Disrupting The Status Quo
Why Physician Families Can No Longer Be Invisible Partners In The Healthcare System.
(Originally published in Physician Family Magazine Spring/Summer 2021.)
By Hayley Harlock
Healthcare systems depend on healthy physicians. To thrive, healthy doctors need healthy relationships; and healthy relationships start at home. As physician families, we understand that physician health and well-being is a family affair. Unfortunately, medicine as an institution does not fully recognize, include or support physician families as the invaluable and uniquely positioned healthcare partners that we are. It is time for this to change. We can no longer remain invisible.
Can you imagine the positive impact that recognizing, including and supporting physician families could have on the health, well-being and longevity of physicians, their families, patients and the healthcare system at large? Can you imagine the positive changes to medical culture if including physician families was the norm, starting at the very beginning of medical training?
Dr. Alika Lafontaine, Canadian Medical Association’s 2022-23 President-Elect, recently said, “Change is a team sport”. I agree. It’s time for physician families to have their rightful place in the starting line-up. There is an assumed disconnect between physicians and their families. As physician families, we know this is untrue. In fact, the 2018 CMA National Physician Health Survey reported that one of the leading reasons physicians seek mental health help is related to personal stressors including family. The experiences (good or bad) of physicians during training and in practice do not occur in isolation, their experiences impact their loved ones, too.
Currently, no system can adequately support the diverse, individual needs of physicians the way their own families can. There is no denying that healthcare systems and the culture of medicine have lacked equity, diversity and inclusion for many years. We know that racism, misogyny and discrimination exist within healthcare. The unique ability of physician families to anticipate and support the needs of individual physicians is one of the many benefits of including us at all stages of training, practice and into retirement.
Well-intentioned stakeholders often share their commitment to changing the culture of medicine to better support the health and well-being of trainees and physicians. But despite good intentions, nothing seems to really change, as highlighted by these 2021 Medscape stats indicating that 42% of physicians report being burned out, 79% reported being burned out prior to the COVID-19 pandemic and 47% of the physicians surveyed reported their burnout as having a strong or severe impact on their lives. All physicians surveyed reported burnout as having a negative impact on their personal relationships. Twenty percent report clinical depression and 69% colloquial depression. Thirteen percent of physicians surveyed disclosed thoughts of suicide. Burnout, depression and suicidal ideation impact not only physicians, but physician families too. We are impacted, and we are in a unique position to help.
The medical system acknowledges family-centered care as an effective and essential framework to providing patients with the best possible outcome. This framework allows for a collaborative method of caring for patients that is based on a holistic approach with proven results. When families are involved and supported by the system, patient outcomes typically improve. Holistic approaches that include and support physician families have the potential to increase support for physicians, contribute to resilience, and help to decrease burnout.
The COVID-19 pandemic has been relentless and has taken a toll on our healthcare workers and their families. Our healthcare workers have sacrificed so much to keep our communities healthy and safe. The families of healthcare workers, including physician families, have always supported and held things together so that their loved ones can effectively do their jobs and take care of others. I believe that the pandemic has amplified the important role that physician families play in the healthcare system. I work with physician spouses and partners every day and have noticed a significant increase in members of our community seeking connection and support.
Lately, physician burnout and the impact it has on physicians, their patients and the healthcare system has been the focus of discussion and research. To date, minimal consideration has been given to the possibility that physician families also experience burnout. The idea that physicians are experiencing higher than ever levels of burnout, depression and other mental health issues in isolation of their families does not make sense. Home and work life impact once another. Physicians are not the exception. Burnout has somehow been associated with an assumed lack of physician resilience, or unfairly been viewed as an individual flaw. In reality, burnout is the result of a flawed system. The same can be said about physician families; lack of support for physician families is a system flaw that needs to be improved.
The pandemic has pushed the healthcare system, physicians and their families to a breaking point. The Canadian Medical Association describes physician burnout as “one of the most significant challenges facing the health care system. It threatens the well-being of clinicians, residents and medical students, which can affect the quality of care given to patients. Healthy physicians mean healthy patients.” What has not been considered enough is how this impacts physician families. The American Medical Association has acknowledged that what has been left out of the conversation is the “effects of burnout on physician families”. I couldn’t agree more. In 2021 and beyond, the impact of physician burnout on physician families must be further considered and studied.
Too many physician families are surviving but not thriving. It doesn’t have to be this way. When physicians and their families are supported and thriving, the health and well-being of physicians are strengthened; ensuring that quality, compassionate patient care can be made possible and sustainable. To achieve the goal of healthy doctors, healthy systems and healthy patients, the health and well-being of physician families must be considered and prioritized.
Disrupting the Status Quo
We often see and hear call outs on social media demanding changes to the system and to medical culture. But words without action do not equal change. Disrupting the status quo requires us to take meaningful action.
After years of experiencing firsthand the gap in support available for physician families, I decided to do something about it and in 2019 established The Flipside Life (TFSL). TFSL is an organization that represents those of us living on the flipside of the white coat. The name is a cheeky play on words, but the work TFSL does is anything but playful. TFSL’s mission is foster meaningful connection and create an inclusive community that supports and champions the wellness of physician families during all stages of training, practice and retirement.
As the founder of TFSL, I facilitate weekly, free confidential peer connection calls where spouses and partners can connect and discuss issues that matter to us and to our community. All spouses and partners of medical students and physicians are welcome. In addition to our weekly Connect Calls, TFSL’s 2nd annual (virtual) conference for physician families, The Better Together Project 2.0 featuring speakers curated from within our community of physician families will take place in July 2021.
When I am not connecting directly with members of our community, I’m advocating for change. I spend my days collaborating with institutions that work with or represent physicians to raise awareness and effect change. I speak to the media and other stakeholders about the invisibility of physician families and the opportunity that could exist if we were acknowledged, recognized and supported.
COVID-19 has created a new abnormal, along with an opportunity to make impactful and lasting changes to the way physician families are considered. It has also created an opportunity for us to improve the way we support physicians and the way the system supports us. Physicians, our families, the system and patients all stand to gain from this change.
If you are looking for support or connection, please join us on a TFSL Connect Call. This is our community, and we are most definitely better together!
By Hayley Harlock
Author Bio: Hayley Harlock is the founder of The Flipside Life (TFSL). She is a fierce advocate for physician families. Hayley is a mom to three school-aged children and wife of a vascular surgeon. Hayley holds a Master of Social Work degree from Wilfrid Laurier University. Prior to staying home with her children and supporting her husband's surgical career, Hayley practiced as a medical social worker at the Hospital for Sick Children in Toronto. Hayley's personal and professional experience, coupled with her natural ability to connect with others and her determination to improve the experience of physician families, make her uniquely positioned to lead the TFSL community. Hayley now spends her days championing physician families and is currently collaborating with McMaster University on a research project that will explore the impact of training on residents, fellows and their partners. In February 2021, Hayley was nominated for the Hamilton YWCA’s Women of Distinction Award for her work and support of physician families. You can connect with Hayley on Instagram and Twitter.
