June 23, 2014

By Dr. Jack Perlov

Ask yourself these questions:

  • Do you find yourself a chronic complainer?
  • Do you dread going to work?
  • Do you dread seeing the department head or if in a clinic your colleagues and just want to do your job, seeing patients?
  • Do you feel isolated in your relations with your colleagues or prefer to relate to the non-medical or support staff?
  • When was the last time you had a talk with your department head or colleagues and felt heard? Felt they were supportive of your concerns? Felt they encouraged your aspirations or development?
  • Do you find yourself detached and disengaged at the end of the day? Depressed? Looking forward to the weekend or holidays?
  • Are you working with the primary goal to buy the “toys” or pay the bills and mortgage.

If you answered yes to several of these questions, you may be suffering from “Toxic Workplace Syndrome” (TWS).

What causes TWS? It’s a combination of things. Partly, it’s physician personality traits: drivenness, perfectionism, stoicism, difficulties seeking support, and a strong need for recognition. It’s also a broken medical system; unceasing and excessive demands, lacking acknowledgment and recognition, an insensitivity to personal predicaments, personal goals and aspirations, and leadership that focuses on achieving goals not on the process of decision making.

TWS can be bad for a physician’s psychological health, which can in turn affect his/her physical health. Detachment, helplessness, irritability, anxiety and depression can lead to substance abuse, and lifestyle addictions. Workaholism, shopping addiction, gambling, playaholism, and excessive spending can affect intimate and family relationships.

Can workplaces be sterilized from their TWS? As a physician, what can you do if you find yourself in this situation?

Take the following steps:

Step 1: Identify that you ARE in this situation!

Step 2: Find someone you trust to help discriminate how much of the difficulty is the workplace and how much your own personality is contributing to the problem.

Step 3: Get a physical to ensure that a medical condition is not compromising your coping skills.

Step 4: Consider psychological or psychiatric help to ensure a psychiatric condition, a Major or subclinical Depressive Disorder, an Anxiety Disorder, a Substance Abuse Disorder or Narcissistic or Obsessive-Compulsive Traits are not affecting functioning.

There are plenty of barriers to tackling this problem, including:

  • stigma
  • shame
  • time pressures
  • fear of the College of Physicians and Surgeons
  • fear of change

You’ll need to be brave to break the cycle; systems and work cultures are slow to change and when it does happen, it doesn’t come easily. But don’t lose hope. As an individual physician, you CAN be empowered to change yourself, or to leave a “sick” system.

Good luck.

J. Perlov, MD, FRCPC
MD Care/Faculty Counselling Service
Associate Professor
University of Manitoba
Faculty of Medicine