Burnout in Health Care Workers by Stefan De Hert, the incidence of burnout was found to be higher among physicians; the incidence of symptoms of burnout between US physicians and a population control sample was 37.9% versus 27.8%[4].

The COVID Pandemic has increased workplace stress for physicians and allied health care workers. We’ve heard the voice of health care workers who are fatigued, overwhelmed and tired. In some areas, the morale is low, people are frustrated, helpless and sad. Many have quit their jobs because of the very stressful work situations that the pandemic brought. In the face of this, there is a worsening and increased incidence of anxiety, depression, and burnout among physicians and health care workers. In addition, the workload has increased and there is a limit to human and material resources to help the sick, which makes the stress even more unbearable. The inability to deliver the care one wants leads to moral injury.

According to Statistics Canada, prolonged workplace stress increases the risk of depression, heart disease and substance abuse[5].

Given the impact of workplace stress on the mental and physical health of our physicians and health care workers, as well as its negative impact on the quality of health and public safety, government and health care stakeholders must put strategies and systems in place to reduce workplace stress and its negative impact on our health care workforce. 

Health care administrators and physician leaders must pay attention to the presence of workplace stress among physicians. They must put strategies in place to reduce the workload of physicians and increase the ability of physicians and allied health professionals to be in control in their workplaces. Leaders should adopt the standard advocated by the Mental Health Commission of Canada in the document - Psychological health and safety in the workplace, prevention, promotion and guidance to staged implementation[6].

To avoid conflict within the workplace, physicians must understand their team dynamics, team members' expectations, and temperaments. Motivating team members and helping them achieve their goals will support workplace peace and harmony. Identifying with team members' expectations and working hard to achieve them as a team will boost personal morale and acceptance within the team. Understanding team members' temperaments and flexing to accommodate them will reduce conflict within the team. Physicians must make effort to break the barrier of conflict within the team and strive for a peaceful working environment that will reduce workplace stress.

Being vulnerable and understanding your limitation is important to reduce workplace stress. Humility to accept correction and feedback from your team members reduces psychological stress. Being ready to acknowledge when you are wrong and apologize to your teammate with a sincere “I’m sorry” will reduce escalating conflicts. Be truthful to yourself upon self-reflection to understand when to ask for help and doing so will help the healing process and prevent harm that comes with workplace stress. Getting help from family, friends and professionals is a good way to fight against workplace stress. The Saskatchewan Physician Health Program is available to help physicians who are experiencing any form of stress.

Workplace stress is present among Canadian physicians and health care workers, and even more prevalent today because of the COVID pandemic. It is a significant contributor to the poor mental health of workers. It does influence physician performance in the workplace and could impact public safety. Workshops on effective communication such as Effective Team Interactions, Just Culture in Healthcare, and Strategies for Managing Unprofessional Behaviours (Saegis) and others can be useful tools in developing those strategies. In any case, to protect the workforce, government, health care leaders and physician administrators must work hard at putting strategies forward to reduce and manage workplace stress among physicians and health care workers.