After discussing this morning with a colleague, I feel the need to share this text that was published in December 2017 because it is still relevant. It was originally written in French and translated using Deepl so there might be a few mistakes..
“To all my colleagues,
I’ve been working in the emergency room for 17 years.I love this job. I love caring for patients. I love the teamwork…but I’ve been thinking about doing something else for a year now. I’m not the only one.
The working conditions have deteriorated over the years, despite the best efforts of some very competent people.
Respect for the work of physicians and our professional autonomy is eroding over time.
Bill 130 will further burden our work by making us responsible for maintaining service coverage in our departments despite inadequate resources and staffing.
In the past year, emergency physicians have been receiving negative messages on a regular basis. Our performance in general leaves much to be desired. We need to work harder and faster. We don’t see enough patients. Most of the people who make these statements are sitting in an office far away from the bedside of patients and they look at statistics to judge us. On the one hand we have to go faster and to do that we have to cut somewhere… and the risk is that we cut quality… it’s very easy to fall too far into the performance trap. On the other hand, the number of complaints and lawsuits is growing exponentially. Patients rightly demand more time to explain, to comfort, to answer their questions. Families expect us to call them to inform them. Managers want more forms filled out. Management wants us to discharge as quickly as possible to relieve the emergency room.
It’s an impossible gymnastics that sometimes hurts either the patient or the doctor, often both. No one gets out of it unscathed. It is the system that is sick.
I saw this quote from Saint Augustine recently and it made me think a lot: “By putting up with everything, you end up tolerating everything… By dint of tolerating everything we end up accepting everything… By dint of accepting everything, we end up approving everything.”
In the last few days, as I have worked and talked with my colleagues, I have come to realize how much harder I find it to work in this environment. I love the people but the environment is toxic. It’s hard to arrive at midnight and see a 14-hour wait in the waiting room and nine unseen stretchers, nine patients lying in bed with an average age of 73, three with fever, two with shortness of breath, one with chest pain, one with a hip fracture, loss of autonomy and one newly diagnosed cancer with back metastases. It’s hard to accept that when I arrive I won’t even be able to see all these people overnight and that more will arrive, on foot and by ambulance.
I still love this job but I anticipate that before conditions get better, they will get worse. I have another job that I love and that is respectful of my skills, my schedule, my time. I also have a taste for new experiences. Since my separation, I have understood that you should never be afraid of change. I have also understood that it is okay to make mistakes. I have no idea if this decision is right or wrong. I just know that I need change. I’d rather make a mistake and try something else than continue doing what I’ve been doing for the last 17 years with growing frustration with an environment that no longer respects the professionals who work there.
So it is with a mixture of fear, excitement, and regret that I am officially announcing that I will be resigning from my position as an emergency physician in March 2018.
I look forward to seeing you tonight, having a beer, sharing one last meal, and celebrating this ending year with you….
Thank you for your support over the years.
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Update 12:30 December 8, 2017
I am receiving calls and emails from journalists.
I will not give an interview because everything has been said. It is important for me to clarify something: I have a lot of respect for the people who work in the network. ALL the people in the network: the housekeeper, the stretcher bearer, the attendant, the clerk, the auxiliary, the nurse, the physiotherapist, the occupational therapist, the respiratory therapist, the lab and radiology technicians, the social worker, the nutritionist, the physician, the coordinator, the head of service, the DSP and the executive director. All are competent and do their best to provide services with the resources available. The big culprit is the lack of resources.
I am leaving the ER but I am not leaving the CISSS de l’Outaouais, I will continue to work there as a medical examiner to improve the quality of care.
I will continue to work there as a medical examiner to improve the quality of care.
Thank you.
Martin Pham Dinh 