Thank you very much, Mr. Chairman. It is an honour to speak to you today.
I am Dr. Arjun Sahgal. I work at the Sunnybrook Odette Cancer Centre of the University of Toronto. Today I am representing myself, as a Canadian physician and professor of radiation oncology, subspecialized in the treatment of brain and spinal tumours.
To provide context, those of us in this field deal predominantly with incurable cancers like glioblastoma. Cancerous brain tumours are the most difficult to treat, and I have been privileged to treat these patients and to try to extend their lives. I have treated patients from those with absolutely no resources to Canadian icons like Gord Downie. It is always humbling that, no matter where they are in the world or whatever their background, the disease indiscriminately takes the patient’s life.
The nature of this work is highly stressful and it presents a major emotional burden. Resources were already limited as we all faced challenges of practising in a constrained and publicly funded health care system, but the past two years of practising during the pandemic have only exacerbated the potential for burnout—and system-wide burnout. From the early days of having shortages of PPE while seeing patients; dealing with the potential of exposing ourselves, our families and other patients to COVID; and triaging patient care based on COVID risk to the current reality of working in an overextended health system and trying to catch up while still managing the increased number of patients with COVID needing care, burnout is being fuelled at all levels of the medical profession.
Moreover, patients and caregivers themselves are burning out, and therefore the realities of limited resources that we face extend to not only the medical practitioners but also the patients themselves. Every facet of care is challenged by the lack of human health resources.
We are short nurses, allied health professionals, personal support workers and doctors. Many have simply retired, quit or looked for another profession as the environment is just overwhelming and under-resourced.
In addition, the system really hasn’t provided additional supports to care for the workers who are at the front line. The system is trying new strategies on the fly, but the question is what can make that difference to help health care workers now? It is not simply recognition.
I often reflect on a system that would improve the efficiency in which we practise through better modernized electronic health record systems, seamless access to imaging tests like MRI and CAT scans, better approval processes for new life-saving drugs and tests, and specialist care and staff to help the administration of health care. More and more, these tasks are being put on doctors, and that is stressing the system and increasing the burnout. In other words, we need to let the doctors be doctors and ensure that clerical staffing is provided by the system so that doctors can look after patients instead of cutting down on patient care to allow time to enter orders and transcribe notes. This would be a major boon for staff retention, especially in northern and rural settings, and would combat what seems to be an increasing proportion of young doctors who are burning out.
I am not an expert, nor do I practise in a rural or underserviced community, but as a specialist I do care for patients from all over Ontario who have rare tumours. I can say, from my northern colleagues, that this problem is much more difficult to deal with in remote centres since there is a much smaller pool of workers and some core services have had to be restricted.
The acceleration of virtual care is helpful in managing the current crisis as we can do more virtually, but we need a fair system and access to resources that span not only hospitals but all care settings, including remote care offices.
Immediate attention needs to be given to new health care models to manage the limited resources that are becoming even more scarce due to the workforce answering with burnout from the constant pressures of understaffing and over-administration.
I do believe that increasing the staffing levels will make a major difference, but this will take time. Accelerated programs for recruitment of nurses and long-term care workers from other countries may be a solution, but we need to train more young Canadians and make it attractive again to go into the field of caring for the sick and needy.
It would go a long way for rural centres to have modernized resources so that the staff could work proudly in that setting, be retained and be able to recruit new staff by offering the latest medical care resources—as they would in downtown Toronto—so that they could do their jobs the way they were trained to do. This could have a positive impact on the burnout rate in patient care.
To summarize, I would say that every health care worker—from the support staff maintaining clean surroundings and security personnel who protected us when protests were happening to technicians, nurses and doctors—strives selflessly to provide only the best care for our patients.
That I believe in and I do believe it's time to protect us from burnout. I thank this committee for this opportunity.