Marie-France Maranda

Burnout, psychological distress, and overwork: the case of Quebec's ophthalmologists

BACKGROUND Studies have shown that physicians are subject to high stress levels that can lead to mental health problems. Ophthalmologists are facing particularly high pressures because of shortages in their number and lack of resources. This study describes the state of mental health of Quebecs ophthalmologists and identifies certain elements of their work environment and personal lives that may contribute to problems. METHODS This cross-sectional study uses self-report questionnaires, including validated instruments, as well as instruments created for the study. A total of 133 out of 266 Quebecs ophthalmologists participated in the study. RESULTS More than 35% of ophthalmologists reported high levels of burnout and psychological distress. The 5 main occupational stressors were growth in demand for services (49.2%), shortage of ophthalmologists (48.1%), amount of work to be done (45.4%), budgetary pressures (44.6%), and repeated training of new work teams (41.9%). Self-acceleration is the defensive strategy used most often to deal with work overload. Nearly half (47.4%) reported having problems reconciling work and personal life. The mean scores indicate that ophthalmologists received little recognition from administration. INTERPRETATION Work overload and systemic organizational deficiencies are burdening ophthalmologists in Quebec. They constantly work harder to preserve their professional ideals, but they receive little recognition from the administration. The levels of distress observed in this context point to the need for the authorities to take action to improve practice conditions. The situation is urgent because population aging has already begun to cause a sharp increase in demand, and younger physicians appear to be suffering most from work overload and burnout.

Hiring substance abusers: Attitudes of managers and organizational needs

A survey was conducted with 70 managers responsible for hiring in large-, medium- and small-sized companies in the Montreal and Quebec City areas. A content analysis of the semi-structured interviews allowed us to examine the social representations underlying the managers’ attitudes towards the issue of substance misusing in the company or the hiring process. This examination in turn allowed us to develop a typology of the managers’ needs regarding the integration of this category of people into employment. Our results show how the representations of the determinants of drug addiction and of the role of the workplace generate attitudes that are closed-minded, ambivalent, tolerant or supportive, and that underlie the managers’ requirements for information on drug addiction, for internal rehabilitation services or external services supporting the reintegration of drug abusers into employment.