winter 2013

p h y s i c i a n   w e l l n e s s
MDLink to primary care



This fall, the NLMA launched MDLink, a new program that helps physicians gain access to primary care by connecting physician-patients with family physician-providers in their own community or a neighboring one.

This fall, the NLMA launched MDLink, a new program that helps physicians gain access to primary care by connecting physician-patients with family physician-providers in their own community or a neighboring one. The program is open to any member of the NLMA who does not have a family physician.

“It is our vision, as stated in our Strategic Plan, to support physician health and wellness services and programs, to ensure physicians are resilient in their professional and personal lives,” says NLMA President Dr. Yordan Karaivanov.

“I strongly encourage any member without a family doctor to avail of this program because by taking care of ourselves, we will offer even better care to our patients.”

MDLink is a program of the NLMA Physician Care Network and is part of an NLMA initiative to broaden the scope and reach of its physician health program. Earlier this year, the NLMA also launched the inConfidence Employee and Family Assistance Program, which offers crisis intervention and counselling services to members and their families.

Physicians are susceptible to the same illnesses as their patients, however, they often find it harder to access independent primary care compared to the general population. They are also among the lowest users of formal health services.

Barriers to accessing care can involve issues of confidentiality and feelings of embarrassment. Tight-knit communities within the medical profession can lead to fears about privacy. While some may worry they are overreacting to a trivial illness or that or that they are imposing upon another physician’s time.

“Physician health issues are bigger than we all think,” said Dr. Derek Puddester, Director of Physician Health at the Canadian Medical Association and Executive Director of the Canadian Physician Health Institute. He is also an Associate Professor of Medicine at the University Ottawa, where he is the Director of Canada’s first faculty wellness program.

On May 25, Dr. Puddester joined Dr. Gina Gari Higgins and Dr. Robert Williams to deliver the half-day Primary Care Training Program workshop at the NLMA to support MDLink providers.

“For many years when I started to do physician health, I had people tell me that this wasn’t an issue. They’d say ‘Derek there’s no doctors with mental illness, come on they got through medical school. There can’t be any doctors with addiction, they’re doctors!’ That’s simply not true,” said Dr. Puddester during the workshop.

Some of the common issues that physicians in Canada encounter include everything from lack of sleep, poor nutrition, limited recreation, stress, money issues, expectations, demands on their limited time to litigation.

Dr. Puddester explained that on average, 50% of Canadian physicians consider leaving medicine; 46% report being burned out; 18% are depressed (slightly higher than the Canadian average); and, 2% think of suicide. Physicians also report significant marital difficulties, separation and divorce rates that exceed the Canadian average.

He said that typically only 25 per cent of physicians will think about getting help when they need it, while only 2 per cent actually get help.

A recent NLMA membership survey on physician health found that 30% of NLMA members do not have a family doctor and 40% indicated it was longer than a year since their last medical check-up.

In 2012, the NLMA committed to moving forward with an enhanced physician health program that provides health promotion, prevention and crisis intervention services. The Association conducted key informant interviews and a series of physician focus groups to examine what NLMA members see as the critical components of a physician health program. Family physicians were identified as ideal program providers given they are skilled at providing care in a manner that respects patients’ autonomy and empowers them to take charge of their own care.

“I can’t emphasize the importance enough that our interventions need to be kept as local as possible,” said Dr. Puddester. “If I’m not doing well with my physical health should I have to go far away to get that dealt with or should I be able to trust someone within my medical family locally to take care of me with dignity, respect and privacy? That’s kind of a no brainer, but it’s tricky. It’s tricky because of the stories we tell ourselves like, ‘if I see them it won’t be confidential, if I see them they’ll document it, if I see them it could end up with the College,’ etc. And none if it could be true, but it’s where our minds go.”

In a video developed by the Canadian Physician Health Institute to promote physician health, a group of physicians recite the words “My colleagues are my sisters and brothers…I promise to help colleagues suffering like me because to be great doctors we need to take care of ourselves and each other.”

“I think that’s true,” said Dr. Puddester. “I can’t think of any chronic disease that disappears simply because you’ve got a license to practice medicine. So that’s the reason why programs like the (NLMA’s) physician health program is so important. There needs to be something for us. We know that we practice better medicine when we’re healthy… Most doctors are already very healthy actually… There are a whole lot of areas where physicians lead and are great role models to their patients. In fact, we know that if doctors as patients are subject to primary care strategies, they will teach that to their patients. So talk about a ripple effect.”

Physicians who need a family physician may contact the MDLink coordinator at 1-800-563-2003/ (709) 726-7424. Family physicians interested in providing care to colleagues are also invited to contact the NLMA to be included as a resource for the program. The NLMA will support physician-providers with orientation and continuing professional development. For more information, visit the MDLink page of the NLMA website.  (



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