2022-23 Mid-Year Update on KRA 2, Well being

Priority activity

Update

1. Continue to provide the PFSP service and monitor assistance levels to meet increasing need.

PFSP has three core service areas: Assistance Line; Case Coordination; and Education, Prevention and Promotion.

• The PFSP received 3396 calls to the Assistance Line in 2022 marking the fourth consecutive year that the PFSP Assistance Line has seen a 15% increase in utilization. To address impacts of this growth on the PFSP, discussions are being held with AMA leadership on how to best support the program and its resources.
• The PFSP provided 9,916 therapy hours to eligible physicians and their families. There were 3,422 hours of administrative time spent providing this counselling service. Overall, this is a 15% increase over 2021.
• Assessment physicians provided 8,760 hours of coverage to the Assistance Line and spent 1,211 of these hours talking with individual callers, providing support and assistance.
• The PFSP’s Case Coordination service experienced a 50% decrease in new accesses over 2021. The reason for this decrease is unknown but the number of physicians accessing this service on a yearly basis is typically small, so the significance of the decrease is uncertain. The PFSP will monitor these numbers over time to determine if this is a trend.
• The PFSP’s Education, Prevention and Promotion activities continued to remain responsive to the changing landscape of physician health. This has been achieved through collaborating with other organizations that support the physician community such as AHS, CPSA, PARA, Well Doc Alberta and the Medical School Wellness offices. Throughout the year Education, Prevention and Promotion Staff promoted the program at both virtual and in-person events.
  • PFSP has two upcoming sessions that encourage and promote self-compassion. The first offering is March 14, 2023, and is entitled “Who you are versus what you do?” and the second is on May 16, 2023 and is a session on life transitions and how executive coaching can be a support for physicians. 
  • In continuing efforts to encourage a more compassionate culture in medicine, the PFSP has launched a physician-authored poetry initiative that garnered enough submissions to have poetry featured in every issue of Alberta Doctors’ Digest throughout the year and into 2023. 
• The PFSP continues to experience a surge in requests for family physicians through the Physicians 4 Physicians (P4P) service for the third year in a row. In 2022 there were 372 requests, a 56% increase over 2021 while 2021 saw a 48% increase and a 9% increase in 2020. In August 2022 a record 58 requests were received. The demand continues to primarily exist in Calgary and Edmonton. The PFSP continues to collaborate with leaders from both Alberta Health Services and Primary Care Networks (PCNs) to explore opportunities for meeting this demand.

2. Operationalize funding from the Affinity Collaboration (BNS, the CMA and MD Financial Management Inc.) to respond to and address the health and wellness needs of physicians and medical learners.

• Implement psychiatry services as an additional offering.

• Components of the Scotiabank and Canadian Medical Association (CMA) Affinity Fund agreement with the AMA are underway. Specifically, service provision to those physicians who fall outside of the eligibility criteria listed in the Grant Agreement is in place. This will ensure that retired physicians and those who may have been too ill to work in the past 12 months are able to receive support. In 2022, 172 hours of therapy and administration time were provided to this group of physicians.
• PFSP continues to work towards operationalizing other physician wellness programs that have been developed within the CMA Affinity Fund Agreement project plan including the Psychiatric Assessment program. Interviews for the psychiatrist role have been completed and the PFSP is pleased to report a psychiatrist will be joining the PFSP team in the first quarter of 2023.

3. Support Well Doc Alberta’s efforts to renew funding and scale and spread the program nationally through affinity funding made available through the CMA/BNS agreement.

• The proposals put forward by Well Doc Alberta with the AMA’s support are being considered and we are hopeful that a long-term arrangement will be secured. 

Priority activity

Update

1. Continue the Shine A Light initiative, highlighting both daily and extraordinary contributions of physicians that keep the system in motion. Use storytelling to facilitate and link to engagement in the AMA.

• Profile grassroots physicians with Shine A Light profiles in each issue of Alberta Doctors’ Digest.
• Profile and engage medical students:
  • Reactivate medical Student Spotlight series of student profiles in Alberta Doctors’ Digest.
  • Engage with medical student leaders and produce a video for students at large to explain how their input feeds into AMA governance. 
  • Seek to return to pre-pandemic levels of participation in the RF by our contingent of student observers and enhance that experience through the RF Buddy mentoring program.
• Profile and engage resident physicians:
  • Collaborate with PARA to highlight the contributions of resident physicians.
• Profile and engage physician leaders following each RF who have brought forward motions that flow into AMA advocacy. Tell their story and experience of engaging in the AMA.
• Highlight students and physicians receiving AMA scholarships, bursaries, grants and awards.

• The Shine A Light program has been revitalized and we are working to profile more physicians more frequently.
• We continue to highlight the everyday accomplishments of physicians showing up to do their job in such challenging times.
• The Joint Physician Advocacy Committee is developing an initiative to encourage and uplift the profession that will further support Shine A Light.

2. Through the AMA Youth Run Club in schools across the province, equip teachers with tools and resources to engage children and youth in physical activity that are optimized for the post COVID learning environment.

• Youth Run Club is back in full swing as a face-to-face offering, still maintaining distance options for those who can’t participate at school for short or long-term.
• Programming continues to support inclusion with girls only and offering for various accessibility needs.
• We are pleased to be increasing the number of Indigenous communities with which we interact.
• Gold Sponsor Alberta Blue Cross and Silver Sponsor MD Financial Management make programming possible with their generous support. This fall this included a push to increase awareness and registration with advertising on electronic billboards in Edmonton zone.

Priority activity

Update

1. Advance the AMA’s Healthy Working Environments framework in the areas of equity diversity and inclusion, psycho-social wellness and safety and leadership, aligning activities with other system partners including AHS and the CPSA: 

• In collaboration with AHS and the CPSA support implementation of the anti-racism online education project. 
• Complete an environmental scan outlining the current supports available to Alberta physicians for navigating conflict. Gaps will be identified for further discussion by the AMA’s Healthy Working Environments Advisory Committee. 
• Explore with Joule the offering of trauma-informed leadership and crucial conversation courses as part of the coaching component of our CMA-funded Physician Leadership Professional Development program.
• Advance just culture and healthy working environments language in AMHSP contract discussions.
• Liaise with CMA for Alberta-specific findings from the recent physician wellness survey and integrate these findings into AMA advocacy.
• Further align work of the HWEAC and the Indigenous Health Committee.
• Advance discussions with AHS related to safe reporting and trauma-informed leadership.

• An online course is being developed jointly by AMA, CPSA and AHS entitled, “Micro-aggression Training for Physicians.” A pilot of the course will take place in March 2023 with a group of testers who are aware of the course or have been involved in its development. This group includes members of both the AMA Healthy Working Environments committee and the AMA Indigenous Health committee. The steering committee aims to launch this voluntary course for all CPSA regulated members (which includes physicians, resident physicians and medical students) this spring. Objectives of the course are: 

1. to increase physician literacy on racism and discrimination, specifically in the form of micro-aggressions in health care settings; 
2. to increase physician knowledge and action on effective ways to respond to potential or witnessed racist actions by or toward physicians, other health care workers or patients; 
3. to complete a collaborative project with multiple provincial medical stakeholders leveraging anti-racist action together. 

• Through the CMA funding for the Physician Leadership and Professional Development Initiative (PLPD), over 100 physicians have taken part in this initiative and 57 physicians completed at least two courses and are eligible to sign up for a final course as part of the coaching opportunity. Two courses have been arranged/delivered for the coaching opportunity:

1. Trauma Informed Leadership – February 9 and10, 2023
2. Crucial Conversations – March 9 and 10, 2023
   
   This initiative will close in 2023 as the grant is completed.

• For AMHSP, both culture and healthy working environment principles are embedded in the AMHSP Negotiating Interests that were put forward initially in 2020, and have been foundational to our discussions with Alberta Health, AHS, and the universities since then. Interests include:
  • procedural fairness in performance-related issues
  • building a diverse and inclusive physician cohort
  • encouraging innovation and entrepreneurship
  • introducing a neutral and fair dispute resolution mechanism
  • strengthening physicians’ voice in governance
  • fair and equitable physician compensation
  • initiatives to prevent physician burnout and promote physician wellness
• An environmental scan of current supports available to Alberta physicians navigating conflict was completed in June 2022. This information will be presented to the members of the AMA Healthy Working Environments committee at their next meeting this spring. The Healthy Working Environments committee is reconvening after a one-year hiatus. 
• The CMA National Physician Health Survey 2021 was released in August 2022 and states, “The key findings from the national study reveal that numerous subgroups are experiencing more negative wellness outcomes, including medical residents; those under 35 years of age; those identifying as women; those practising six to 10 years; caregivers of a child and/or parent or family member in the home; those living with disabilities; and those working in small town/rural or isolated/remote areas. Still, not all the results are discouraging: there are signs of a culture shift toward prioritizing wellness. That is, medical residents and younger physicians report accessing support for their mental health challenges more frequently than practising physicians who are at a later career stage. While some of those who need wellness supports are accessing them, there are still significant barriers to overcome, such as stigma, availability and concerns around confidentiality.” 
• Alberta-specific findings from this CMA survey were released in January 2023. In general, “Respondents from AB are significantly less likely to have been experiencing burnout at the time of the survey (49% vs. 53% national total). Across other key psychological measures, there are no significant differences: half test positively for depression, and a quarter experience moderate to severe anxiety levels; 38% report having had thoughts of suicide at some point in their life and 14% have had thoughts in the past 12 months.” 
• AHS will be updating the AMA Healthy Working Environments committee on safe reporting, trauma-informed leadership training and other related initiatives at their next meeting this spring.

2. Support individual physicians and groups in conflict situations that exist within practices and with AHS.

• PFSP is monitoring the number of calls related to conflict situations within physicians’ work environments.
• The AMA receives periodic updates on the pilot Edmonton Zone Medical Staff Association’s program which funds a 0.3 FTE Physician Advocate to support physicians in conflict. Assessment data will be considered by the five Zone Medical Staff Associations in consideration of this program's possible expansion. 
• At their upcoming spring meeting, the AMA Healthy Working Environments Advisory committee will discuss ways to support physicians in conflict situations. As well, essential external partners to move this work forward will be identified.