Dr. Derek Puddester, psychiatrist-author-health ambassador-conduit of joy
“The humanities are of critical importance in medicine today—being in touch with our humanity is essential.”
It only takes a few steps into the delightful journey of learning about Dr. Derek Puddester to discover two important things about him: that his personal life is as rich and fulfilled as his professional life; and that he’s the kind of person who positively impacts everyone he meets.
This is a man who’s achieved great success as a clinical psychiatrist at the Children’s Hospital of Eastern Ontario (CHEO), and as a professor and Director of the Faculty Wellness Program at the University of Ottawa. Yet his colleagues are just as likely to tell you about his unquenchable joie de vivre, love of travel and penchant for Evil Dead The Musical as they are to rave about his success in launching ePhysicianHealth.com and eWorkplaceHealth.com, receiving the 2010 C.A. Roberts Award for Clinical Leadership (among many others), and changing and saving lives around the world.
Ottawa, Ontario’s Dr. Kimberly Sogge, who recommended Derek as a Kickass Canadian, had this to say: “Improving the health and wellness of healthcare providers is a passion of mine, and Dr. Derek Puddester is the best I know of (in this field) in Canada. There may be nothing more noble than creating an infectious wellness in the heart of an unwell system of care.”
Dr. Simon Davidson, uOttawa’s former Chair of the Division of Child and Adolescent Psychiatry, and the man responsible for recruiting Derek from Memorial University in Newfoundland, says: “Of all the child and adolescent psychiatrists to have applied for promotion within the Faculty of Medicine at the University of Ottawa, Dr. Puddester has enjoyed by far the fastest trajectory of progress through the ranks, and deservedly so. The combination of his broad-based clinical and educational skills, together with his thoughtful and visionary leadership style, make for an individual who has already accomplished a great deal and effectively is only beginning his career.”
My friend—and one of the team members of both ePhysicianHealth.com and eWorkplaceHealth.com—Dr. Emma Stodel also had wonderful words about her colleague and mentor: “Derek is a visionary, with the chops to make things happen and to change lives. Working with him has changed my life and who I strive to be. Derek models dedication to his work as a clinician and an educator… yet he balances this with a similar dedication to his family, theatre, travel and so much more. Indeed, balance is what I respect most about Derek. He has the biggest heart of anyone I know, yet this doesn’t make him a pushover. He is brilliant in his field of expertise, but is humble and quick to praise others. He deals with tragedy on a daily basis, but is quick to smile.”
Everything in my so-far brief excursion into Derek’s world reinforces what these three think of him. In the midst of his extremely busy schedule, he’s still able to quickly put together comprehensive notes in response to my questions—and they come complete with smiley faces and good humour. It’s a pleasure to share his story here, because his enthusiasm and joy are infectious and should be channeled to as many people as possible.
For those of you who aren’t among the tens of thousands of people worldwide who have benefited from Derek’s work, I’ll start by introducing some of his astonishing professional accomplishments.
Among Derek’s many titles, he’s Medical Director of the Behavioural Neurosciences and Consultation-Liaison team at CHEO and Director of Professional Development and Continuing Education for the CHEO Department of Psychiatry. His work at the hospital is focused primarily on children and youth affected by severe physical and mental disorders.
At uOttawa, where Derek is also Associate Professor in the Department of Psychiatry, he’s achieved incredible feats as Director of the institution’s Faculty Wellness Program. Working with a multidisciplinary team of members from the medical and academic communities, Derek develops and delivers preventative, educational, interventional and rehabilitation services to medical students, residents and staff physicians.
Perhaps the most pivotal contribution Derek has made through the Faculty Wellness Program is his work with e-learning. Since launching ePhysicianHealth.com and eWorkplaceHealth.com in 2008, Derek and his team of uOttawa Faculty of Education superstars have improved—and in some cases saved—the lives of countless people around the world.
ePhysicianHealth.com, for which Derek won the 2010 International Award of Excellence in Business/Professional Education from the International E-Learning Association (IELA), is having a particularly resounding impact. “We have thousands of users every month, who come from almost every country on Earth,” says Derek. “I’m humbled and pleased with that result.”
The bilingual website—available in French at e-santedesmedecins.com—provides a series of modules on physical and mental health issues, each of which offers practical advice from Canada’s leading physician health experts on how doctors and medical students can maintain and enhance their own health and wellbeing. Derek realized that the time had come for such a free online resource when the demand for his workshops on physician health began to reach exponential heights. As it turns out, it couldn’t have come a minute too soon.
“I often get emails from users of the site,” he says. “Some of them are straightforward notes of appreciation, some of them are inspirational stories of how the site has saved their life. I can think of many stories of suicidal physicians who sought emergency care after consulting the site, teams who used the modules on disruptive behaviour to modify their communication and shared accountability, and hosts of learners who used the site to promote their health and wellbeing. We’ve saved and influenced thousands of lives.”
The site’s most popular module is Depression, Burnout and Suicide, which Derek expected based on the project’s initial needs assessment. But he’s delighted to report that the next two most popular modules are Fitness, Nutrition and Exercise and Resiliency. “This suggests that physicians are highly interested in health promotion and disease prevention, and will use that interest to promote their own wellbeing,” he says.
Another component of the website that gets a lot of hits is Carpe Diem, the 22-minute documentary Derek produced and directed in partnership with uOttawa, the Canadian Medical Association (CMA) and the British Columbia Physician Health Program. Launched in 2010 at the inaugural Canadian Physician Health Conference, the documentary’s goal “was to share stories of the resiliency inherent in the Canadian physician community,” says Derek. “To focus on the positive, the beautiful and the sustainable. We filmed all across Canada, and the locations added a depth to the dialogue that resonates well with audiences.”
Derek’s dedication to making life better for Canadian physicians has been a longstanding hallmark of his career. Since 2000, the Dr. Derek Puddester Award has been given out annually by the Canadian Association of Internes and Residents (CAIR) to “an individual who has improved the health and well being of residents in Canada.” But his overall commitment to healthcare takes a much wider view, extending to the general public as well as members of the medical community.
“I’m deeply concerned about mental healthcare in general,” he says. “We have fought a war on stigma for many, many, many years and we seem to be winning. More than ever before, patients are willing to seek care and early intervention to promote their mental health. Yet our system is poorly coordinated, largely piecemeal and lacking a national vision to respond to (an increased demand for assistance). Canadians deserve better—particularly children and youth living with highly treatable mental health concerns.”
As Derek sees it, coordination is a huge part of the solution, and the only responsible and logical way to move forward in the field. He’s happy that the era of the solo practitioner is finally over, and that governments, medical associations and patient-leaders (such as fellow Kickass Canadian Julie Drury) are helping carve out a place for an integrated model of healthcare.
In spite of his concerns about the healthcare system, Derek takes inspiration from our country’s efforts in primary care and health promotion. As a global leader, particularly in the areas of integration, patient safety, standard development, accreditation, medical education and health professional sustainability, he says, “Canada has much to be proud of.”
Derek’s pride in the country goes well beyond its medical accomplishments. The son of a military father, he was born in Germany but raised mainly in St. John’s, Newfoundland. Thanks to his father’s position, Derek spent much of his youth travelling across Canada, an experience that gave him “a sense of the beauty and delight that is our country.”
His favourite memories include hiking in the Rocky Mountains and building snow forts along the Atlantic coast. But no matter where he travels or lives, he insists that Newfoundland will always be home. “I feel a deep connection to the culture, the geography, the arts, the food and most importantly the people,” he says. “Every time I’m there, I feel a spiritual connection that is unlike any other I’ve enjoyed on earth… I simply can’t get to Newfoundland enough.”
Derek may well have stayed in Newfoundland, had Dr. Davidson not had the “good fortune and delight” of recruiting him to uOttawa in 2000. And he may well have missed his calling as a doctor, had another mentor—his Mount Pearl Senior High English teacher Mr. Eldred Barnes—not spotted Derek’s gift for medicine.
Derek carried out the bulk of his education at Memorial University of Newfoundland, including a BMedSc in 1994 and MD in 1995 (he’s since picked up an MEd from uOttawa in 2008 and Graduate Certificate in Executive Coaching from Royal Roads University in 2011). But his academic career began in the arts, with a BA in English and Russian studies in 1991.
As a high school student, Derek had thoughts of pursuing medicine, but didn’t think he had enough scientific inclination to go through with it. Fatefully, Mr. Barnes confronted him and said, “You really like to help people, and medicine is an art as well as a science.” Then he dared Derek to apply to medical school, and the rest is history.
That’s not to say, however, that Derek has abandoned his artistic side. He says that his arts background informs his medical career on a near-daily basis. “The arts teach us how to feel, think and communicate. These are all skills that are necessary to a sustainable career in medicine, particularly fields like child and adolescent psychiatry and physician health. I find myself in many clinical encounters thinking about novels I read, poems I’ve enjoyed, plays I’ve seen, paintings I’ve appreciated; all help me search for pattern and meaning in the complexity I see. It’s amazing how insight into the human condition can come from such an array of disciplines… The humanities are of critical importance in medicine today—being in touch with our humanity is essential.”
In addition to applying his artistic proclivities to his patients and studies, Derek makes time to follow his creative passions in a more direct way. He’s written novels, plays, short stories and hundreds of poems. “Some have been published, which is always fun, and others sit contentedly in journals and diaries,” he says. His most recent novel, which he describes as “a love story about a complicated friendship that evolves into a lifelong dance of love and (quest for) meaning in a postmodern world,” has been accepted for publication and is slated for a 2012 release. (First, though, he has to complete the Time Management Guide for Canadian Physicians and Residents, which he’s writing with a colleague at McGill University for the Royal College of Physicians and Surgeons of Canada.)
Derek draws inspiration for his creative works from many sources. Newfoundland is high up on that list. So is his family.
The Puddester clan includes Newfoundland dogs Max and Seamus, Derek’s partner, and Derek’s beloved young son, whom he calls “the best thing that has ever happened to me. He inspires me more than any sunset, makes me laugh more than any movie or play, and sustains my spirit more than any system of belief. He gives meaning to my life.”
That Derek’s family has been recognized as a unit is perhaps one of the things about his country that makes him most proud. “As a gay man, I think it’s important that Canada is mature enough to respect my human rights, which has included the right to adopt my son, get married—and divorced—and live with an expectation of dignity and human decency.”
Building on his family is just one of the things Derek hopes to do as he continues to hurtle—in between play breaks—along his astonishing career trajectory.
Here’s his current to-do list:
Have more children
Learn and teach mindfulness meditation
Perform in community theatre productions
Take film classes
Travel to new places and revisit beloved ones (especially Newfoundland and Iceland)
Introduce new local courses in professionalism and advocacy
Launch the Canadian Institute of Physician Health
Publish more healthcare books
Publish more novels, plays and poems
Raise funds for and develop 14 additional modules for ePhysicianHealth.com
Translate ePhysicianHealth.com into more languages Continue contributing to medical research and policy development
Delivering dozens of keynote speeches each year, and fulfilling current duties at uOttawa and CHEO
Take in as many productions of Evil Dead The Musical as possible
Still striking a balance. Always striking a chord.
* * *
For the latest on Derek’s work, join him on LinkedIn, follow him on Twitter, read his blog, or visit ePhysicianHealth.com and eWorkplaceHealth.com.
Written by Amanda Sage on December 6th, 2011.
© 2011 Amanda Sage. All Rights Reserved.
Designed & developed by Thomas J Bradley.
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The best ideas are those brought to fruition with the help of good friends, colleagues, experts, and coaches. ePhysicianHealth.com, now in use in over 90 countries around the world, owes its success to such collaboration.
Recently, the Canadian Medical Foundation released their annual report and highlighted their support of the project. The CMF dedicated support and resources to fully translate the site to french and has also funded and led a major marketing project which launches in April 2011.
Thanks to their leadership, ePhysicianHealth.com/eSantedesMedecins.com continues to make a difference in the lives of thousands of users across Canada and beyond.
I had a wonderful opportunity to give rounds at my Alma Mater earlier this winter on the topic of physician health. It was so nice to be able to give something back to my medical school; they had offered me a world-class education, supported my interest in politics and the humanities, and tolerated bright green shoes at a time that such tolerance was still unexpected!
It was great to have local experts on physician health present - Rosemary Lahey from the Newfoundland and Labrador Medical Association's Physician Support Program and Dr. Michelle Neary, Memorial's Wellness Consultant also shared their resources and expertise.
Memorial is a school buzzing with innovation. Its a special place, home.
Here is a summary of their article on the event (MUN Med Winter 2011, article by S. Gray):
MUNMed grad Derek Puddester (Class of 1995) has a refreshing take on health. A child psychiatrist by training, he’s become well known in the field of physician wellness.
Just visit ePhysicianHealth.com and you’ll see what he’s created. This comprehensive online physician health and wellness resource is designed to help physicians and physicians-in-training be resilient in their professional and personal lives.
During a recent visit to St. John’s, Dr. Puddester, who is the director of the Canada’s first Faculty Wellness Program at the Faculty of Medicine, University of Ottawa, gave a presentation on his work titled Physician Health: It’s all about You. Really!
“There are many challenges facing physicians in maintaining a healthy lifestyle from lack of sleep, poor nutrition, limited recreation and demands on their limited time,” he said. “Some of the consequences of this is that about half of doctors consider leaving medicine at some point – 46 per cent report being burned out and 18 per cent are depressed. But only two per cent seek help.”
Help is what ePhysicianHealth.com offers. The site is divided into 14 modules, each focusing on specific mental and physical health issues. Nothing is taboo, from substance use disorders, anxiety, nutrition and fitness to depression, burnout and suicide. The most personal subjects are addressed – with real solutions and readily available to Canadian physicians, anonymously, with a click of a mouse.
“It’s a great site which uses doctors in practice to present interactive modules on everything from mood disorders, harassment and intimidation in the work setting, to boundary issues,” said Dr. Scott Moffatt, Discipline of Family Medicine. “It uses video clips to highlight the issue and then reviews how to deal with specific issues. It’s a site that any of us can access to get current Canadian information on stuff around physician health, to use individually or in the development of presentations.”
Wellness consultant Dr. Michele Neary is also a fan of the site. “It is so important for the messages about wellness to get to the broader audience. Students learn by example and if their mentors and tutors are exhibiting healthy choices about lifestyle and stress management, they are likely to emulate them. I also think that it is important that physicians and others in the medical field take care of themselves. A healthier medical workforce translates into happier people and better outcomes for the medical community and the people who are served by it.”
Dr. Puddester’s voyage to becoming a guru of wellness began after he was recruited to the University of Ottawa while finishing his residency at McMaster University. “I was offered a Fellowship in child psychiatry, but I quickly moved to being on staff. Now my time is divided between child development and being an associate professor.”
Derek has some great memories of medical school at Memorial, and a lot of gratitude. When he entered medical school he had six courses left to finish an English degree. Determined to finish, he did all but two when he rang out of money for tuition. “I needed $666 for the last two courses, and Vera Griffin, who was the student affairs officer, got me the money – she got me my BA.” Because of this, Dr. Puddester has always given generously to the Student Contingency Fund.
While doing his MD at Memorial, Derek almost chose surgery as a specialty. “Paul Gardiner, Mary Wells and Maxine Crampton really influenced me – they are all amazing surgeons and gifted communicators, dedicated to their patients.” Although eventually drawn to psychiatry, Dr. Puddester said those three people had an enormous influence on him.
An amazing meeting thanks to the leadership of Dr. Sandra Boone and colleagues at the American Medical Association in collaboration with the CMA and BMA.
MD News was on site and captured many of the scientific events and speakers. Check them out at: http://www.mdnews.com/video?video=13859&page=1
Young Psychiatrist Honored for Efforts to Improve Mental Health of Fellow Physicians (Medscape Medical News)
October 22, 2010 — Derek Puddester, MD, director of the Faculty Wellness Program for the Faculty of Medicine at the University of Ottawa, Ontario, Canada, has been honored by the Canadian Psychiatric Association for his work in improving mental health services for his fellow physicians.
The association bestowed the Charles A. Roberts Award for Clinical Leadership on the young physician at its 2010 annual meeting, which was held in Toronto last month.
Dr. Derek Puddester
Simon Davidson, MB, FRCP(C), who endorsed Dr. Puddester's nomination for the award, told Medscape Medical News that he had the "good fortune and delight" to recruit the graduate of Memorial University of Newfoundland, in Canada, in 2000 to come and work in Ottawa as a child and adolescent psychiatrist.
Since that time, Dr. Puddester has not only managed to excel in that capacity but has also done exceptional work in establishing a wellness program geared toward helping physicians attain and maintain their mental and physical health, Dr. Davidson noted.
"Of all the child and adolescent psychiatrists to have applied for promotion within the Faculty of Medicine at the University of Ottawa, Dr. Puddester has enjoyed by far the fastest trajectory of progress through the ranks, and deservedly so," Dr. Davidson said.
"The combination of his broad-based clinical and educational skills, together with his thoughtful and visionary leadership style, make for an individual who has already accomplished a great deal and effectively is only beginning his career."
No Talent for Medicine?
In an interview with Medscape Medical News, the 30-year-old Newfoundland native confessed that he probably would not even have thought of applying to medical school if it had not been for a particularly astute university professor who told him he would miss his calling if he did not become a physician.
"I did English and Russian studies as an undergrad at Memorial, and one of my mentors knew that I thought about working in medicine, but I really didn't feel that I had the talent for it," he recalled. "I don't see myself as a super intellectual, and I'm not really a scientific kind of person. My strength didn't lie in biology and biochemistry."
Then his mentor confronted him: "He said, 'You really like to help people, and medicine is an art as well as a science. If you don't pay attention to this, I think you are going to miss your calling.' So he kind of dared me to fill out an application to medical school. And I kind of did it as a 'Yeah, whatever — I'm not going to get in, but I respect you, and if you think I should do it, I will.' And I got in! And I remember saying, oh no, now what do I do? Everybody is going to find out that I'm really an art student."
In fact, his arts background turned out to stand him in good stead. "Actually, having a humanities background is probably the thing that has brought a lot of sustainability and a lot of health to my work in medicine," Dr. Puddester says.
His interest in physician health was inspired by the work of Michael F. Myers, MD, a global expert on the subject who was professor of psychiatry at the University of British Columbia, Canada, before moving to the State University of New York Downstate Medical Center, in Brooklyn, where he is professor of clinical psychiatry.
"Dr. Myers is viewed as one of the pioneers of physician health in Canada," said Dr. Puddester. "His scholarly output has been incredibly powerful. For anybody in physician health, we think of Mike Myers as the guru, the master, the inspiration. He was a real mentor. I'm so grateful that I can say he's a really good friend. He's amazing."
Another role model is Graeme Cunningham, MD, a physician who conquered substance abuse himself to establish the Homewood Health Center, one of the premier facilities for physicians with substance and alcohol addictions. Troubled physicians from around the world come to his center in Guelph, Ontario, Canada, for rehabilitation.
"His programs and services are brilliant. What I really love about Graeme is he put on the table the notion that disruptive behaviour by doctors can no longer be tolerated. Thanks to him, we now have policy efforts, diagnostic efforts, and treatment efforts in the physician health community to help the 5% to 6% of doctors with disruptive behaviour get help and get back to their workplace and not hurt others. Graeme's work is seminal and very important. He's a remarkable man," Dr. Puddester said.
Stigma a Barrier to Care
In the beginning, the physician's health movement in Canada focused on physicians who were addicted to drugs. The field started to open up in the 1990s to also embrace mental health as programs started to see some physicians with mental health issues as well as substance abuse issues.
Now, says Dr. Puddester, things have evolved to the point where all programs are focusing not only on mental health but also on physical health issues.
For example, the Faculty Wellness Program at the University of Ottawa helps physicians learn how to be patients. It helps them find experienced family physicians of their own and embrace ideas of primary and preventive care.
Physicians aren't very good at taking care of themselves, so we are attempting to get them to practice what they preach. But there are things that hinder them from following the advice that they give to their patients.
"Physicians aren't very good at taking care of themselves, so we are attempting to get them to practice what they preach. But there are things that hinder them from following the advice that they give to their patients," Dr. Puddester says.
Perhaps the most formidable obstacle physicians face is time — more specifically, the lack of it. "Canadian physicians work 70 to 80 hours a week, on average. Most Canadians don't do that. So most doctors work 2 work weeks for the average Canadian work week."
Another barrier is access to resources. Just as Canadians in general find it difficult to access primary care, so do physicians.
"Doctors find it doubly so, in fact, because they don't want to take a slot that they want their patients to have. Also, being a physician patient requires working with a physician provider who is comfortable working with doctors, and that's a unique skill set," says Dr. Puddester.
It can be really embarrassing and shameful for doctors to admit that they're human, that they may be vulnerable, and that they may have healthcare needs. They worry about taking that to a colleague.
The third barrier is stigma. "It can be really embarrassing and shameful for doctors to admit that they're human, that they may be vulnerable, and that they may have healthcare needs. They worry about taking that to a colleague," he says.
Balance Key to Good Health
Finding a healthcare professional at the primary care level is very difficult for physicians. The Faculty Wellness Program is trying to help by keeping a database with the names of family physicians who are willing to give up some time to take care of colleagues.
The program also keeps track of psychologists who can help physicians with mental health issues, and of specialty clinics that can help with substance abuse problems designed especially for physicians.
Key to good health is taking time away from a busy practice to spend with family and friends, Dr. Puddester says, and here, he practices what he preaches.
"My family is really important to me. We spend a lot of time together. Ottawa is a great city for families and kids, and we do a lot of outdoor stuff," he says.
Right now a favorite activity is geocaching, in which a global positioning satellite device is used to hide and seek objects in various locations. "It gets you out in the woods. You get a set of coordinates, and then you go there and there might be a prize or a puzzle. It blends a physical activity with a mental activity, and it gets you out in the woods. We really like geocaching."
My professional life is divided in 2: I spend half my time working with children and youth with severe physical and mental health problems, which I love and enjoy, and I have this other half, which is physician health. I feel very blessed that I'm able to have a foot in both camps.
Another favorite pastime is travel. "We love to explore the world. I spent a big part of the summer backpacking around Iceland with my son and my partner. We climbed volcanoes and learned to speak another language. It was great," Dr. Puddester said.
Christmas is a time for rituals. "We go out to Montebello for Christmas and see Santa Claus come through the chimney. We go skating on the canal, and skiing in the Gatineau's. Those kinds of rituals are very important to me and my family," he says.
In keeping with his arts background, he also does creative writing.
"I'm not perfect. I'm a human being, and there's a lot of stuff I can work on too. But I do try to keep my focus on what's important. My professional life is divided in 2: I spend half my time working with children and youth with severe physical and mental health problems, which I love and enjoy, and I have this other half, which is physician health. I feel very blessed that I'm able to have a foot in both camps. I have a good life. I'm very lucky."
Authors and Disclosures
Journalist Fran Lowryis a freelance writer for Medscape.
The International E-Learning Association (IELA) is dedicated to advancing the knowledge and practice of e-learning in the classroom and the workplace. With members hailing from every continent—and from the realms of business, industry, government, and academia—the IELA is a vibrant and diverse community of e-learning professionals, researchers, and students.
IELA presented its international awards of excellence at its "International Computer-Aided Learning Conference" on September 17 2010 in Hesselt, Belgium. ePhysicianHealth.com was selected as the winner in the Business/Professional e-Learning Category.
ePhysicianHealth.com is now in use in over 80 countries around the world and growing by 50% per month. It is wonderful to see the resource be of such value.
Congratulations to our team of content experts, instructional designers, programmers, and -of course - our users.
So honoured to share the following...thanks to the team of nominees for a delightful, unexpected, and encouraging surprise!
(uOttawa Media Relations, July 28 2010) - Dr. Derek Puddester, Director of the Faculty Wellness Program at the University of Ottawa, is the recipient of the 2010 C.A. Roberts Award for Clinical Leadership. This national award is bestowed upon a CPA (Canadian Psychiatric Association) member clinician who has been instrumental in developing new treatment approaches, creative program design or administrative innovations, and who has been recognized for consistently providing superior quality psychiatric care to patients. Upon taking his title as Director of the Faculty Wellness Program, Dr. Puddester not only provided service to our faculty members, but has developed the program substantially to meet the depth and breadth of his vision and has contributed to the success of e-health projects nationally and in 40 other countries. This is indeed an honour and well earned prestige. Congratulations to Dr. Puddester for all his hard work and dedication!
RNAO has hosted a one-week institute for health professionals on the theme of workplace health and wellness for several years. Jam-packed with cutting-edge, evidence-based, and common-sense recommendations, it is highly regarded for having a meaningful shift in workplace culture in Ontario.
I was honoured to deliver the closing keynote and had so much fun working with participants on the theme of implementing things learned back in their home workplaces. We spoke about social networking, managing resistance, staying focused, taking care of themselves/others/patients, and shared a lot of emotions about issues related to underestimating one's ability to influence others.
So very grateful for the opportunity to work with such a great organization and such innovative learners.
Check out RNAO and their globally-respected work here: http://www.rnao.org/
The World Medical Association is preparing to shed a lot of light of physician health and sustainability thanks to the leadership of Canadian President Dr. Dana Hanson.
In August, Dr. Michael Myers and myself will join Dr. Hanson and others in Brazil where we will partner with the Brazilian Medical Association and deliver an action-packed, interactive, and practical two-day curriculum in physician health.
To say we're honoured and excited simply doesn't capture it! The Associacao Medica de Brasilia has also been promoting Carpe Diem and ePhysicianHealth.com resulting in a marked increase in access and utilization from South America.
Check out the Brasilia event here: http://www.amb.org.br/resiliencia/eng
Now...I need a Rosetta Stone!
The CARFLEO conference was jam-packed with brilliant educators and students from across Canada and they tackled topics like pornography, intimacy, sexual orientation, drugs, communication, community, and engagement with great passion.
CARFLEO filmed the speakers discussing these topics in advance of the conference as part of building a curriculum resource bank. I thank them for letting me share my clips on: Engaging Youth, Preventing Suicide, Tough Issues, Curriculum of Life, on Growing Up, on Orientation, and Homeless Youth here.
The team at VitalSmarts (www.vitalsmarts.com) offers evidence-based, practical, cutting-edge training in organizational health and well-being. Two streams of practice focus on "crucial" communication skills: conversations and confrontations.
These communication models are based on the resilience and expertise of highly competent and successful leaders who innately brought such skills to their work environments. After much study, the VitalSmarts team wrote "Crucial Conversations" and "Crucial Confrontations" - both New York Times bestsellers and well-regarded globally.
Both have been adapted for the health sector after critical research - see www.silencekills.com. In Canada, these principles are now being taught in hospitals and clinical settings and are slowly being introduced into the health sciences. uOttawa will be offering training in both models on a monthly basis starting in June 2010 and registration is already brisk.
To register, contact the Faculty Development Office at www.medicine.uottawa.ca/facdev and see the attached brochure!
Ontario is firmly committed to making health care accessible, cutting-edge, evidence-based, and sustainable. These are no small goals in today's economic environment and its fantastic to be part of these efforts.
Today, I'm honoured to be speaking with the Hamilton Family Health Team on themes of personal/professional sustainability and interprofessional collaboration. I completed my residency at McMaster and always welcome an opportunity to return to Hamilton and express my appreciation for the rich training it offered me.
What are family health teams? Check this out (www.hamiltonfht.ca):
"Family Health Teams (FHTs) are a key piece of the Ontario government's plan to build a health care system that promotes good health, improves the care individuals receive, reduces wait times and increases access to care.
In Family Health Teams, family doctors work in teams with other health care professionals to see more patients and to keep them healthy.
The Hamilton Family Health Team (HFHT) includes 129 family doctors, nurses and nurse practitioners, dietitians, mental health counsellors, psychiatrists and pharmacists. These teams are located in many different locations across the city of Hamilton, and together they serve over 250,000 people."
Working in health care in Ontario is a privilege and an honour. But its also challenging, demanding, and stressful. Working in teams, such as the Hamilton Family Health Team, promotes better patient care, improved health professional resiliency, and sustainability of the health care system. I'm looking forward to spending time with such an innovative group of professionals and learning more about the care they provide to their patients and to each other.
On May 2nd 2010, the Canadian Medical Association's Centre for Physician Health and Well-Being and the Association of Faculties of Medicine of Canada's Resource Group on Physician Health and Well-Being (now there's a mouthful!) will be coming together for the first time to deliver a special workshop.
The venue is the Canadian Conference on Medical Education which, this year, is being held in my hometown of St. John's, NL. Its going to be fun to show many of my colleagues around one of Canada's most european cities and a particular joy to see so many of my friends back home showcasing their talent on the national stage.
Practicing what you (don't) Preach; Preaching what you (don't) Practice: Teaching, Learning, and Evaluation in Medical Student and Physician Health and Sustainability.
Derek Puddester, MD MEd FRCPC (uOttawa)
Dorothy Emslie, MD CFPC (McMaster)
Barbara Fitzgerald, MD FRCPC (UBC)
Susan Edwards, MD CFPC (uToronto)
At the end of this 90 minute workshop, participants will be able to:
- explain why a physician health and wellness curriculum is an essential component of a healthy medical school
- be familiar with practical, applicable, and evidence-based pedagogical methods relevant to this topic area
- be able to integrate teaching in physician health into a busy and crowded curriculum
- identify methods to promote faculty development and sustainability
The speakers are fun, energetic, and blunt. They will encourage participants to challenge current dogma, pursue critical thinking, explore the "hidden curriculum", and consider how best to make real and meaningful changes back home.
We anticipate a large group for this session which will beheld in the Convention Centre - Hall A.
Thanks to AFMC and the CMA for creating and supporting this initiative.
To mandatory nap or not to mandatory nap
It’s safe to conclude that most people would not take issue with a requirement that they take a nap at some point during their workday. The United States Institute of Medicine even urges that a five-hour snooze should be made mandatory for all medical interns and residents who are putting in 16-hour shifts.
The Canadian Association of Interns and Residents, though, isn’t convinced of the value of mandatory naps. In fact, Executive Director Cheryl Pellerin says that if naps are added into contracts, they could interfere with a resident’s training — he or she might miss a procedure vital to a good education..
Mandatory naps are among options being bandied about in response to growing concerns that lengthy shifts for interns and residents compromises the safety of patients. While many jurisdictions are still exploring alternatives, the European Union has adopted a maximum 48-hour workweek as its solution to the problem (CMAJ 2009. DOI:1503/cmaj.109-3111).
The US Institute of Medicine waded into the debate with a recommendation that every resident or intern should be obliged to nap for five hours — at some point between 10 pm and 8 am — for every 16 hours they work. During the nap, there should be no interruptions or pages, the institute says in its report, Resident Duty Hours: Enhancing Sleep, Supervision, and Safety (http://books.nap.edu/openbook.php?record_id=12508).
While interns and residents in Europe are now limited to 48 hours of work per week, the situation in the US and Canada is less stringent. In 2003, the Accreditation Council for Graduate Medical Education capped the hours a US intern or resident could work at an average of 80 hours per week over four weeks. In Canada, while regulations vary from province to province, an intern or resident generally works no more than 60 to 80 hours per week. Only three provinces have maximum weekly hours built into their legal contracts; Manitoba’s regulations are the highest at 79 hours.
Mandatory naps would be "kind of difficult to institute," says Dr. Roona Sinha, past president of the Canadian Association of Interns and Residents. "What matters more is trying to make the person functional the day after."
Shorter shifts and more rest hours after long shifts would be preferable to mandatory naps, Sinha adds.
Pellerin concurs, saying that more effective handovers of patients as shifts change would be more significant that midshift naps. An association working committee on postgraduate medical education is currently investigating the best ways to structure handovers so that the incoming physician or resident is well informed about the patient, so that fewer mistakes are made. That review is expected to be completed early this year. While most of the concern about lengthy working hours has been focused on interns and residents, some say the scope of concern must be extended to include all physicians and surgeons.
People are wary about limiting the hours worked by physicians and surgeons but it’s something that needs to be addressed, says Dr. Derek Puddester, director of the faculty wellness program at the University of Ottawa and coeditor of the Royal College of Physicians and Surgeons of Canada’s CanMEDS Physician Health Guide.
Younger physicians aren’t inclined to toil as many hours as their older counterparts, Puddester says, adding that the younger generation has been socialized to value work–life balance, so as they move up and become practising physicians, that ethic will likely be a condition of employment. As a consequence, he predicts limits on weekly work hours will be introduced within the next five to seven years for most doctors.
Cheryl Ulmer, coeditor of the Institute of Medicine report, concurs. "Doctors are human too," she says.
But others, such as Dr. Thomas Nasca, chief executive officer for the Accrediation Council for Graduate Medical Education, says capping work hours or introducing mandatory naps for physicians and surgeons isn’t feasible. "Who’s going to take care of the patients while we’re sleeping?"
Nasca adds that the cost would be prohibitive, citing a study that indicates it would cost roughly US$80 billion per year to train the physicians that would be needed if doctors adopted the work-week standards of airline pilots (Am J Surg. 2009;197:820–5). And that doesn’t take into account the notion of continuity, which is integral to effective patient care, he says.
When the Accreditation Council for Graduate Medical Education implemented an 80-hour work week limit for interns and residents in 2003, it promised a review of the guideline after five years.
The results of that review, which included a national duty hours congress, independent literature reviews and consultations with over 140 medical organizations, will be presented in February, Nasca says.
Thus far, it’s clear from the review that the number of duty hours and nap times aren’t as crucial as top-notch supervision, Nasca adds. "This is not an issue of right or wrong, it’s an issue of competing goods."
Published at www.cmaj.ca on Jan. 5
I've enjoyed the opportunity to work with educators across Canada on a number of issues of shared interest including mental health, substance use, resiliency, and normal development. It makes sense that the silos of health and education work closely together and with the populations we are dedicated to serve.
The Catholic Association of Religious and Family Life Educators of Ontario have invited me to give a keynote at their annual meeting in Toronto this May. The issues they've asked me to comment on are not without controversy, challenge, or complexity -- and I am looking forward to our conversation very much.
Candid conversations about sexuality, identity, relationships and genuine collaboration with youth and families will occur and will, no doubt, reflect the diversity inherent in our communities.
For more information check out http://www.carfleo.org/CARFLEO%20Conference/CARFLEO%20conference2010.pdf
2010 Canadian Psychiatric Association's International Continuing Professional Development Conference
Special thanks go out to the CPA for hosting a brilliant learning adventure last week! It was an honour to work side by side amazing professors and clinicians (such as Dr. Jodi Lofchy, Dr. Pierre Blier, Dr. Claudio Soares, and CPA President Dr. Stanley Yaren. An amazing learning environment, engaging and rich speakers, and a remarkably interactive and engaged group of delegates. I spoke on topics such as time management, contemporary issues in physician health, and intergenerational issues in medicine. Issues in mental health are never dull and of paramount importance to public health and our communities at large. To learn more, check out: www.cpa-apc.org!
Physician health can be an elusive topic, even for physicians. We are all aware that it is critical to our physical and mental well-being to maintain harmony between work and personal life endeavors, yet this is often the most difficult task physicians face daily.
The 2010 International Conference on physician Health will provide a wealth of scientific information, innovative skill-building and new ways to think about how to achieve work-life balance and still care for patients.
This is of vital importance to physicians and a matter of public/global health.
AND the meeting is in fantastic Chicago from October 3-5th at the chill Swissotel in the downtown core. Hard work by day...jazz, theatres, and speakeasy's at night...perfection anticipated!
and consider submitting an abstract: http://www.ama-assn.org/ama1/pub/upload/mm/433/abstract-submission-form.pdf
Thanks to a partnership between uOttawa, the Canadian Medical Association, and the British Columbia Physician Health Program, Canada's first billingual documentary on physician health is live on www.ePhysicianHealth.com. Called Carpe Diem, the film is by Hugh Kellam, with Derek Puddester acting as Producer/Director.
This 22 minute documentary features experts in physician health, medical students and residents, and health care leaders frankly and openly talking about what makes Medicine so positive and meaningful over the long term. The Canadian landscape serves as the set with features filmed on two coasts, the Praries, major centres in english and french Canada, and during the first Canadian Physician Health Conference in Vancouver BC.
Thanks to all who participated -- enjoy!
www.eWorkplaceHealth.com was launched last friday at the Quality Worklife-Quality Health Care National Summit. We had several hundred in attendance including many of our funding partners, in-kind supporters, and - of course - colleagues from the Collaborative.
Feedback thus far is very positive and use is high. 28 countries and 2200 users in 3 days - very exciting!
Check it out!