A male doctor sitting outside the hospital building trying to catch some rest. He is wearing blue … [+]
Physicians are often under a great deal of stress due to the nature of their work. They are responsible for the lives of others and face constant pressure to ensure everything they do is measuring up to the best possible care, all while workloads increase and resources decrease. Physicians face high levels of stress, often little work-life balance and may be more prone to depression and other mental health issues because of work demands.
At a time when most Americans are making difficult decisions between necessary health expenses and basic needs, the rising costs of care are untenable. In fact, they are rising at a rate higher than inflation. Additionally, the health care industry is already facing shortages of mental care providers and failing to meet current needs for mental health support. These external forces, in tandem with physician demand on work hours and lack of support, has created the perfect storm for our health workforce to need us as much as we need them.
The month of September is devoted to acknowledging and preventing death by suicide. But this year in particular requires a special look at the health industry and the role that care givers, particularly physicians, play. A new study of almost two million people involved with the health industry found those in health care fields die by suicide more than 50% more than individuals in other professions. Moreover, a study by the American Foundation for Suicide Prevention found the rate of physician suicide is higher than that of the general population. In fact, female physicians are 2.3 times more likely to die by suicide than the general population, while male physicians are 1.4 times more likely.
Further, The Physicians Foundation released results of a national survey in 2021, concluding that 55% of physicians know a physician who has considered, attempted or died by suicide. These statistics highlight the need for immediate action.
What’s Happening To Physicians?
There are many overlapping, if not compounding, causes of physician suicide that include burnout, financial stress, relationship problems, depression and mental health issues, substance abuse and other contributing factors.
The average accumulated debt after medical school alone is over $200,000. But during required residency, physicians often earn between $50,000 and $65,000, which frequently doesn’t balance out loan payment requirements after cost of living. Add in many younger physicians are starting families, purchasing homes and increasingly having to take on care of loved ones like parents. The demands of caring for two separate generations in your own home can become overwhelming fast.
This can set any young physician on a path of overworking and neglecting self-care. But it’s also important to acknowledge that even within the health system, there is stigma associated with seeking help, which can prevent physicians from getting the support they need.
Dr. Mill Etienne also calls attention to burn-in, a phenomenon understood well by those in the tech industry. It’s the reason your computer has a screensaver – to literally save it from getting stuck with something etched on the screen. He fears day-in, day-out repetitive trauma may be scaring our physicians.
According to Janae Sharp, founder of the Sharp Index, a nonprofit dedicated to preventing suicide and improving physician, nurse and clinician mental health, “There is no shame in a human response to stress or in mental illness.” She contends their organization’s work won’t be done until people can honestly talk about things like depression and death by suicide the same way they speak about cancer,” which doesn’t happen in any setting today.
The Impact On The Health System
The impact of physician suicide on the health system is significant. It leads to reduced patient satisfaction, as patients may be left without a trusted physician. This can be especially damaging in smaller communities where physicians are often well-known and well-respected. It also increases health costs by further driving up shortages of providers.
Subsequently, these problems lead to reduced quality of care as remaining health providers become further overworked, and inevitably unable to provide the same level of care. This of course, is not to mention the monumental impact loss of life has on colleagues and loved ones. A devastating tragedy and trauma to all those around.
What Can Be Done?
There are several prevention strategies that can be helpful in avoiding physician suicide, most falling on the health organizations themselves. These include promoting work-life balance so physicians can step away from work to recharge, reducing stigma around seeking mental health support and improving access to mental health resources. However, these strategies involve rethinking workplace environment and culture, as well as developing early warning signs and intervention systems that trigger needed outreach when it’s warranted.
Tracking hours of work and other measurable competencies goes a long way in flagging behavior change and need. While no one appreciates being micromanaged, early warnings of burnout, moral injury or emotional need are vital to everyone’s success. This also includes holding technology accountable for the demands it places on physicians, and oftentimes its inability to meet their real world needs.
Additionally, providing assistance to physicians and their families is essential. Physicians don’t work in a vacuum. Families and loved ones sometimes need counseling services, support groups or other resources that can help them collectively cope with the stress and pressure of the physician’s work. Hospitals and clinics must actively change language and policies to reduce stigma, and perhaps most importantly, encouraging physicians to seek help. By guaranteeing confidential and accessible mental health care, health systems can intervene at critical times to ensure any and all appropriate treatment is available to everyone.
Education and training for the prevention of physician suicide is also critical. This includes teaching coping skills and self-care strategies, stress reduction techniques, promoting physician wellness and educating medical staff about suicide prevention.
What we cannot do is continue to ignore a growing problem in our country and health systems. Health care organizations and policymakers have a critical role to play in addressing physician suicide rates. They can implement mental health services and resources, create a positive work environment, foster a culture of support and acceptance and advocate for policy changes. It’s time we all step up to care for those who care for us.