Doctor closes specialty clinic in year 3 of pandemic to focus on critical care: ‘I had to make a choice’

The COVID-19 pandemic has taken an incredible toll on Alberta hospitals and the people who work inside them. Many have faced burnout and experts say they need support.

An Edmonton doctor who guided many through the pandemic is grappling with his own difficult decision after reaching a point of exhaustion.

Read more: Health workers call for radical changes to health care to treat pandemic burnout

Dr. Darren Markland said he has decided to stop his practice as a kidney doctor, though he will continue his work as a critical care physician.

“This pandemic was me putting my nephrology practice on the side so I could do critical care. It was like watching a ship slowly sail away. I thought I could swim out and get it,” Markland said. “And that was my realization. The ship had gone over the horizon.”

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The doctor said the COVID-19 pandemic made his decision to step back from the role a “necessity.”

“I thought I could do it, until I couldn’t,” he said. “I had to make a choice, I had to do this. It was because of two-and-a-half years of just getting pounded.”

On Wednesday, he completed his last clinic. He said it was an incredibly emotional moment.

“My office staff brought in the people I’ve been looking after for the last 15-20 years so I could say goodbye to them. That feels like you’re deserting them,” he said. “That was really hard.”

Read more: Rate of doctor burnout in Canada has doubled since before pandemic: survey

Exhausted from long hours in the ICU, Markland said his greatest fear was that he would cause harm to his other patients.

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“[I knew I had to leave nephrology] when I made a mistake. I was so busy that I made a mistake,” he explained. “A patient suffered as a result of that. I own that. I apologized and I spoke with them. But I knew I had to really figure out if I was present.”

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The doctor said he believes that the challenges in Alberta’s health-care system are “profound.”

“We are seeing so much illness that has not been tended to. Critical care is still incredibly busy,” he said. “My greatest fear is how devastated primary care has become.”

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Markland said he’s worried about his co-workers feeling as though they may also need to make concessions or push themselves too hard.

“If we aren’t looking after the people who are looking after the public, we will fail. One-by-one, we will go down with physical or mental illness.

“We know it’s happening, if we look at our burnout rate for nurses and our loss of family physicians.”

Read more: No moving on from COVID-19 for Canada’s exhausted health workers

Professor Abi Sriharan is working on a national study about health-care worker burnout. It’s a project that began even before the COVID-19 pandemic.

“What we need is organizational leaders to say, ‘What is it about our organization or system that we can reimagine?,’ so that the work becomes an environment where people can provide the optimum care they wish to provide.”

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Sriharan, who works at the University of Toronto, said it’s estimated that one in three women plan to leave or cut down their front-line clinical-care responsibilities at the end of the pandemic.

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“We are now looking at what we can do to keep them and how we can provide support and rethink about health-care delivery.”

She said many people are leaving front-line care and trying to find a new role in the sector.

“Think about your family member going to see a doctor or nurse who is overworked, overstretched and they can’t give you 100 per cent,” she said. “This isn’t the [health-care workers’] problem, this is about as a collective how we can rethink the system to support them.”

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