Protecting physician safety in medicine

During the vigil, I found myself reflecting on many other similar events I’ve been involved in where a life has been lost far too soon. Whether it was a missing man formation flown after the loss of pilot with the Snowbirds, the many ramp ceremonies in which I participated while deployed in Kandahar, or the funeral of a family member or friend who died of cancer. None of these situations are ever easy.

When tragedies arise, we may find ourselves asking questions like: How could this have happened? How can we stop this from ever happening again? What could I have done to stop this? However, there are rarely answers to those questions. It’s important to keep in mind these tragedies are often incredibly rare events, and we cannot let rare events impact how we live our lives. Of course, we need to learn from them and do what we can to protect ourselves, but we can’t stop living and we can’t stop appreciating all the good that’s around us.

This tragic loss in our medical community has resulted in a conversation about safety in the healthcare system. I’ve received several emails from physicians across Alberta with stories of their own close calls. I suspect all of us who have practised medicine or are currently practising medicine have, at one time or another, been in a position where we have not felt safe in some way. We do not know what led to the tragic incident in Red Deer and I won’t try to speculate. In general terms, it’s important to note that as physicians, part of our job is to provide patients with news and information that can provoke an emotional response. This may result in an interaction that can, and sometimes does, make us feel unsafe.

This highlights just how challenging it is to practise medicine. Medicine is about helping people during some of their most difficult times and managing the emotional responses that come with it. It means helping people suffering with mental illness, personality disorders and addictions; providing care to patients who are in pain or have complex needs; and supporting and guiding those facing life-altering medical conditions or terminal diagnoses. However, it does not mean any physician should have to put their physical or psychological health at risk. Occupational health and safety is not something we can ignore in health care, and CPSA understands this.

Some physicians have shared with me they are afraid of ending a patient relationship they feel is unsafe because the patient may file a complaint against them. It’s true that the patient may file a complaint with CPSA, but you have the right to end a patient relationship if you feel unsafe.

CPSA’s standard of practice on Terminating the Physician-Patient Relationship in Office-Based Settings offers additional guidance. It’s important to note this standard recognizes your safety is paramount, and you should not have to tolerate inappropriate behaviour by patients. It’s important to read the entire standard, but please note it specifically states:

Notwithstanding clause (4), a regulated member may immediately discharge a patient if:

a. the patient poses a safety risk to office staff, other patients or the regulated member;

b. the patient is abusive to the regulated member, staff or other patients;

Please do not let the fear of a CPSA complaint get in the way of your own safety. Take time to review and understand the standard, and please reach out to us if you have any questions.

Without question, these are some very challenging times for physicians that have induced an incredible degree of stress for you, but I’m confident we can get through this and come out stronger on the other side. This is the time to focus on your health, your family and your patients. Focus on what you can control and do your best not to worry about the things that are transitory and out of your control.

Please take care of yourselves and each other.

Scott