As a retired physician who has now become involved in suicide awareness and advocacy, I believe burnout is a very real issue among physicians and I am pleased to see that many medical schools and residencies are addressing the need for physician self care.
Did I ever think I was in a high-risk suicide group? Growing up, I have to say it was a topic I never thought about. I did lose my paternal grandmother to suicide before I was born. My father told me she had been badly disfigured in a car accident and had three sons in WWII, and it was too much for her. I accepted that explanation and didn’t think much more about it.
Fast forward to 2000, when I lost my oldest sister by 10 years to suicide. From that time on I learned much more about suicide than I ever really wanted to know. As I sometimes say, I’ve become a member of a club I didn’t ask to join. Besides my family history, which is significant, I had pursued a career in medicine and learned that female physicians had a higher suicide rate than the general population.
All of that information could classify me as someone at high risk and was troubling. Sometimes the saying “What you don’t know doesn’t hurt you” is so true — I now knew information that left me questioning. I can only say I have been blessed thus far without depression, and I have empathy for those who suffer from depression because of the stigma that still surrounds it. My personal belief is that it is hard for physicians to ask for help since they are the ones who’ve gone into the profession to help others. But who helps them when they need help?
Drivers of burnout include work load, work inefficiency, lack of autonomy and meaning in work, and work-home conflict. It may be hard for a physician to seek help for mental health issues because of stigma and the feeling that they are the ones who should be helping others and not needing help themselves. This can lead to self-medication with drugs or alcohol because of possible feelings of shame, guilt and confidentiality issues.
Depression is a significant risk factor for suicide among physicians, but physicians who took their own lives were less likely to be receiving mental health treatment compared with non-physicians who took their lives. The depression rates among residents is higher than similarly aged individuals in general U.S. population-28 percent of residents experience a major depressive episode versus the general population rate of 7-8 percent. Suicide rates among physicians are 1.4 times higher in the male population and 2.27 times greater in females compared to general population.
The Ohio Physician Wellness Coalition (OPWC) is a statewide coalition which is addressing physician burnout and providing physician wellness initiatives. They are working on developing continuing medical education E programs and the possibility of conducting meetings around the state for physicians to discuss issues related to the causes of burnout.
Members of the OPWC include: Ohio State Medical Association, Ohio Osteopathic Association, Ohio Hospital Association, The Academy of Medicine of Cleveland and Northern Ohio, Ohio Academy of Family Physicians, Ohio Psychiatric Physicians Association, Ohio Chapter, American College of Emergency Physicians, Ohio Chapter, American Academy of Pediatrics, Columbus Medical Association, and Ohio Physicians Health Program.
Sallie Wilson Luther, D.O., is a board member for the Ohio Chapter, American Foundation for Suicide Prevention and is walk co-chair of the Dayton Out of the Darkness Walk.