medicine , long work hours , relative neglect of self-care , less time with family and friends , the financial stresses of medical education and perceptions of inadequacy . 2
Physician suicide has a double peak with the highest incidence occurring in late-middle age and the second peak during the training years of residency and fellowship . 4 The peak during training is often attributed to the intense and stressful time of training with working long hours , risk of medical errors and balancing work and family obligations . The higher peak later in life has been attributed to physicians ’ loss of identity either by retirement or deterioration of their own physical health .
The idea of “ physician , heal thyself ” has been proven grossly inadequate . In training primary care colleagues on suicide screening , I always emphasize that “ suicide prevention is everyone ’ s business ” – we must be our “ Brother ’ s Keeper .” Suicide statistics clearly reveal that clinicians cannot heal themselves . Unless we pay attention and keep an eye out for each other , it may be hard to recognize that a colleague is struggling . Suicide is the last stop on a road that is typically paved by other mental health problems . Have you noticed personality or mood changes in a physician friend or colleague ? Do they seem more disconnected from family or friends ? Has there been a recent crisis in their lives , or reported problems on the job ? Has excessive drinking or drug use become evident ? Are they sleeping badly , are they irritable and bitter , are they becoming monosyllabic and distant ? Have they lost their sense of humor ? We are all vulnerable to feelings of being stressed , overwhelmed , a failure – leading to hopeless feelings and helpless fears . Such feelings typically precede the onset of suicidal ideation .
It is a true paradox that the healing profession is failing to heal its own members . A better understanding of physician suicide is essential to lower the number of tragically untimely deaths in otherwise healthy colleagues . So what can be done ? We must first as a profession – and as individuals – overcome the enormous stigma in seeking help , especially psychiatric care . Many physicians understandably fear losing their medical license or hospital admitting privileges , which deter them from seeking care . We should be continuing to lobby for changing the antiquated “ mental health questioning ” from our medical license renewals and insurance credentialing forms . Our medical staff offices need to treat psychiatric and addiction treatment no differently than medical care received for other chronic medical conditions . It is unlawful to discriminate based on age , sex or race : so why do we stigmatize those brave enough to seek mental health care ? please share them with a trusted friend or a counselor / therapist . If a colleague approaches you with a concern , be open to hearing them out . Otherwise , the silent epidemic will continue and more physically healthy physicians will die by their own hand . It is a moral imperative and indeed our responsibility to be “ Our Brother ’ s Keeper .”
References :
1
Bucknill John Charles , Tuke Daniel H . A Manual of Psychological Medicine : Containing the History , Nosology , Description , Statistics , Diagnosis , Pathology , and Treatment of Insanity : with an Appendix of Cases . Blanchard and Lea . 1858
2
Physician Suicide . Overview , Depression in Physicians , Problems With Treating Physician Depression . Nov 12 , 2019 . emedicine . medscape . com / article / 806779-overview .
3
Prevalence of Depression and Depressive Symptoms Among Resident Physicians : A Systematic Review and Meta-analysis . Mata DA , Ramos MA , Bansal N , Khan R , Guille C , Di Angelantonio E , Sen S
JAMA . 2015 Dec 8 ; 314 ( 22 ): 2373-83 .
4
The suicide mortality of working physicians and dentists . Petersen MR , Burnett CA , Occup Med ( Lond ). 2008 Jan ; 58 ( 1 ): 25-9 .
5
Romine Taylor . An ER Doctor Who Continued to Treat Patients after She Recovered from Covid-19 Has Died by Suicide . CNN , Cable News Network . Apr 28 , 2020 . www . cnn . com / 2020 / 04 / 28 / us / er-doctor-coronavirus-help-deathby-suicide-trnd / index . html .
Dr . Wernert , MHA , is the Executive Medical Director of Norton Medical Group and practices with Norton Behavioral Medicine .
DID YOU KNOW ?
TAKING A STAND AGAINST BULLYING
The GLMS Physician Wellness Program is available to all GLMS members . This was designed as a safe-harbor for physicians to address normal life difficulties and physician burnout in a confidential , professional environment . We offer free , confidential counseling for members with no insurance billed . Call Raskin & Associates at 502-394-9990 to set up your confidential appointment .
See the inside back cover of this issue for more information or visit glms . org / programs / wellness .
Our colleagues are suffering in our midst and we all must do more . We need to reach out in a compassionate way to physicians who are experiencing the “ insult ” of a medical malpractice claim , or the “ assault ” of a licensing action . We must pay attention if a colleague appears impaired from alcohol or possible drug use . We must acknowledge that we perpetuate much of the professional “ shame ” we feel when we can ’ t keep up . If you have such feelings ,
SEPTEMBER 2021 9