Health practices of Canadian physicians

RESULTS

We received 3213 completed surveys, for a response rate of 40.5%. We ran data tables in SPSS (statistical analysis software) and applied χ² and ANOVA (analysis of variance) testing. We weighted data for nonresponse using the raking ratio method to match physicians’ demographic characteristics known to the CMA: province by type of physician (generalist vs other specialist) and sex by age group (20–39, 40–49, 50–59, 60–69, and ≥70 years).

As shown in Table 1, one-third of respondents were women and one-third were born outside of Canada. Respondents were most likely to be middle-aged; in private, group-based, or urban or suburban practices; and paid fee-for-service. Almost half were family physicians and more than half of respondents came from Ontario or Quebec (36% and 24%, respectively; data not shown). Physicians spent a median of 40 hours per week on patient care (mean 37.5) and a median of 6 hours per week on other professional activities, such as administration, management or committee work, teaching, research, or continuing medical education (mean 10.5). Those physicians who accepted on-call hours were on call for a median of 60 hours per month, and spent a median of 10 of those hours in direct patient care.

More than 90% of physicians reported being in good to excellent health, while 5% reported that poor physical or mental health had made it difficult for them to handle their workloads at least half of the time in the previous 4 weeks (Table 2). Twenty-three percent of women and 20% of men reported a history of anhedonia for 2 or more weeks in the past 12 months, and 29% of women and 20% of men reported a history of sadness or depression for 2 or more weeks in the past 12 months. A quarter of respondents had long-term physical or mental conditions, or other health problems, that had reduced the amount or changed the nature of their activity at work, and 13% had somehow modified their work environments because of disability. Nearly all (86%) had disability insurance and 86% also recognized its importance; most (75%) were satisfied with their disability insurance, but 9% had been denied such coverage.

Regarding physical health characteristics (Tables 3⇓–5), most of the female but less than half of the male physicians were at a healthy weight, which was (like most of our sex-related comparisions) a highly statistically significant difference (P < .001) between the sexes; 8% of physicians were obese. Only 25% of Canadian physicians had smoked more than 100 cigarettes in their lifetimes. Among Canadian physicians who had ever smoked, 8% currently smoked daily, 6% smoked occasionally, and 87% did not currently smoke, making a total of 3.3% of physician respondents current smokers. In the past month, 5% of male and 1% of female physicians had smoked cigars, and less than 1% of physicians of either sex had smoked a pipe. Most physicians of both sexes reported drinking alcohol in the past year. During the past month, those who drank had typically consumed 1 to 2 drinks per session. One-fifth of female and one-third of male physicians had consumed 5 drinks or more at least once in the past year, and 4% of women and 12% of men had done so at least monthly. In the past year, on days when they drank, 0.8% of female and 1.3% of male physicians typically drank 5 drinks or more. One-third consumed daily multivitamins and minerals. Physician respondents exercised an average of 4.7 hours per week, including mild exercise. Women ate fruits and vegetables 5.3 times daily and men 4.5 times daily, on average; Canadian physicians drank caffeinated beverages 1 to 2 times a day.

More than half of male and three-quarters of female physicians had received physical checkups in the past 2 years, and more than 80% had had their blood pressure checked in the past 2 years. Although three-quarters of both sexes had received influenza vaccinations in the previous year and three-quarters of female physicians had received clinical breast examinations in the past 2 years, only one-third of men had received testicular examinations from clinicians in the past 2 years. All but 15% of men and 22% of women had had their cholesterol measured in the past 5 years and all but 14% of female physicians had had Papanicolaou tests in the past 3 years. Among women physicians younger than 45 years of age, 79% had never received mammograms compared with 15% of those 45 to 64 years of age and 6% of those 65 years of age and older. Fourteen percent of those younger than 45 years, 68% of those between the ages of 45 and 64 years, and 66% of those 65 years of age and older had received mammograms within the past 2 years (data not shown). Table 6 further outlines the clinical preventive measures undertaken by physician respondents.

Table 7 addresses Canadian physicians’ personal and professional attitudes. Female and male physicians both typically believed that they were considered more professional if they lived balanced lives, but only about half agreed that they had good work-life balance. About 30% disagreed that they worked in environments that encouraged them to be healthy. Only 11% disagreed with working when they were ill if they could work, and all but a quarter of physicians did self-care if they could. However, almost all respondents said they were aware of resources that they would be comfortable using if they needed help for a physical health problem; 15% were not aware of resources that they would be comfortable using if they needed help for a mental health or substance abuse problem.