Each Physician Counts
By Steve Adelman, MD
Last month I wrote about the MMWR’s report of an alarming increase in overall suicide rates when comparing 1999 with 2010. The demographic breakdown of the data did not include an analysis of employment or professional status.
It is well-known that physicians have an especially high suicide rate. Over the years, various studies suggest that physicians kill themselves at a rate that is about double that of the general population. Approximately one U.S. physician per day commits suicide. This represents an annual physician suicide rate that is the equivalent of 3 graduating medical school classes. If these high suicide rates are sustained, more than 2% of all medical school graduates will take their own lives.
The suicide rate of female physicians is particularly high. Women account for almost one half of all physician suicides, and they kill themselves almost four times as often as female non-physicians.
Time will tell whether or not the overall increase in completed suicides reported in 2010 continues to be sustained. It may be related to the economic downturn that led to high unemployment and the glut of home foreclosures.
We also do not know if the already high rate of physician suicides is increasing. The information on physicians cited above is based on data collected intermittently over the past 40 years. However, in 2013 the medical profession is rife with reports of physician stress and burnout. Few of us would be surprised to learn that suicide remains a significant occupational hazard in our profession.
There has been much speculation as to the causes of the heightened physician suicide rate. There are many reasons to believe that the current environment may be increasingly hazardous to the health of physicians. To wit:
- We are victims of our own success. The explosion of medical knowledge and therapeutics has increased longevity, and as people live longer, their medical care becomes more complex and demanding. Concurrently, there is growing pressure on the health care dollar. In this environment, many doctors are called upon to do more with less.
- Technology and regulatory requirements add new layers of complexity to the practice of medicine, and the pressures to be a productive physician have never been greater. There is less time available for the sustaining human connection that is at the heart of the doctor-patient encounter, and this frustrates every physician I know.
- The demanding health care world we live in makes it more difficult than ever to balance the demands of work with the pleasures of family and community, and many of us find it increasingly difficult to take good care of ourselves.
It is incumbent upon us, as a profession, as members of health care teams and organizations, and as individuals, to meet these challenges effectively in order to improve the quality of physician life in our society. I am hopeful that we in the physician community will use our wits, our energy, and a spirit of self-help to establish successful strategies to counter the occupational stresses and pressures that may contribute to our unusually and unacceptably high suicide rate.
On October 3, 2013, the Massachusetts Medical Society and Physician Health Services are jointly sponsoring a one-day “Caring for the Caregivers” CME event that will focus on peer support, mindfulness, compassionate care and resiliency training as strategies that can be utilized to improve the work life of practicing physicians. Stay tuned.
Dr. Adelman is director of Physician Health Services, Inc., a corporation of the Massachusetts Medical Society. For more information, visit www.physicianhealth.org. Opinions expressed here are his own, and do not necessarily reflect those of the Massachusetts Medical Society or Physician Health Services.