Clinicians at Risk for Suicide.

Clinicians at Risk for Suicide.

Topics

Clinician Health

Clinician suicide poses a major threat to our health care system.

The first question everyone asks is, ”Why?” Why did Andrea Liu, a 26-year old radiology student kill herself just weeks before graduating from NYU Medical School? Why did Dr. Ben Shaffer, a successful orthopedic surgeon for 25 years, author of more than 50 publications, and team physician or consultant to more than a dozen major sports organizations, drive his son to school one May morning in 2015 and then hang himself from a bookcase?

In the United States, 300 to 400 physicians die by suicide each year, the equivalent of two large medical school classes. This results in more than a million patients losing their doctor. According to a research study encompassing data from the past ten years, physicians are committing suicide at a rate that’s more than twice as high as the average population.

Why Are Clinicians Dying by Suicide? What Can Be Done to Help?

In response to the growing concern, researchers are ramping up their efforts to understand the causes of clinician suicide; leading hospitals, medical schools, and professional organizations are pioneering new programs and interventions; and regulators are reconsidering how they might revise the licensing/renewal process to support their efforts.

In the United States, 300 to 400 physicians die by suicide each year, the equivalent of two large medical school classes.

There is a lot that can be done in the prevention clinician suicide, and three areas of concern are now coming into focus:

• THE HEALTH CARE SYSTEM. “Many doctors cite inhumane working conditions in their suicide notes,” says Wible. Pressured to spend more time with EMR systems than with patients, physicians no longer feel in control of their time. Increasing demands and disappearing rewards leave many feeling trapped and desperate.

• THE CULTURE OF MEDICINE: Like doctors, first responders make life and death decisions under trying circumstances and routinely cope with the reality of death and dying. Unlike doctors, they are supported by their colleagues, supervisors and professional organizations. Physicians are expected to ignore their own pain and penalized for even seeking help. They end up feeling trapped and desperate.

• THE INDIVIDUALS WHO GO INTO MEDICINE tend to be intensely focused, driven to succeed and unforgiving of their own, and often other’s, imperfections. They end up spending more time at work than at home, thinking more about their patients than themselves and defining their self-worth solely in terms of their profession. When that’s threatened, they feel trapped and desperate.

These articles that follow explore what we know and don’t know about each of these issues, and consider some of the promising approaches now being developed to deal with them. Virtually everyone believes radical changes are needed in the practice and culture of medicine, but no one expects the transformation to hap-pen quickly. In the meantime, physicians can help protect themselves by learning how to honestly assess their own situation and reduce their “suicide potential,” a process we at PBI are eager to help with.

Learn more about raising awareness and preventing clinician suicide on the National Physician Suicide Awareness (NPSA) Day website.

References

1. Collier R. Physician suicide too often “brushed under the rug”. CMAJ. 2017;189(39):E1240-E1241. doi:10.1503/cmaj.1095498