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The skeletons in the closet behind the white coat

The skeletons in the closet behind the white coat

The desire to care and cure can be very demanding to any physician's life. Sometimes, a doctor's passion to care takes him far away from his or her own personal health and life outside the job. In demanding, physical, disciplines like an ER physician or a trauma surgeon, they often lose their family life at the cost of maintaining never-ending clinical work. They can be incentivised by maintaining a certain role-model appearance and entirely hide any form of personal pain from patients, colleagues and staff at work. Because they understand the intensity and toll of pain on one’s life and health, they refrain from transferring more emotional pain from self to others.

There are plenty of examples where doctors hid their behavioral problems or even chronic diseases. There is an anesthesiologist in UK who hid his problem drinking; a psychiatrist who hid her bipolar disorder. Some doctors are even compelled to hide their pregnancy, especially during training. Other physicians may hide of their cancer diagnosis and continue practicing and while receiving their personal care. There are many reasons for them to hide their own illness while continuing to care for sick patients, including not enough emotional support and ensured job security.

In Ontario, Canada, pregnancy and parental leave include eight weeks and nine weeks respectively. We compare that to general population and non-physician staff in the same hospital; those benefits extended to 36 weeks to 72 weeks. Provincial government is compelled to expand that pregnancy and parental leave benefits from 36 weeks to up to 72 weeks. So my question is, what is the difference to physician moms and their babies versus general population?

In the United States, stories are completely different and incomprehensible. All medical institutions and hospitals reserve rights to negotiate maternal and parental benefits and quite often physician moms settle for less pay compared to the male doctor with same specialty. This is an example with pregnancy, but this situation is similar with any health issues; especially chronic, irrespective of gender. The hospital terminated a physician from her psychiatry residency training because of her frequent visit to oncology and needing to have treatment for her skin cancer.

Some people consider stories like this a thing of the past with increased dialogue on mental health and work-life balance, but incidents similar to those described above persist. A former classmate of mine struggled with depression her entire adult life. During medical school, her depression became so severe she could not get out of bed and would watch the lectures and submit assignments online. She is a brilliant person and a talented doctor-in-training but during her residency, she was struck with another bout of major depression. As a result, she was not able to keep up due to her ongoing mental health condition and was advised: “you are not cut out for this specialty” and “you should consider switching to another residency program.” This is an evolving story, and the end is still to come. It highlights the continued attitudes within the medical industry. A question raised from this example is: should a doctor be barred from continuing their training or continuing to practice because of a health condition? Especially workplace offering any options for accommodations, simply; all or nothing.

Overall, there is not enough workplace support for health conditions plaguing a physician in training or while practicing. Additionally, chronic health conditions in physicians, mainly during training, provide the life-changing label of not as worthy, unbefitting and fewer satisfactory doctors. These subtle demeaning attachments to illness take a toll on a physician's health and overall life. Doctors consider hiding their health condition over undignified passion. Governments and authorities have yet to act in addressing or rectifying this situation. Recently, many training institutes have started considering a physician’s health, sleep requirements and periodic entertainment. Engineering and technology firms and institutes recognize the importance of a low-stress workplace; the health industry has yet to change to match others.

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