Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 13 1 2024 12 01 System-Based Interventions to Address Physician Burnout: A Qualitative Study of Canadian Family Physicians’ Experiences During the COVID-19 Pandemic 1 9 4605 10.34172/ijhpm.8166 EN Maria Mathews Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada Samina Idrees Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada Dana Ryan Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada Faculty of Nursing, Memorial University, St. John’s, NL, Canada Lindsay Hedden Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada Julia Lukewich Faculty of Nursing, Memorial University, St. John’s, NL, Canada Emily Gard Marshall Department of Family Medicine Primary Care Research Unit, Dalhousie University, Halifax, NS, Canada Judith Belle Brown Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada Paul Gill Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada Madeleine McKay Doctors Nova Scotia, Dartmouth, NS, Canada Eric Wong Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada Leslie Meredith Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada Lauren Moritz Department of Family Medicine Primary Care Research Unit, Dalhousie University, Halifax, NS, Canada Sarah Spencer Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada Journal Article 2023 06 14 Background Medical professionals experienced high rates of burnout and moral distress during the COVID-19 pandemic. In Canada, burnout has been linked to a growing number of family physicians (FPs) leaving the workforce, increasing the number of patients without access to a regular doctor. This study explores the different factors that impacted FPs’ experience with burnout and moral distress during the pandemic, with the goal of identifying systembased interventions aimed at supporting FP well-being and improving retention. Methods We conducted semi-structured qualitative interviews with FPs across four health regions in Canada. Participants were asked about the roles they assumed during different stages of the pandemic, and they were also encouraged to describe their well-being, including relevant supports and barriers. We used thematic analysis to examine themes relating to FP mental health and well-being. Results We interviewed 68 FPs across the four health regions. We identified two overarching themes related to moral distress and burnout: (1) inability to provide appropriate care, and (2) system-related stressors and buffers of burnout. FPs expressed concern about the quality of care their patients were able to receive during the pandemic, citing instances where pandemic restrictions limited their ability to access critical preventative and diagnostic services. Participants also described four factors that alleviated or exacerbated feelings of burnout, including: (1) workload, (2) payment model, (3) locum coverage, and (4) team and peer support. Conclusion The COVID-19 pandemic limited FPs’ ability to provide quality care to patients, and contributed to increased moral distress and burnout. These findings highlight the importance of implementing system-wide interventions to improve FP well-being during public health emergencies. These could include the expansion of interprofessional team-based models of care, alternate remuneration models for primary care (ie, non-fee-for-service), organized locum programs, and the availability of short-term insurance programs to cover fixed practice operating costs.

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