10/09/2020
Dr. Stephanie Klein is a family physician in North York and the Faculty Wellness Lead for the Department of Family Medicine at NYGH. You can usually find Dr. Klein starting her day with an early morning workout and meditation, both are key, she says, in keeping her well. Dr. Klein practices community family medicine at her family practice office and teaches medical trainees at the University of Toronto. Dr. Klein also works at the Senior Health Centre and lately she has been spending much of her time at the COVID-19 Assessment Centre at Branson. Dr. Klein is passionate about physician mental health and wellness and is a member of the OMA Burnout Taskforce. Outside of medicine, Dr. Klein is an avid golfer, huge sports fan and animal lover.
Q & A’s
Q: If someone is not coping well through these uncertain times and feel they are in crisis, what advice do you have?
A: I think the key is to know there are people out there who want to help and you’re not alone. This can be hard to remember when the suffering feels so severe. Your family doctor is there to support you during a crisis. Speaking with your family doctor will help you create a personalized plan to address what’s going on. Many times, having that first discussion and creating a plan, will help you feel better. Reaching out to trusted friends and family can also be valuable.
There are helplines for support such as the North York Toronto Health Partners Mental Health and Addictions Access Point support line at
416-640-1934 open from 9:00 am to 5:00 pm Monday to Friday and Distress Centres of Toronto is available 24/7 at 416-408-HELP (4357). If you are in a mental health crisis, I would suggest going to your nearest emergency department which can connect you to resources in an expedited way.
Q: As a family doctor, what suggestions do you have for people during this period of uncertainty particularly as businesses and institutions are opening (albeit with restrictions).
A: It’s human nature to struggle with the unknown and we have faced a lot of unknown and uncertainty throughout the COVID19 pandemic. We are creatures of habit and accustomed to routines and a degree of control over our lives. When there’s a major disruption that can be a driver for stress and poor mental health. We are also inundated daily with exposure to sensationalized news stories which can be very distressing for us as we attempt to process all the change around us. Now, as we approach the school year and with more businesses opening, there is concern that cases may increase. I think many are suffering from pandemic fatigue as well.
My first suggestion is; in the face of ambiguity or uncertainty, assume everything is neutral and not negative. It’s so easy to jump to false conclusions and have that affect our behaviours and feelings. It’s tough to do, but if you can resist that automatic “worst case scenario” thinking, it will help with coping in this period of uncertainty. Instead, recognize that many times we are biased to think negatively about a situation, and it would be more beneficial to change that to a more positive outlook during times of uncertainty.
Another strategy is knowing that trying to “predict the future” is futile, and no matter how hard we may try to control how things will go, we can’t in this situation. It’s best to know when to let go. Focus on things we can control such as enjoying quality time with friends, family, time outdoors, healthy meals, exercise and anything that keeps you well!
Q: People are fearful of a second wave – how might you suggest they manage their fear and anxiety?
A: This is an understandable fear of many, and this again relates to a degree of uncertainty, and wanting to know what the future holds and how it might affect us. We may question if things will be worse than they were the first time or if things will ever go back to “normal”. Spending excess time worrying will only feed the underlying fear and anxiety, so it’s best not to let these thoughts or fears take over and prevent us from living the lives we want to live.
The fear around a second wave drives behaviors like not leaving your house or avoiding activities and prevents us from being able to enjoy post-COVID life. To manage this fear and anxiety, first it’s important to maintain social connections, so you feel like you’re facing your challenges together, which is much easier. Focus on staying in the present rather than thinking too much about what you “used to be able to do” or worrying too much about what might be.
It’s also important to recognize that it’s okay to have these feelings. Sharing your thoughts with a trusted friend, journaling, practicing self-compassion, breathing exercises and meditation are all helpful strategies to calm things down when feeling overwhelmed.
Lastly it goes without saying that prioritizing self-care is key. That means allocating time for exercise as a natural way to release endorphins and reduce stress, ensure adequate sleep to restore and recover, eat well balanced meals, spend time doing things you enjoy like a hobby and nurture the important relationships in your life.
Q: You have a special interest in older adults, what issues during the pandemic are you seeing with this population and what general advice might you have?
A: Throughout the pandemic I observed the greatest challenge facing older adults was the social isolation and loneliness. There was a lot of time spent away from their families and disconnected from social networks. This, understandably, had consequences on their mental health. Additionally, many of the senior’s community programs were shut down which meant less opportunities for exercise and physical activity. While staying home and isolated from the community helped protect older adults from being exposed to COVID19, the unintended consequence of these measures was the increased risk of functional decline.
It was great to see that many people and organizations came together to support seniors through friendly phone calls, grocery delivery, connection to social services etc. In terms of advice, I think the most important thing is to stay connected however you can. By telephone, IPAD, socially distanced visits, zoom etc. It’s a great time to have the younger adults teach their parents or grandparents how to use technology.
The other key advice is to ask for help or attend to medical needs that come up before things get worse. Very often I spoke with older adults who had a new medical concern but were fearful of seeking medical attention due to concerns about catching COVID. It’s important to call your doctor if a new medical issue comes up and listen to their advice if they feel it is necessary to visit the emergency department or go for tests. Often the risk of not addressing a new medical issue may be greater than the risk of catching COVID.
Q: What are the key issues people have been experiencing relative to their mental health during COVID-19 and what general advice do you have as a family doctor?
A: One of key issues I have observed people experiencing relative to their mental health during the pandemic is a disruption to their usual routine and habits. Working from home had its benefits like less stress with the commute, more time to spend with family, the ability to work in PJ’s! However, it also meant there was a lack of structure at times, less interaction with people outside your home and more responsibilities with childcare since schools were closed. The usual outlets for stress relief were also closed such as the gyms, restaurants, entertainment, travel etc. For a lot of people spending too much time at home brought them out of their routines. I heard a lot of people struggle with maintaining exercise, healthy eating habits and healthy sleeping habits. These are the key elements of self-care and when falling out of that routine, I noticed a lot of people suffer with respect to their mental health.
I also observed a lot of adolescents and young adults present with anxiety. To be honest, I don’t think this was an “issue” stemming from the pandemic. I think the opposite. For the first time doctors became more accessible through virtual means by connecting through videoconference and telephone. I think this reduced a barrier for younger adults in seeking help as they could access support easily from their own homes and devices.
The general advice I have is to create structure and routine but also set boundaries and set aside time to re-charge. Working from home meant there wasn’t an easy separation from home-life and work-life over the last 6 months. With remote access, you had the ability to work at all hours of the day, and not even leave your room! Therefore, setting boundaries or time limits on your work schedule is so important. Making time for self-care activities should be incorporated in your schedule. I often suggest writing it in your calendar, so it’s not forgotten or put off when things get busy. The times spent doing the things that make us happy will re-energize for the next day ahead and help reduce the feelings of stress and anxiety.
Q: Why did you choose to work with/be affiliated with North York General Hospital?
A: I’m what they call an NYGH “Lifer”. In the sense that I started as a first-year medical student and haven’t left since then! I was very fortunate to be placed at NYGH as a medical student when I first had the opportunity to experience the incredible learning environment. I love the community feel but at the same time NYGH has a strong reputation for academic excellence. All the staff are brilliant educators, and everyone supports one another in delivering excellent patient care. I completed many rotations and my family medicine residency at NYGH so it was a no-brainer when it came down to choosing where I wanted to set up my practice. I was welcomed by mentors to join their group and have enjoyed the opportunity over the last couple years to build my family practice serving the community in North York. There is such a strong collegiality at NYGH that anytime I visit the hospital or need some advice, there’s always a friendly response from colleagues. NYGH has given me so many opportunities to grow and develop.
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