I would like to build a challenge for physicians to be wellness champions for us – and for themselves. We were already facing a health crisis before COVID-19: rising inactivity, declining mental health, increased isolation. Now we’re in new territory.

The COVID-19 pandemic has impacted each of us to varying degrees. For some, it has affected their health or the health of a loved one; for others, it has affected their livelihoods. Healthcare workers know this as well as anyone.

Why we Need Physicians to be Wellness Champions

When the general public pictures the pandemic and its effect on healthcare workers, images of hospital ICUs and wards bursting at the seams come to mind. Chilling headlines of some of Canada’s morgues running out of space spark a sense of urgency and significance of the epidemic.

Though we rarely picture physicians working at a desk or behind a computer, much of what they do when not seeing patients involves looking at a screen. With the increasing use of electronic medical records (EMR), this behind the screens work has become even more prominent: patient information is available instantaneously and work can easily be taken home beyond specified working hours.

Many physicians spend several hours outside of booked patient visiting times to complete pre-clinic reading for appointments the next day, reviewing lab results and imaging from prior visits, faxing prescriptions, writing referral letters (or consult notes if they’re specialists responding to referrals), charting after assessing patients, and filling out billing codes so they can be paid for their work.

While technology has automated much of the mundane administrative tasks in medicine, it has also prompted a shift in the type of work that physicians participate in, and not necessarily in a healthy way.

Physician Burnout During the Pandemic

One of the strongest predictors of physician burnout is how much time they spend doing computer documentation. This is a frightening fact, considering a recent study found that physicians spend on average half their working time on electronic health records.

The reality is, physicians are spending proportionally more time behind the screen and less time in front of the patient.

With COVID-19 pandemic public health guidance asking many businesses to limit the number of non-essential contacts, many of my colleagues in ambulatory medicine have shifted their practices to providing virtual care, adding significantly more screen time to their days.

As a recent graduate of the family medicine program at the University of Alberta, I am often seeking overall wellness for my patients, including their physical, mental, emotional, and spiritual wellbeing.

I account for their occupation, financial, and cultural circumstances to allow me to formulate a comprehensive management plan. In medicine, we call this the patient-centered approach.

Ironically, through caring for their patients, many healthcare providers neglect to care for themselves. In my own life, I have witnessed how the boundaries between work and personal life easily become blurred, especially since the dawn of the pandemic.

After doing a placement in occupational medicine with EWI Works, I would like to build a challenge for physicians to be wellness champions during this pivotal time and “walk the walk”.

Wellness Champions: Walk the Walk

While there is hope on the horizon with vaccine rollouts, many elements of e-Health, EMRs and telemedicine are here to stay and will continue to spread long after the pandemic is over.

Here are some ways physicians can prepare for this shift:

• Physical wellness: optimize work-from-home spaces to minimize strain and prevent injuries. It’s worthwhile for physicians to invest in wireless headphones and free up their hands if they are speaking with patients over the phone and also needing to document on the EMR at the same time.
• Mental and emotional wellness: According to the Canadian Physical Activity Guidelines for adults, it is important to limit sedentary behaviour to 8 hours or less daily and break up long periods of sitting as much as possible. Similar to taking a holistic patient-centered approach, it is imperative for physicians to not only design their physical space to be ergonomically effective, but they might also want to consider an “ergonomic” approach to how they structure their day and trying to integrate regular short breaks (this free break reminder tool can help you make this a habit).
• Social wellness: physicians can design a virtual clinic water cooler station in a way that allows for easy socializing and interactions with their staff and colleagues. Using secure social media apps to interact with other colleagues by sharing in some laughter throughout the day injects some social relief into the workday and provides a mental microbreak at the same time.
• Safety considerations in the clinic: pre-emptively set up clinic office space to allow for safe and meaningful patient care. Adjust computer monitors in clinic rooms to various heights to accommodate a variety of users. Create an open setup where the physician can easily see both the patient and the screen simultaneously to build better patient rapport with good eye contact and prevent musculoskeletal injuries caused by twisting.

Finally, in one of the virtual office assessments that I joined during my elective time at EWI Works, I also learned of the importance of routine from one of the senior ergonomists.

Building movement into your day

Incorporating physical activity into a routine workday, especially for those working from home, can help meet Canada’s Physical Activity Guidelines of 150 minutes of moderate-to-vigorous-intensity aerobic physical activity per week.

One way to do this is simulating commuting to and from work. This dedicated commute time helps prepare our minds for starting work and provides an opportunity for cognitive debrief at the end of the day.

If providing telemedicine services from home, physicians can simulate the commute to their clinics by walking around the block in their neighbourhood for the duration of time it would normally take them to commute to work.

It’s a simple, healthy step; one that can help physicians walk the walk and be the wellness champions we need them to be.

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