Simple Steps Can Help Boost Clinic Morale

Medical Post
Helping Hand Column, November 22, 2005

Work together to foster a positive outlook and help all team members feel more appreciated

Q: Every day that I go to work at the medical clinic, I am struck by how physician morale is so low. People seem to be unhappy, irritable and are starting to keep to themselves. I chose this clinic over a solo practice so I would not be lonely. Is it possible to feel lonely with others around? What can we doctors do to make our clinic a better place to work?

A: Physician morale seems to be at an all-time low. Morale is a key ingredient of a successful workplace. While doctors, as a group, are known to be dedicated, hard-working, conscientious and wanting to please others, many are finding it increasingly difficult to maintain a positive outlook.

In my practice, colleagues constantly tell me they would accept that they are working harder than ever before, with fewer resources, if only they felt it was worth it in terms of better patient care. Yet, most of the time they feel that despite greater efforts, they are still not providing the level of patient care they would like.

Morale is related to burnout. Burnout is a state of chronic stress due to workplace problems, in which people become negative, feel they are being acted upon and not exercising choice, and start to pull away from colleagues and lose a sense of job satisfaction.

Even the strongest and healthiest of physicians can become ill in an unhealthy environment. According to a 1999 report from the Canadian Centre for Occupational Health and Safety, an unhealthy workplace can triple the chance of cardiovascular disease, double the chance of substance abuse, and increase injuries, infections and mental illness. A 2002 discussion paper from the Canadian Policy Research Networks shows that health professionals are the least likely of all workers to describe their work environment as healthy, with job satisfaction below the national average.

There is a sense of lack of control and choice over issues at work. It helps to address this openly, and identify as a group what you can and cannot control. You can’t control that people get sick and that resources are limited; but you can control some aspects, such as what you have available to care for patients, how you work together and how much you work.

As humans, we need to feel appreciated for what we do. The medical workplace is not known for constant praise and encouragement. As a group, you can explore ways to make someone feel appreciated and encourage doing this more often. Some ideas include writing a short thank you note on a Post-it and sticking it to their door, celebrating birthdays and special events as a group, and sending flowers or small gifts.

In your clinic, consider setting up a bulletin board to post achievements or putting together a small newsletter with positive stories of the clinic activities and the people in it. In Ottawa, the medical community has worked with the mayor to proclaim a day in October as Physician Appreciation Day. The goal is to expand this throughout the province and country in the coming years. If you would like to collaborate and have a similar day proclaimed in your community, please contact me.

Being busier than ever before, we may not have the time to promote a sense of community and connection in our workplace. We are too busy to take the time to get together to eat lunch or go for a walk. It is now easier and quicker to send off a quick e-mail than to take the time to seek out a colleague to talk with them. Thus, we feel increasingly isolated.

Your clinic can find ways to communicate in person, stay connected and work as a group. Senior colleagues can take a mentoring role and help newcomers get oriented and incorporated into the group. Relate to colleagues as people, not just someone with whom you work.

Some groups suffer from a sense of lack of fairness and respect for each other’s contributions. It is best when your group can address this and accept that the value of work is dependent on the time it takes to do it. That is, an hour of clinical work is as valuable as administrative work, teaching or research.

All of these areas take time to address. The ideal way is to have a retreat, where these issues and goals to address them can be raised. This must be followed by regular ongoing assessments, to maintain the relationships and priorities. Taking time to listen to and understand each other, and expressing appreciation are the best ways to connect and restore physician morale.

Mamta Gautam is an Ottawa psychiatrist who specializes in treating physician patients. If you have a question you would like addressed in this column, please contact Dr. Gautam at Please include “Helping Hand” in the subject line. All inquiries will be confidential. Your questions will not be replied to, but may be selected to be answered in this column, which is intended to be educational, not therapeutic.