According to 2019 data from the Canadian Medical Association, one in three physicians experience burnout, more than one in three has screened positive for depression, and in the prior 12 months, nearly one in ten had experienced suicidal ideation. These statistics may seem shocking, but they’re no surprise to general internist, Dr. Jillian Horton.
“Six or seven years into my training, I began to be aware of just how disease-causing the culture of medicine is,” she says. “Sometimes I’m surprised that the numbers aren’t even worse.”
Dr. Horton has long championed the belief that compassion in medical education is the key to addressing doctor burnout. It leads to more compassionate physicians and to a better outcome for patients. In her new book, We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing (Harper Collins), Dr. Horton throws open the window onto the flawed system that shapes medical professionals and reveals the rarely acknowledged stresses they experience.
Horton herself was on the brink of personal and professional collapse when she attended a meditation retreat for burned-out doctors. The experience was life-changing. As she and her fellow doctors shared their secret guilt and grief, as well as their deep-seated fear of falling short of the expectations that define them, Dr. Horton discovered that she wasn’t alone in her struggle and of the power of compassion.
“There’s a lot of mixed messaging in medicine. [Medical professionals] are told to be compassionate, but also to really emphasize boundaries,” says Dr. Horton. “But that messaging has expanded so that people have begun to question really simple things. Can I perceive my patient as a friend, in my heart? Can I care about them the way I care about my neighbor? And you know, the simple answer is, of course you can.”
Through her work directing programs in wellness and humanities at the Max Rady College of Medicine and treating people with addiction at the Health Sciences Centre in Winnipeg, Manitoba, Dr. Horton encourages doctors to take an extra moment to ensure that patients feel seen and heard.
“When I see people interacting with patients without that quality of relationship, I say that was not an efficient encounter,” she says. “You didn’t do the most basic thing that you need to do to care for this person. If they like you more, they’re more likely to take your advice.”
Beyond showing compassion for patients, Dr. Horton believes that to properly address the disturbing statistics about physicians and depression, there also needs to be a shift in the way doctors are supported throughout their careers, especially in our post-pandemic world.
“A lot of our physician’s support programs have been primarily for when you’re in a crisis, severely depressed, or suicidal. There’s a number you can call,” she says. “Well, what about when you’re not at that point but life doesn’t feel very good, it’s joyless, and you feel isolated. I think there’s a growing urgency to create a behavioral model where you don’t have to wait until your problem is, to use a cancer analogy, stage three or four to seek help.”