2023-24 Year-End Update on KRA 2, Well being

Activities

Year-end update

1. Optimize the Physician and Family Support Program (PFSP) by improving communication of available supports, including preventative health supports. 

PFSP has three core service areas: Assistance Line; Case Coordination; and Education, Prevention and Promotion.

• For the period of January 1, 2024 – July 31, 2024, the PFSP received 2,264 calls to the Assistance Line. This is a 4% increase in calls over the same period in 2023. The PFSP continues to see utilization of these services increase although less dramatically than it has been over the past five years where growth was averaging between 12%-15% per year. The PFSP is pleased to report that the program has fully shifted into the new service delivery model of two first-on-call physicians per week. 
• For the period of January 1, 2024 – July 31, 2024, the PFSP’s Case Coordination service experienced a 140% increase in new accesses over this same period in 2023. While fluctuations from year to year are expected given the small number of physicians accessing this service each year, this increase is notable as it is in large part due to the legislative changes that impacted the College of Physicians & Surgeons of Alberta’s (CPSA’s) Physician Health Monitoring Program. Until the end of 2023, the cost of monitoring was subsidized by the CPSA, and few independent medical examinations (IMEs) were required. In this new system, the CPSA is no longer able to provide this subsidy and IMEs are more commonly required by the CPSA. As of January 1, 2024, physicians and medical students with financial need who require IMEs and/or monitoring services have been able to apply for funding through the AMA’s Compassionate Assistance Program (CAP). The Professional Association of Resident Physicians of Alberta (PARA) will continue to provide financial support to those residents who require monitoring services and the PFSP will continue to administer these services for residents. To date, the PFSP has supported a total of 42 treatments and assessments. There have been ongoing challenges with the transition that the PFSP continues to work through to help ensure physicians are supported. 
• In the first six months of 2024 the Education, Prevention and Promotion service supported numerous events that focused on prevention with some of those also providing an element of education and/or program promotion. The highlight of this period’s events includes the Resident Wellness Conference and offered residents the opportunity to participate in sessions on family planning, nutrition skills, physician wellness, occupational hazards and changing self-criticism to self-compassion and yielded the following feedback from participants: hopeful, informative, compassionate, engaging. 
• As of July 2024, the PFSP has reduced the scope of services offered through the Education, Prevention and Promotion program due to the retirement of the Education Lead, however, the program continues to be promoted through conference activities and by hosting the PFSP booth at various events. In the fall of 2024, the PFSP will resume conversations to determine the path forward for this valuable part of the PFSP.
• The PFSP continues to experience a surge in requests for family physicians through the Physicians 4 Physicians (P4P) service. 
• 356 requests for family physicians were received in the first six months of 2024 which is on pace with last year. This is the number of requests received from the Assistance Line and in cases where the Assessment Physician and client determine a family physician is required. 
• 337 (95%) of these requests were for providers in Calgary and Edmonton. 
• Of the 107 active P4P providers, only 31 are in Calgary and Edmonton therefore taking the bulk of the requests.

2. Offer at least three wellness-themed educational events targeting different career stages, namely learner, early career, mid-career and transitions (including part-time and retirement). 

• The AMA hosted two offerings of the Your Life in Retirement Workshop, in December 2023 and August 2024. These were interactive workshops for physicians contemplating retirement or who are already retired, facilitated by Dr. Philippe Erhard. Feedback from the sessions was extremely positive. 
• Due to staffing changes within the organization, a third workshop was not offered this year.  

Priority Activities

Year-end update

1. Advance the AMA’s Healthy Working Environments framework in the areas of equity, diversity and inclusion, psycho-social wellness and safety, and leadership, aligning activities with other system partners including AHS and the CPSA:

• In collaboration with AHS and CPSA, support creation and implementation of a second anti-racist educational module on anti-Indigenous bias. 
• Offer group coaching to AMA leaders enrolled in the CMA-funded Physician Leadership Professional Development program. 
• Contribute to the ongoing process of reconciliation guided by the Indigenous Health Committee. 

Anti-Racism Education:

• Accreditation of the Micro-aggression Education Module (AMA, CPSA, AHS collaboration) was completed in March 2024. 
• Further details about the module, and a trailer video are available on the AMA website. 
• Further development of a second anti-racist educational module on anti-Indigenous bias has been paused due to competing priorities within the AMA and partner organizations.

Group Coaching: 

• Group coaching for physicians who were enrolled in a multi-year CMA/AMA leadership development initiative was offered between February – April 2024. Four cohorts of participants had the opportunity to meet with Executive Coach, Dr. Amanda Brisebois individually at the beginning and end of their group coaching cohort.
• The cross-organizational collaborative coaching with 11 leaders from AMA, CPSA and AHS, took place in January and February 2024. The objectives included building empathy and a broader understanding of challenges faced by those within other health care organizations, and increasing understanding of the health system and roles each of the organizations play. Completion certificates informed by the LEADS Framework were developed by the AMA and were provided to each of the participants. Formal program evaluation of this pilot project was completed and the final evaluation report was made available to the AMA Board.

Indigenous Health: 

• There was a three-part Indigenous health agenda item at Fall RF 2023. This included a group viewing of the film The Unforgotten, an Indigenous-inspired lunch prepared by an Indigenous chef with 20 guest Indigenous leaders in attendance, and a panel discussion with four Indigenous physicians. The Indigenous Health Committee (IHC) members conducted a thematic analysis of the survey results from the fall. 
• Resources and materials for National Day for Truth and Reconciliation were developed collaboratively with IHC and AMA staff for dissemination to AMA membership in fall 2023.
• IHC welcomed a new chair, Dr. Cassandra Felske-Durksen in late 2023. Dr. Felske-Durksen’s first meeting with IHC was held in January 2024. Several meetings between the IHC chair and AMA leadership have taken place to inform the AMA on key Indigenous Health issues, begin building working relationships between the AMA Board and Indigenous leaders, and to engage the AMA in the ongoing process of reconciliation. 
• A new AMA land acknowledgment statement and AMA Guide to Indigenous Land Acknowledgments was launched in Spring 2024, after approval by the Indigenous Health Committee and the AMA Board.

2. Support members experiencing work conflicts. 

• Provide a webinar for members on conflict resolution to educate on tools that teams can use to manage conflict and investigate the feasibility of access for members to conflict resolution services.
• Explore the potential for scaling a model currently being piloted by the Edmonton Zone Medical Staff Association.  

Conflict Resolution Webinar: 

• ACTT has offered a webinar for members of the Physician Champion Network called Calming the Waters: Techniques to De-escalate Conflict. 
• A member-wide conflict resolution/managing differences webinar is taking place September 2024.

Physician Advisor: 

• The current contract for the Physician Advisor pilot concluded on May 31, 2024. 
• Four of five zones will have Physician Advisor contracts by end of summer 2024. 

Priority Activities

Year-end update

Advance the AMA’s Healthy Working Environments framework in the areas of Equity Diversity and inclusion, psycho-social wellness and safety and leadership, aligning activities with other system partners including AHS and the CPSA:

• In collaboration with AHS and the CPSA support implementation of the anti-racism online education project.
• Complete an environmental scan outlining the current supports available to Alberta physicians for navigating conflict. Gaps will be identified for further discussion by the AMA’s Healthy Working Environments Advisory Committee.
• Explore with Joule the offering of trauma-informed leadership and crucial conversation courses as part the coaching component of our CMA-funded Physician Leadership Professional Development program.
• Advance just culture and healthy working environments language in AMHSP contract discussions.
• Liaise with CMA for Alberta-specific findings from the recent physician wellness survey and integrate these findings into AMA advocacy.
• Further align work of the HWEAC and the Indigenous Health Committee.
• Advance discussions with AHS related to safe reporting and trauma-informed leadership.

• The AMA, the College of Physicians & Surgeons of Alberta and Alberta Health Services collaborated on a new online training course for Alberta’s physicians on race-based micro-aggressions. The course launched on June 14 and is available to all regulated members through the myCPSA virtual learning platform. Early results from post-training survey respondents are excellent and indicate that the VITALS tool and scenario-based learning are very useful. CME accreditation is expected in October 2023.
• Results of the environmental scan were discussed with the HWEAC. There was discussion on how to share this information with membership.
• PLI courses on Crucial Conversations and Trauma-Informed Leadership were offered in the Spring 2023. Approximately 39 physicians have met the criteria to participate in group coaching, which will be scheduled at a future date.
• The CMA National Physician Health Survey 2021 was released in August 2022 and states, “The key findings from the national study reveal that numerous subgroups are experiencing more negative wellness outcomes, including medical residents; those under 35 years of age; those identifying as women; those practicing six to 10 years; caregivers of a child and/or parent or family member in the home; those living with disabilities; and those working in small town/rural or isolated/remote areas. Still, not all the results are discouraging; there are signs of a culture shift toward prioritizing wellness. That is, medical residents and younger physicians report accessing support for their mental health challenges more frequently than practicing physicians who are at a later career stage. While some of those who need wellness supports are accessing them, there are still significant barriers to overcome, such as stigma, availability and concerns around confidentiality.” Alberta-specific findings, from this CMA survey, were released in January 2023. In general, “Respondents from AB are significantly less likely to have been experiencing burnout at the time of the survey (49% vs. 53% national total). Across other key psychological measures, there are no significant differences: half test positively for depression, and a quarter experience moderate to severe anxiety levels; 38% report having had thoughts of suicide at some point in their life and 14% have had thoughts in the past 12 months.” PFSP continues to advocate and collaborate on these important issues.
• Both the Indigenous Health Committee and HWEAC have been working towards identifying their respective committee priorities.
• AHS updated the AMA Healthy Working Environments committee on safe reporting, trauma-informed leadership training and other related initiatives at their spring meeting. AHS established a Bilateral Complaint Resolution group in October 2021. Its purpose is to focus on improving processes for worker-to-worker concerns, including harassment and violence complaints. The work is ongoing with an anticipated end date of June 30, 2025.

Support individual physicians and groups in conflict situations that exist within practices and with AHS.

• PFSP collects statistics regarding the number of calls related to workplace or occupational concerns.
• The AMA receives periodic updates on the Edmonton Zone Medical Staff Association’s pilot program which funds a 0.3 FTE Physician Advisor to support physicians in conflict. Early data on program uptake has been presented to the Board.

Priority Activities

Year-end update

Continue the Shine A Light initiative, highlighting both daily and extraordinary contributions of physicians that keep the system in motion. Use storytelling to facilitate and link to engagement in the AMA.

• Profile grassroots physicians with Shine A Light profiles in each issue of Alberta Doctors’ Digest.
• Profile and engage medical students:
  • Reactivate medical Student Spotlight series of student profiles in Alberta Doctors’ Digest.
  • Engage with medical student leaders and produce a video for students at large to explain how their input feeds into AMA governance.
  • Seek to return to pre-pandemic levels of participation in the RF by our contingent of student observers and enhance that experience through the RF Buddy mentoring program.
• Profile and engage resident physicians:
  • Collaborate with PARA to highlight the contributions of resident physicians
• Profile and engage physician leaders following each RF who have brought forward motions that flow into AMA advocacy. Tell their story and experience of engaging in the AMA.
• Highlight students and physicians receiving AMA scholarships, bursaries, grants and awards.

• The Shine A Light program has been revitalized and we are working to profile more physicians more frequently.
• We continue to highlight the everyday accomplishments of physicians showing up to do their job in such challenging times.
• The Joint Physician Advocacy Committee has launched a gratitude initiative to encourage and uplift the profession that will further support Shine A Light.
• Medical Student Spotlight has been reactivated but we hope to do more in this area next year.
• We celebrate our award winners, scholarships, in summer and fall of 2023.

Through the AMA Youth Run Club in schools across the province, equip teachers with tools and resources to engage children and youth in physical activity that are optimized for the post COVID learning environment.

• Youth Run Club is back in full swing as a face-to-face offering for the 2023-24 school year with inclusive program involving girl run clubs, kids with accessibility needs.
• We are pleased to be increasing the number of Indigenous communities with which we interact.
• Gold Sponsor Alberta Blue Cross and Silver Sponsor MD Financial Management make programming possible with their generous support.