For most of my medical career, physician burnout was treated as a personal failing, something to overcome through sheer grit. Medical learners and physicians often faced stigma, even career consequences, when they asked for help. Thankfully, our understanding of burnout has evolved since my early days as a doctor – but too many of the root causes remain unchanged, and new ones have emerged.
Nearly half (46 per cent) of practising physicians and residents continue to report high levels of burnout, according to the Canadian Medical Association’s (CMA) 2025 National Physician Health Survey (NPHS). Behind this statistic are heavy workloads and a relentless administrative burden that ignore the human needs of those who provide care.
In the CMA’s Beyond Burnout series, doctors also talk openly about the impact of incivility in the workplace, the erosion of patient trust fueled by false health information and the backlash against diversity, equity and inclusion efforts in health care.
Three in four physicians and residents say they’ve experienced “intimidation, bullying, harassment and/or microaggressions” on the job. More than half of this behaviour was attributed to patients, friends or family. However, also identified as significant sources of incivility were physicians (53 per cent), other health-care providers (28 per cent) and senior leaders or other administrators (27 per cent). Incivility between colleagues, whether its rudeness or explicit bullying, increases the likelihood of physician burnout, anxiety. It creates work environments in which clinicians and medical learners no longer feel safe to speak up, ask for help or learn from mistakes, and can also increase absenteeism and turnover.
Another emerging threat to physician wellness is the spread of false health information, which can strain doctor-patient relationships and can cause moral distress for physicians. A recent CMA/Abacus Data survey found that 97 per cent of doctors have had to intervene to prevent harm or address consequences after a patient followed false or misleading health information found online, including advice from artificial intelligence (AI). This follows the CMA’s Health and Media Tracking Survey2026 Health and Media Tracking Survey that found people who followed health advice from AI were five times more likely to experience harms than those who did not.
There are ongoing risks to the well-being of physicians and medical learners from underrepresented backgrounds as well. Racialized physicians – who already face structural inequities, bias, prejudice and racism on the job – scored lower on psychological safety at work compared to white physicians (61 per cent vs. 67 per cent), are less comfortable raising safety concerns (60 per cent vs. 71 per cent) and are less likely to feel culturally safe in their workplaces (66 per cent vs. 77 per cent). Now, reversals seen internationally on diversity, equity and inclusion initiatives, including hard-won progress on reconciliation in health care, compound the likelihood of burnout and other psychological harms.
So where do we go from here?
Medical culture must continue to evolve. Leaders at every level must take responsibility for managing conflicts and supporting inclusion and equity at work, especially critical as team-based models of care scale up across the country.
Ultimately, though, we cannot keep asking individuals to adapt to broken systems. Incivility in health-care settings is exacerbated by staff shortages. Unnecessary paperwork takes up time that could be spent helping patients understand the health myths and misconceptions they encounter online. Equity, diversity and reconciliation in health care require sustained, system-level investments.
Data and collaboration are key to driving this kind of change. On May 20, the CMA is holding a webinar that will show how NPHS data can inform system-level strategies and organizational initiatives that improve physician health. The Canadian Association of Physicians with Disabilities, Medical Society of Prince Edward Island and The Well Doc Initiative will share real-world examples of how this crucial data supports policy change and advances safer, healthier care environments.
The Beyond Burnout series reminds us that physicians are human. We choose medicine to help others, but we can only do that well when the system supports us, too. If we are serious about fixing health care in Canada, physician wellness can’t be an afterthought. It must be part of the cure.
Companies that run medical clinics are often guilty of cutting corners that compromise staff and patients. Rarely is adequate support staff hired to be on-site. The staff members who are present are under significant stress and run off their feet, phones often go unanswered,
workflow slows, results of investigations are often late to be managed, and patients complain more. Also, although a clinic MD may have a leadership role, in my experience, onsite staff are rarely consulted about workflows, automated patient messaging, and other implemented administrative changes. This is an overall example of the negative aspect of universal healthcare that is often privately administered in Canada. Policies, regulations, and inspections could solve this. When I worked at/within different clinic systems in the USA, we did not have the problems I described above. Work life there was relatively serene.
Thank you, Dr. Burnell and the CMA, for continuing to address this issue. Much of the frustration comes from drivers we cannot control, such as the flourishing of false health information, ever-increasing patient expectations, and the “medicalization” of just about everything in society. The administrative burden, specifically patient form and letter requests, is probably the main driver why young family docs leave primary care practice after a few years. My office receives paperwork requests for every imaginable human want or circumstance, and much of it has absolutely nothing to do with the practice of medicine. I am a “late career” physician, but if I was just starting out and looking at the next three or four decades of my life completing paperwork on my evenings and weekends, I would likely rethink my future too.
As a retired physician I am glad to see that the leadership of the CMA has risen to the occasion by acknowledging what is obvious, quality care is only possible if the people responsible for providing care are healthy. I suspect one of the most common reasons physicians retire is linked to disillusionment with regard to their professional environment. That seems consistent with burnout to me. Burnout, from my perspective, is a non-medical term used to group together many causes of unnecessary stress and disappointment that can negatively affect mental health. I agree that such labels are often seen as weaknesses in the medical culture and that formal leaders are some of the worse offenders, if only because of suboptimal advocacy for the people they claim to be responsible for enabling and empowering and that includes provincial regulatory colleges. I am hopeful, however, that meaningful change will occur in the medical profession if only because if it cannot model its stated values, who can, especially in the present world scene? Cultural change starts, ideally, at a very young age. The foundation of any change is empathy and skilled communication that is committed to generative dialogue – so-called principled-interest-based-communication. If prospective physicians simply learned how to communicate optimally cultural change will follow. The medical profession needs to, in my mind, promote that from birth to fellowship and beyound. The practice of medicine is a collaborative effort and, therefore, communication is key. Regulatory colleges, in particular, need to be seen as collaborators within the healthcare system, not threats. Formal administrators should have to demonstrate expertise in collaborative communication before they are ever considered candidates for authority over others – enough with the MBAs.
I feel often the college of physicians and surgeons of my province is contributing to stress and burnout!