Why are so many doctors choosing suicide?
There is a grim statistic that haunts the medical community: the doctor suicide rate.
Somewhere between 300-400 doctors will die by suicide each year, with male surgeons and anesthesiologists being the highest casualty. However, suicide spans all genders and specialties and does not discriminate. “Happy” doctors may choose to end their lives, too.
While this sad reality is receiving more public attention as of late, there are still challenges in preventing these deaths. Why? Because the structure of the healthcare industry promotes stress, anxiety, and sleeplessness—the perfect storm for causing or exasperating mental health issues and addiction in the medical field.
Now let’s dig into physician suicide, why it’s so common, and what can be done to prevent it.
History of physician suicide
Unfortunately, physician suicide is not a new phenomenon.
It has been known and discussed amongst the medical community for the past 150 years. Even the list of historical medical figures who have ended their lives is quite long, from the famous doctor and psychiatrist (and friend of physicist J. Robert Oppenheimer) Jean Tatlock to Jonathan Drummond-Webb, a prominent South African heart surgeon.
It goes without saying that being a doctor is stressful. Traumatic. Anxiety-inducing. Insomnia-inducing. That hasn’t changed much in the past 150 years. Doctors still have to make life-and-death decisions, deal with sleepless nights, and battle feelings of guilt and sorrow.
Why physician suicide is common
Pamela Wible, M.D., has dedicated her life to finding answers as to why physicians kill themselves. In her years of interviewing doctors and the loved ones of doctors who have killed themselves, she’s found some interesting common denominators.
As she wrote in the Washington Post, the main factors in causing these suicides are patient deaths, malpractice lawsuits, med school stress, pressure from the government and health insurance companies, bullying, sleep deprivation, and job demotion.
But internal factors can play a large role in contemplating suicide, as well.
Even the everyday stresses in one’s personal life can magnify the stresses at work and vice versa. Wible wrote that “happy” doctors may end their lives, too. It doesn’t matter if the doctor appears to have the most picture-perfect life: Behind closed doors, they could be suffering from crippling mental health issues and feelings of inadequacy, regret, and guilt.
Unfortunately, 40 percent of doctors don’t seek mental health care because they’re afraid it might hurt their career. In the past, some state medical boards have even penalized doctors who have been diagnosed with a mental health disorder. As a result, doctors worry about getting their license suspended or revoked.
An author of a 2017 Mayo Clinic study on medical licensure questions and physician reluctance concluded that the questions about mental health on medical license applications make physicians feel stigmatized, getting in the way of “treatable mental health disorders and probably contributing to the high rates of suicide among physicians.”
Steps to prevent physician suicide
Because physician suicide is getting talked about more, resources are now becoming more available to doctors.
The American Foundation for Suicide Prevention offers helpful links and a toolkit specifically for med schools and residencies on how to spot and prevent suicide. At the American Medical Student Association, members can access 28 days of free therapy, with the option to continue at a low weekly rate.
But the real change must happen systemically.
First, med schools need to come to terms with the fact that they are creating a toxic culture that breeds depression, addiction, and overly competitive behavior.
Some universities, such as The University of Southern California Keck School of Medicine and The University of Pittsburgh School of Medicine, are paving the way in supporting their students.
At the Keck School of Medicine, they offer med students regular check-ins with a psychologist, free therapy, tools to self-evaluate and track mental health, and mandatory days off. The University of Pittsburgh School of Medicine combats burnout and depression by offering access to mental health professionals, mentorship, and peer-counseling referral and advocacy services.
Second, once these students join the workforce, a system needs to be created where they can comfortably and freely admit to needing support for depression, anxiety, or addiction without fear of punitive consequences. Peter Grinspoon, a primary care doctor, author, and recovering addict, wrote about this in the Los Angeles Times.
“My experience on both sides of doctor rehab has taught me that an oversight system that defaults to sanctions and punishment keeps addicted doctors from getting treatment, which is the worst-case scenario for them and their patients,” Grinspoon wrote. “When doctors abuse drugs and alcohol, they must be met with compassion and care.”
The more the medical field and world-at-large accepts that doctors are human beings that deserve support, counseling and empathy, the fewer suicides we will hopefully see.
If you’re a medical professional experiencing thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255. There is help. You are not alone, and you are appreciated.