A message to the profession from Alberta’s health agencies

The reason for this letter to the profession is threefold: first and foremost it is to thank all of you for the tremendous commitment you have demonstrated so far; secondly it is to highlight some of the moral and ethical reasoning that underlies our obligations to society; and finally it is to share some principles of leadership that may be valuable in coming days.

The reality we live with as a profession is that society depends on us. During times of crisis this becomes even more obvious. In the words of Eric Wasylenko, a physician/ethicist colleague:

Society has provided training for us and given us resources to do our work. In return for the promises we profess to keep when we become physicians, society places a high degree of trust in us, and expects of us to collectively serve their health needs at all times, and most certainly while we face crises together. It is not a moral requirement for a physician to be heroic in their actions. It is however a moral requirement for physicians to serve the population diligently, in the unique way we are skilled and knowledgeable to do, even in the face of significant risk to ourselves. That is part of the foundation of our fiduciary commitment to the patients we serve and to the population as a whole.

Saying that, it’s also important that physicians and other members of the healthcare team be able to keep themselves healthy. We say this out of personal concern for each of you and for your wellbeing. It’s also essential for all healthcare providers to stay healthy so we can serve the public. Where possible, we find ways to collectively meet our obligation to society, while protecting the health of our colleagues. Our organizations demonstrate this in many ways: by providing situational training, equipping us with appropriate PPE, by using evidence to inform our decisions, by adapting our usual mechanisms for coverage and sometimes by accommodating unique circumstances for individual physicians. But we recognize that deep into this pandemic crisis, it will be harder to do all of this. That is where physician leadership will be essential.

Some of you have official leadership roles, but it is important to recognize that every physician is a leader even though they may not have a position of authority. Whether you recognize it or not most of you will be looked upon as leaders in the months to come. You will be asked to lead people such as patients, colleagues and teams through challenging times and make some incredibly hard decisions. That will put an even greater stress on you. As physician leaders of health agencies in Alberta, we felt it important to share a few tips that will help:

1. You are not in this alone. You have a team around you and it’s essential to look after yourself and your team. Your team is putting their own health on the line and doing so with pride and conviction. The best thing you can do as a leader is to recognize and be supportive of the efforts of the entire team. Tired and distressed team members may sometimes struggle to provide high quality care and they will be looking to you to lead from the front and set the example. Every single member of the healthcare team will be essential to success. The clerical staff, cleaning staff, administrators and other healthcare providers are all doing an incredible job and we can’t lose sight of that. There will be times when one of us will not be at our best. We will be concerned about family or friends, we could be unwell or simply tired. This is not the time to read things into people’s actions or fight with them. Instead, just ask them how they are doing. Find ways to share with each other your own coping strategies and ways that you are supporting team members.
2. This is a time to recognize your own strengths and weaknesses. We all have things we’re good at and things we may need to work on. We all have fears and we all have degrees of self-doubt. Embrace these realities and support each other. It’s also important to not pretend to be someone you’re not. Be true to yourself, and rely on the strengths of each other.
3. Last, but by no means least, is the reality that positional authority entails specific responsibilities. But positional authority is not where leadership derives its positive strength. People will follow you not because of your position or authority, but because they trust you. Build that trust now and continue to build it at every opportunity. Look after each other, and everyone on your team, even if you are not in charge. There will be members of your team that will have fears about what’s in front of them and may not want to participate. It’s important to recognize those fears, understand the concerns and find ways to alleviate them. As organizational leaders, we are committed to exercising our assigned authority with compassion, respect, transparency and decency. We will attempt to be as evidence-informed, and as open to your suggestions, as possible.

The days ahead are murky and filled with many challenges. There will be decisions to be made and actions to be taken that will be hard for us to manage. This is not the time for conflict. If we fight amongst ourselves the battle will be over. This is a time when we all need to come together as a team and support each other. We have a unique opportunity here in Alberta to be one large healthcare team focused on a common enemy. We have the capacity to include our community healthcare teams, AHS, public health, universities, associations, regulators and lawmakers together in this fight. Focus on what can be controlled and not on what can’t be controlled. Be there for each other and be the leaders that society expects you to be.

We want to recognize and thank all of you for what you’re doing now and what you will be asked to do in the days to come. Be professional and diligent, but also be safe and be kind together.

Sincerely,