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dr. nowak: preventing the collapse of our health system means looking after the humans working within it

caring for those in health starts with governments, workplaces, and health leaders shifting the dialogue from “what’s the matter with you?” to “what matters to you?”

to get health care unstuck, it will take a commitment to listening to health professionals, citizens, families, and caregivers. getty
extraordinary wait times for emergency care. five million canadians without a family doctor. hospitals unable to safely staff beds due to personnel shortages.
according to the canadian medical association, these are symptoms of a more serious disease: a health system not only stuck, but in a state of collapse.
central to this collapse are the growing demands on the people behind the care. nine in 10 nurses feel more stressed at work since the covid-19 pandemic began, with one in four intending to leave their jobs or change work in the next few years. for doctors, one-third are experiencing high levels of burnout, with some surveys showing 40 per cent looking to retire earlier as a result of added stress during the pandemic.
this crushing system is the fault of no one person, or government, or organization. rather, it is the result of decades of layered policy and piecemeal change without a cohesive big picture plan — and it will take all of us to get unstuck before these symptoms become irreversible.

instead of talking about heroes, let’s talk about humans

after all, how we care for the care team is tightly woven with our ability to get kind, careful, timely health-care for ourselves and our loved ones when we need it most.

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instead of talking about heroes, let’s talk about humans. to look after the humans working in health and caregiving, it starts with governments, workplaces, and health leaders shifting the dialogue from, “what’s the matter with you?” to “what matters to you?”

the institute for healthcare improvement has a defined approach to the crucial conversations needed for this shift. it begins with a series of questions:

• what makes for a good day for you? what makes you proud to work here? when we are at our best, what does that look like?
• what gets in the way of what matters? what are the pebbles in our shoes? what gets in the way of a good day?
• what should we tackle first?

the answers to these questions will not be the same for all care teams or in all settings. it will involve uncovering hard truths in physical and psychological safety, supporting health professionals in their best possible work, including citizens and caregivers as valued members of the care team, investing in teams and the digital infrastructure to support teamwork across the health system, all while respecting meaning, purpose, and self-determination.
we can get health care unstuck, but it will take a commitment by governments and health systems to listening to health professionals, citizens, families, and caregivers. then, it will take dedicated action from the public and the private system to change what really matters — shifting the dialogue that positions those working in health and caregiving as heroes to one that values them as humans.

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dr. dominik nowak is a family doctor and health systems leader. as chief medical officer at telus health, dr. nowak bridges disciplines with health, community, and business leaders toward a health system that is more kind, caring, and careful. he is also a faculty member in the dalla lana school of public health and the department of family and community medicine at the university of toronto.
join dr. nowak and healthing’s lisa machado for the second part in the ‘health talk with dr. nowak’ series as they explore the complicated role of caregivers. register by clicking here. to see the first episode, “how to make the most of time with your doctor,” click here.
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