MDs raise ‘serious concerns’ about workloads, leadership, culture at CancerCare Doctors Manitoba letter cites effect of ‘burnout and distress’ on patient care By: Tyler Searle Posted: 6:01 PM CDT Tuesday, Sep. 24, 2024

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Doctors are raising “serious concerns” about burnout, heavy workloads and distrust in the executive leaders who operate CancerCare Manitoba, a letter obtained by the Free Press shows.

Doctors Manitoba wrote to oncologists and hematologists at CancerCare last Friday inquiring about working conditions after the advocacy group was “contacted by a number of physicians raising serious concerns,” said the letter.

The two-page document outlined several allegations, including: excessive workloads; limited engagement, communication and trust in CancerCare leadership; poor workplace culture and support; a fear of reprisal for speaking out; and issues with recognition and payment for extra work.

“Many are concerned these issues have caused significant burnout and distress and are creating significant challenges with physician recruitment and retention. Some are also concerned about how these issues are affecting patient care,” it said.

The document is signed by Doctors Manitoba director Ian Foster and Dr. Shelley Anderson, medical lead for physician health and wellness, who ask physicians to “share what is working well and what concerns you have about your work environment.”

A spokesperson for Doctors Manitoba said such letters are routinely sent out to physician groups after concerns are raised.

“With regards to our letter to CancerCare physicians, we are at the very early, diagnostic stage of understanding the problem and how widespread the concerns are,” he said.

“We have been doing this type of work more and more in recent years across Manitoba, which is perhaps not a surprise.… We hope to see a change in the culture broadly in health care, that embraces front-line feedback and promotes and embraces physician engagement on a regular and ongoing basis.”

The spokesperson referenced the results of an annual physicians survey, released in June, which found only a third of physicians felt they could raise concerns in Manitoba’s health system without fear of reprisal.

Leaders from Doctors Manitoba and CancerCare met Monday to discuss the concerns outlined in the letter, he said.

In an interview with the Free Press, CancerCare president and CEO Dr. Sri Navaratnam acknowledged the agency is grappling with workload challenges.

“We are hearing you.”–Dr. Sri Navaratnam, CancerCare president and CEO

“It’s not unique to CancerCare Manitoba and it’s not unique to Manitoba,” Navaratnam said. “With the workload issues — whether it is physicians, nurses — it’s there, so am I surprised about (the letter)? No. But, we are working toward (improvements). I’m confident that way.

“We are hearing you.”

Navaratnam, who is an oncologist, said CancerCare has created a committee to evaluate and address physician workloads.

Recruitment efforts are underway to help bolster staff, she said.

The agency has lost 16 physicians to retirement and other causes in the past five years, but added 19 in the same period. Six new oncologists have been recruited this year, including one from Ireland. Of those new recruits, four are already working, Navaratnam said.

Another potential recruit was interviewed Tuesday, and interviews with other physicians are scheduled in the coming weeks, she added.

The Doctors Manitoba letter indicated physicians have expressed concerns over wait lists within some areas of CancerCare, saying “resources have not kept pace with growing patient demands.”

Navaratnam agreed the departure of some specialized staff presented challenges, but CancerCare has addressed wait lists by asking staff to see patients during weekend clinics. Such clinics are voluntary and employees are paid, she said.

Wait lists published by the provincial government show median wait times for head and neck cancer surgeries is about four weeks.

Data for the period from June 2023 to June 2024 shows surgery wait times spiked to eight weeks last September and remained high for most of the following four months, peaking at 10 weeks in January.

They returned to four weeks in February and have been static since, according to the data.

Estimated median wait times for radiation therapy are currently at three weeks, and remained about the same between June 2023 and June 2024, the data shows.

CancerCare is aware the additional clinics could result in burnout among physicians, which is why the agency is driving hard to bring in additional staff — including physicians, fellowship positions and administrative support, Navaratnam said.

The Doctors Manitoba letter comes less than a month after Dr. Maclean Thiessen, an oncologist specializing in breast and gastrointestinal cancer, filed a lawsuit against CancerCare.

Thiessen alleged the agency reneged on a recruitment agreement that saw him leave his job in Calgary and move to Winnipeg, where he said his work goes “beyond what he was contracted to provide without additional remuneration.”

CancerCare has not filed a statement of defence. The claim has not been tested in court.

Thiessen is listed as practising at CancerCare Manitoba at Health Sciences Centre on the College of Physicians and Surgeons of Manitoba registry, which is updated daily.

The doctor, speaking through his lawyer Avery Sharpe, declined to comment on the Doctors Manitoba letter Tuesday.

Multiple people reached out after the Free Press wrote about the lawsuit last month, similarly expressing dissatisfaction with the workloads and working environment at CancerCare.

tyler.searle@freepress.mb.ca