The last two years have been intense for healthcare workers. With long hours, canceled vacation and strained home life, how do we manage mental health and what should we be aware of. Cardiac surgeon Simon Maltais, MD discusses his new book.
What trends do you find causing the most mental anguish for physicians and staff?
How are they coping with a pandemic, overtime, extra stress and strained family life?
What are some of the symptoms of maladapted health care workers mental health?
Last year health care workers risked their life to help covid-19 patients and were seen as heroes and this year if a medical staff is skeptical about taking a vaccination they can be fired … how do we make sense of this? A underpinning emotion with the way it’s been politicized is that, health care workers feel a bit left out and lonely. We canceled vacation, risked our lives and now what.
Are people being misdiagnosed or delayed diagnosis or delayed symptom onset of more serious heart issues because of the fear of corona virus?
ICU beds are filled up, hospital resources are strained and that means surgeries that should be easier and quicker to access are delayed.
When on call as much as many have been the past two years, has that led to burnout, being tired and perhaps not performing at the level the health care workers would expect from themselves and make mistakes?
One of the unintended effects are highly experienced doctors retiring or quitting early and now the patients suffer and younger doctors don’t get to learn from them.
How are doctors and nurses handling home life when they are required to be on call or just plain work more hours than usual?
How do you keep your family happy when at any moment you called back to work, this could be at your kids game, a wedding or even on your hard earned vacation?
We must find a way to get relief from the High Alert State that we find ourselves in because it can damage our family and lead to mental health problems.
Being called away from family vacation and date night and your kids game is a part of the doctor life and each time you do it, it can chip away at your family’s foundation if you aren’t proactive to mediate these disturbances.
What can hospitals and clinics do to support the staff?
Dr. Simon Maltais is a cardiac surgeon and author of Healthcare Anonymous. He advocates for healthcare workers' mental and physical health. Dr. Maltais is has a doctorate degree in biomedical engineering and heart regeneration. He does heart transplantation, mechanical heart devices, and alternative cardiac interventions and has published more than 160 articles
He is forming a community to help health care workers in dealing and healing of chronic unhealthy behaviors, addictions, and associated physical and mental health-related issues like depression, burnout, and anxiety.
Show notes can be found at https://adoctorsperspective.net/179 here you can also find links to things mentioned and the full transcript.
E 179 Health Care Workers Mental Health Simon Maltais MD
00:00:06 – 00:05:10
Episode one hundred seventy nine healthcare workers mental health. I'm host that the justice trust claire. Today we hear dr simon multi perspective your joint award winning podcast host and bestselling author. Dr justin tros declared as people behind the curtain and talk to doctors and experts about their speciality marketing own life balance. Let's hear a doctor's perspective looking back to the show. I got some big news coming up soon but for now just know. This is my last hurrah in germany. By the end of the year. I will be out. It's been a good two years especially during all the corona virus and restrictions that we've had versus other places. I felt like we were in a really good place. Yeah we're gonna wear mask all the time at this point whatever but we were able to take our kids a lot of parks and things started opening up close and they'd open again so overall you know it's been really good and they're talking about this is because clinic i'm working at. We still grew. We still treated a lot of patients. We did the safety measures as you're supposed to and today's episode will be about the mental health of health care workers by a heart surgeon before you go into that anymore. The logo and color scheme has been updated so excited to show. You got that deep red lighter shade of green and i did a rebrand for my personal for my chiropractic for the media. Wanna do the wind sheets. Cv revisions so redid the logo for that. Let me know what you think. And then while i was doing what might as well do the podcast logo. Maybe some people didn't like the reverse perspective but anyway now it's changed. Hope you like it if you're looking for one cheese if you're looking for all the books that people have recommended all the series is that we've done that specifically like marketing or rehab. You can just go to a doctor's perspective dot net slash guide and all the links. Are there even all the affiliate things in the products. That i recommend so go check it out if you can support the show that way by shirt whatever finally get to do little vacation. Sore dini italy an island. Who so that'll be fun. Playing the water and a boat rise and just sees them caves and some hiking Should be good good time. So what are you doing. Where have you been in. Twenty twenty one. Let me know when all the social media which is on the top right of the website you can click that so again. We're going to talk today about with a cardiac surgeon discussing mental health. When you're on call all the time during the cova pandemic and you're missing family events and you've got gotta cancel vacations and you're tired and maybe you're making some mistakes. Maybe you're not but statistically you're more likely to if you're exhausted and you don't get a break three charge so i want to discuss all of that. What we can do about it. He wrote a book he wrote. A book called healthcare anonymous. It'll have a workbook and an action plan and all those things so we'll talk about that today. The transcript and the show notes can be found at a doctor's perspective dot net slash one seven nine. Let's go hashtag behind the curtain from germany in malibu california today with a cardiac surgeon who's also the author of healthcare anonymous. It's learning how to put yourself first while pursuing a calling and he does a lot of advocating for healthcare workers mental and physical health. Just so you know. He's board-certified from canada. He was a previous vice chair of the mayo clinic. His doctor degree in biomedical engineering and harvey generation. He is a leader in heart. Transplantation mechanical hard devices and a bunch of other cardiac stuff published about one hundred and sixty papers articles. I don't know how you do that a lot of old. And but i think right now. His biggest passion right now is for mentally a community so we can talk about identifying preventing and being active about unhealthy behaviors addictions and other mental health issues. That we have as doctors and healthcare workers like depression burnout anxiety that i cover everything here assignment multi that you just the no. It's great it makes me tired series. Oh my alkalies are out there again all that stuff. No it's important though you know. Sometimes you gotta get some credibility like all right. Who's this guy. What's he who is he to say. That we should have these stuff. And i would think with the way everybody talks about like. Oh i got health problems and it's always about blood pressure it's always about you know strokes and how to prevent heart disease. It's something that as a society i don't know for. I don't know you could tell us over. Focused are overly medicated. But at the same time as a patient is super important. What kind of brought you into like a cardiac side. And then the quick summary into morphine into like i gotta do something out there for other doctors that i see struggling they come. What's the backstory has always been very challenging topic you know and even to draining one of the things that really attracted me to the business was was the physiology of heart disease and then the city of the need for a very fine it technical abilities to do the operation and so this combination of is so is very appealing to me and end.
00:05:10 – 00:10:00
The patient's also very rewarding afterwards. They get better. They feel better really quickly after heart surgeries it to me. That was a great appeal. So it combined my you know my interest for the heart conditions in general but also my so the need to to get rewarded gratification. Or sort of this feeling that. I'm helping others and then over the last two years. It's as you know it's been a difficult year you know with the pandemic and then Seeing myself and other colleagues whether it's healthcare workers or art surgeons or even people were other people working in a hospital setting going through things. It appeared to me that i need to speak up about it and so i decided to write about what i call it in the book. Healthcare disease healthcare diseases a new term. It's not something here really is the system that tells us that makes people sick but but it is an environment that i think are. We're working in the makes things very difficult. Just become the culture because of the tragedies because of the suffering of people in a lot of us are unfortunately like whip to to deal with that most of the times thing we are not and then eventually you know we love some of these conditions that you mentioned whether it's zaidi depression or and we feel it's an acute moment. I know you're what you're so to get to a point where you can't feel it anymore whether my opinion and that's all the point of the book is it's a chronic problem that finally manifests itself through to symptoms. So so that's it was more of a calling need to sort of create a movement and help the help maybe others with personal stories sharing jump off real quick with the corona stuff where it's kinda hitting the rounds where you know last year. There's nothing you can do about it. You're the hero and this year free and forced to work and then now it's like if you don't get vaccinated for whatever reason you can lose your job which i mean. That's got to be really stressful to be in that situation as a chiropractor we. We did our measures. We could separate our schedules and all this kind of stuff. But it's a little bit different in hospital where you're required to see these types of people. Yeah and you feel. Feel a bit left out if i would have to. Maybe put a your bounced around between either politics are the you know the culture of the day and for and for physician and or no nurses and people working in this environment for two years day in day out having their vacation cancel and and we feel a bit left out in then that would be that or lonely you know and you know i'm not and this is not a debate of vaccine no vaccine but there's policy that have to be implemented but But having to go to work and sort of go through crowd of angry non-vaccinated people are are having vacations removed It hits the spot and right when you feel like you you've been you know in my one of my previous mentors always said you know. There's only one letter difference between hero and zero right and and you certainly feel that. Sometimes you go from them being called a hero to to perhaps being used in in in a certain way and the consequences of that is i think from a personal standpoint. It affects your family. It affects your finances and affects your mental health. And that's actually. I think the ultimate price that this society will in the long run from this like there's a lot of the patients you see are going to be different than just the general practitioner and things. But is there just the lack of proper diagnosis going on. Somebody comes in and the first thing is do you have corona like. I'm bleeding like i went to the hospital. For a reason i was bleeding and the first thing they were worried about was my corona status and went dude. I'm literally bleeding. I need help right there since being missed. There's a lot of things we don't understand. I mean in heart surgery alone. Were seen an increase in what we call. The observed predicted mortality. You know we typically know what the mortality will be for certain type of operation during the foget endemic and that's published data. We've seen people are dying more from just the same operation and that's because there's delayed presentation there's things we don't know about cova Were as you said earlier. There's misdiagnosis people have been treated for kobe or pneumonia associated with povich for a number of weeks and then all of a sudden maybe the hardest problem so Sammy look into that. And that's in two or three weeks of that going on so it has really exploded the system bids for lack of blood words. You know everybody's sort of made the best out of it and and tried to disagree just survive really you know and at least for my patients. I feel whether it's United states or in canada.
00:10:00 – 00:15:09
Where i practice as well. It's it's constant delays by. We don't have icu beds. We don't have. We don't have the capability to do just regular heart surgery in the wait lists are increasing bullet. Coming sicker okay. So we're really seeing these side effects if you will the unintended consequences of of covert were some people just like us. They're not even those aren't full. The hospitals on it was like okay but they are full the wings they gave up everything else. There's a backlog of like you said all this other stuff then delayed diagnosis. Yeah absolutely and then. I think the paper of people are sicker so therefore they stay longer in hospital and what you were saying about. In back of these massive departures from nell staff from ovid vaccine it directly impacts patient care and how they're being treated in the hospital for sure. So let's i guess it's kind of hard not to talk about kobe with the burnout and everything because it's so much more stressful but we work in high intensity environments. You have their life on their line. How was delivering of cares. It affected it in a positive or negative way. I mean our best medical people maybe not working at the best that they could because of the overwhelm that they're experiencing well. It certainly feels like the word call schedule right when your own call. You're constantly in the hospital. So that the 'cause you're tired you're hungry you're longley. You're sort of always in a sort of stress so the system. We all feel the bit on hype you know for the last couple of years where you're like being on call all the time constantly tires hours long that and then you know that's data as well you know whenever you're you're in. Those state of mind does lead to mistakes where i think that hits. The spot is the culture of healthcare whether your doctor or nurse every month do want to do was best for the beijing right. We're all perfectionists to some degree and not being able to be fully delivering are the highest level of care or or even or even making mistakes that we didn't intend to as a great impact on on our mental health. I think or for some people. It will be receiving a complaint from patient for some. It will be sort of facing death you know to us in the same week but it will. It does add up and leads to so significant consequences. People changing jobs people leaving their job. People having depression issues and then years now faced with a with a health worker the workforce that is gone from the system for six months and it has to heal from that so so it has a direct impact on on the delivery karen and while we see this as maybe a island right with someone they somebody has a depression or an event or you know god forbid suicide. The patients are the ones directly impacted by that. You know. I just recently had a colleague who retired after twenty five years just as a various number of reasons including ovid. Well that's fifteen more years that patients in agony be like treated for you know on. This has a lot of experience and things and so. That's unmeasurable meeting. Twenty five years in the got us a long time like no not really not enough for a surgeon. Not for a doctor. Who could be doing like you said so. You're sixty five seventy if you like what. You're doing a lot of patients that can miss out exactly twenty more years about the one hundred fifty two hundred patients a year. That's that's thousands of patients that this particular individual could have helped and we're not even talking about nursing and other sort of healthcare workers. So then what are we looking at as for as prevention or i guess i step back families. If you're on call all the time you got a husband wife at home you got kids. You're trying to not just always work all the time. You probably already were getting yelled at for not being at home enough again with and then now you have this. What's happening there. Do you have any insights. Yeah i mean inside is to take ause. I think in realize what's going on. I think that would be my my biggest advice Because not everyone has this ability and that's also in the culture our train to make the differentiation between work and home right and to some extent it's important to be able to talk about these things but when it becomes just one that makes it very hard to survive you know for both yourself and the family which years about things in the house. You're constantly in this sort of high alert state. I think some some individuals that had this ability to have a balanced own life and sorta take the work as a part of it than not all of it. Were perhaps it in a better state to deal with the consequences of being of work taking so much lace with the pandemic. And i think now at this point the ones that have been able to do that perhaps have a better way to cope with this prolong. Now you know pandemic Where i feel like we're whether the problem is constantly bringing things home where more your state of mind now is directly impacting.
00:15:09 – 00:20:03
Your kids your family and things. And i've seen i mean there's a high that's also posed things as high rate of divorces this irate of addictions whether it's alcohol and things within the condemning in healthcare workers and i and i assume part of that because of that so taking up ause i think is is important recognizing that that's part of the issue and recognizing yourself but also having the hospitals in departments active on it then and realize that that's part of their longevity program right so making sure that people are are balanced in some way but the but unfortunately that sort of balances out the resources and the need for the patients and things like that so it's always more of a conceptual concept than something. That's hard to sort of apply on but hopeful that you know part of the book part of the message here will be. We'll be heard and some some places other places started. Do we'll put a focus on that. You know because you're not happy at home and that's another saying one of my mentors. You can't be happy at work of homes all chambal you know. Are you allowed if you're not on call. But something happens and they need you know. I'm i'm at the zoo with my family for the first time in twenty five days like this person is going to have to die. Like i'm not going like. Can you ever do that. Like mentally are legally or like what happens in those types of i mean. I'm not just saying for hard but you know an ortho or something like that. I mean you're gonna lose his leg if you don't come right. Well i guess he's gonna lose a leg. He technically is a guy on call. But you know the reality is. Oftentimes you get pulled away from family. Obligations obligations altogether I've had to fly back to from vacations. I've had to cut dinner. Shorts is my major's going off not being on call or being the one supposed to be called sometimes. The person that's on call is busy doing something else. And so so you sort of have two tragedies at once well yeah it does happen a lot of suffering but the but yet you do have to do that and then you know what happens. Is you solve slowly chip away a little bit of it every time you get back to where you were before with yourself or with your family but the reality is you don't and so what happens is gradually downward slope. Where every time you get up and go every time you can't sole family vacation every time you you go back you do have to. You do have to realize that has a direct impact on your work life balance and on your family so While duty calls. I i guess i'm not answering your duty calls you so they have to. Sometimes maybe pounder you know. People who are like students are thinking of who maybe catch this podcast. They're thinking about becoming doctors or those type of doctors that would be on call. Would you'd have to miss family. You need to consider that. Do you wanna family. Do you have family. Are you okay with always. Maybe having to go to work and doing these things because if that's not themes that you want to do with your life and you're going to have to pick a different type of specialty where you don't have that situation i would think because that's a real part of life art of the what we do. That's why i think you know for departments and hostile hiring more people you know to do the work hiring. The people being able to translate the the ability to do a certain type of names. You know they always historically a lot of servers over living that life you're describing right and say i'm the one i this is what i do. I always have to put this first But then there was not as much maybe passage of information or passage of training. I think you know being able to delegate and help others bring your bring their skills up so you do have life. A little bit is probably the solution but like you said realistically there are specialties. That perhaps don't have as much you know commitment from a lifestyle. I know things that are similar to us. Neurosurgery heart surgery. You sort of have to go and help their others be knocked. Her physical therapy chiropractic. Have any emergency after hours. You gotta headache all right. Well remember that seinfeld episode the madala. Just you know the real guy answer exists so you know. It's it's a life choice you make. But in any specialties. Give yourself all in. You can get called all the time you know. So it's a matter of balancing that sort of Ability to live a balanced life. I kind of the closing couple of questions. You're at the hospital or clinic or something and you noticing a lot of your co workers are having some of the problems that you're talking about. Is there a way for them to go to. Hr or whatever and management and talk about when you have some kind of group therapy or have access to be able to go and talk to somebody for thirty minutes a week because it's it's getting out of control.
00:20:03 – 00:25:04
What can we do to help ourselves. There are some systems you know. There's physician helplines. There's programs attempt to court the hospitals so the system is always there to help. If you need to the problem i think is creating a community between us where you feel like you can either prevent or speak up about these things without fear of retaliation because unfortunately it doesn't happen all the time but you feel like by speaking up about burnell depression or feeling this. I'm exhausted or i have the significant issue you feel best would affect your professionalize of nice people. Wait to consult there to go to the formal process that the hospital have in order not to now insane retaliation but order not to affect their career and i think the while the system is there to help it tends to answer an acute problem when people have obviously many episode or of a really losing this issue then they have people to help acutely. But the problem's been there for a while so establishing systems i think that are progressively continuously so the helping people Create a community where people feel like they can speak up with her. I know in the recent place i was. We read like meditation afternoon. Every friday yoga we sort of created this ability to people speak about issues and and a bit sort of deescalate things. When they're they're busy tend to sort of per separate little bit so being more proactive about it. But there are systems out there We are trying to create a community of sort of like minded people that want to help and want to create a space for people to speak up and so hopefully we need a bit more of that in this sort of movement or endemic. So the time you know. I do setup up anything like a web page for your book or for some of this outreach. You're referring to yes so healthier anonymous dot com. Find the book you can find the blog you can find out up yet as of today but The typing healthier anonymous dot com. We will have a blind. We have a facebook page. We also were also have a podcast every week. The talk about all things healthcare related With the book you get access to community you get a working in a workbook to as a path to sort of recovery. So i mean we're at as a small level with all the humility humility in the world. We're trying to create a movement. Help people within the book. There are some personal stories of a lot of people that have gone through things and got on the other side. And there's sort of these practical tips for both the physicians or the healthcare workers and the hospitals to sort of increase the awareness about about health mental illness. And maybe started bath recovery kronos you. It's not easy to write a book especially with this magnitude of an impact. It can have on healthcare system. Even if it's just one hospital or one big clinic that would take it in utilize what's written in there. You know what. I mean work through. Let's go through it together. They could change all the lives in that place. The patients the community so it doesn't have to be the biggest world thing but if you can the small pockets and then things change and then things grow so. I really hope that this works for you. I mean whether it works for me or not. It was an open heart. Different type of open heart process works but it also i think if we can i if you go back and start the process even sooner in medical training nursing training to increase awareness about this maybe also taylor people's personalities whether your nurse or doctor to go two different directions depending on what you want to add a life and and sort of objectives you malicious as opposed to for me going to the most prestigious you know profession in the world that i could get in you know and i love what i do. Don't get me wrong with my personality. Was directly so the catapulted the heart surgery and i feel like perhaps maybe in training if i would have been exposed to different things it would have been a better v. I know it so So maybe even sooner in training trying to assess the importance of a healthy mind you know as a doctor at in order to optimize patient. Care very good. This was great. I really appreciate your time to be on the show and to share your message because this is stuff that i've talked about a little bit in different aspects for for burn out in different things so it's really good to another viewpoint and hit this topic again in a different light where it's a community based so i really appreciate your time today. Thank you for the invitation. And thank you for what you do for our community as well. Another great interview has ended while you're on your phone.
00:25:04 – 00:27:53
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