Louisville Medicine Volume 69, Issue 4 | Page 10

PHYSICIAN DEATH BY SUICIDE AUTHOR John J . Wernert , MD , MHA
TAKING A STAND AGAINST BULLYING

PHYSICIAN DEATH BY SUICIDE AUTHOR John J . Wernert , MD , MHA

Does the choice to become a doctor increase your personal risk of suicide ? Sadly , the answer is YES . We have long known that the practice of medicine carries with it one of the highest suicide rates of all American professions . The pandemic crisis has only increased our professional awareness . It is estimated that between 400 – 450 physicians will take their own lives in the US in 2021 . In fact , this number may be underestimated because these untimely deaths are often underreported for a variety of reasons .

The increased rate of suicide among physicians has been known since 1858 1 however , physician suicide has remained a silent epidemic for the past 150 years . The first editorial on this topic by the Journal of the American Medical Association ( JAMA ) was issued in 1903 . Over the subsequent decades , physician suicides were treated at best , with silence . At worst , they were seen as indicators of personal weakness or flawed personality proving that the individual was not “ cut out ” to deal with the demands of medical practice .
Even before the pandemic , there had been growing attention on this topic , as we are in the age of increased rates of physician burnout and mental health diagnoses among physician populations ( see our Louisville Medicine Vol 68 , March 2021 edition ). In recent years , the American Medical Association and the Association of American Medical Colleges have launched campaigns to identify , educate and guide physicians on burnout . Since COVID-19 , there has been increased coverage of burnout , mental health diagnoses and suicides attributed to the stress and workload of being a physician during this unprecedented time . The story of Dr . Laura Breen , a New York Presbyterian ER physician who contracted COVID-19 and then later died by suicide 5 illustrates not just the physical toll , but also the intense emotional suffering to those who are working on the frontlines .
None of us is immune . Compared to the general population , suicide completion rate among doctors is 44 % higher ; female physicians have a higher suicide completion rate than male doctors . Additionally , 22 % of us have reported suicidal ideation compared to 9.2 % of the general population . 2 Rates of clinical depression among physicians have been estimated at 19 % and 28.8 % among resident physicians 3 compared to 7.1 % in the general population . The incidence of serious depression increases rapidly in medical training , increasing four-fold in the first four months of the internship year . This increased rate is often attributed to the high stress culture of
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