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Dr. Joshua Tepper

Finding Joy in Work

As we enter 2017, the concept of finding joy in work may sound more like one of the warped slogans from George Orwell’s novel 1984 than a desirable and achievable goal.

The world as a whole has entered a period of change and uncertainty almost unprecedented in our lifetimes. Echoing that larger change, the medical profession here in Ontario is in its own significant period of upset, frustration and upheaval.

The incidence of burnout is growing among not just physicians, but also nurses, health profession students and residents. In Ontario especially, the workplace environment has become to many a place of tension and unhappiness.

Health Quality Ontario is committed to helping care improve in the world, but we know that is much less likely to happen when people don’t find joy in their day to day work. That is true for doctors, nurses and frankly anyone in any role in the health care system.

Creating a quality health care system can only be achieved if those within the system derive satisfaction, if not joy, from what they do. The two are inextricably linked not only to each other but also to improving the experience of patients in the system, and this is not a one way relationship.

Research shows an association between not being happy at work or being burned out and lower patient satisfaction and reduced patient safety. Canadian research has also demonstrated that providers (specifically physicians) who are healthier and practise preventive health measures are more likely to promote healthy behaviors in their patients.

Last May, I wrote about how improving the experience and work life of healthcare providers is seen by many as necessary to achieve the Triple Aim of improving a patient’s experience of care, improving population health and doing this at a reasonable cost – a concept known as the Quadruple Aim.

I also discussed how our Quality Matters framework for achieving a high quality, patient-centred health care system has incorporated this concept. At the Health Quality Transformation conference in Toronto last October, a well-attended workshop saw panelists discuss successful initiatives to achieve the Quadruple Aim from a variety of perspectives.

This is not just an Ontario discussion. In Boston last fall, the biennial International Conference on Physician Health was held under the direction of the Canadian, American and British Medical Associations. This year’s theme: "Increasing Joy in Medicine."

I was particularly struck by the words of one of the speakers at that meeting as quoted in a story from the American Medical Association:

"It’s not merely work-life balance... some people have the idea that there’s some magical work-life balance and if I only get that formula then it will all fall together for me," said Jon Kabat-Zinn, PhD, professor of medicine emeritus and creator of the Mindfulness-Based Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. "There’s only life. And so if you don’t bring your life to work, there’s no life in work; and when you get home you have no energy for life either so we’re talking about one seamless whole."

Joy at work is not something that exists independent of the rest of your life.

As we enter this new year with all its challenges, we need to work together to find the path to joy in work because that is also part of the path to the best care for our patients.

The deep passion and commitment we bring to our work must be nurtured in order to create and maintain a truly high-quality health care system.

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