Healthcare organizations must make it easier and safer for distressed physicians to get psychiatric care, says an expert who has learned from many survivors' families that their departed loved ones had received no help at all.
The United States loses roughly one physician per day to suicide. The exact statistics are unknown.
"We don't know whether that's increasing or decreasing, but anecdotally it's not going away," says Michael F. Myers, MD. "I continue to get emails from colleagues or learn of doctors either in NYC or other places who have ended their lives—so our work isn't done."
Myers is a professor of clinical psychiatry and the immediate past vice-chair of education and director of training in the department of psychiatry and behavioral sciences at SUNY-Downstate Medical Center in Brooklyn, NY.
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As part of this work, Myers co-authored the book, Why Physicians Die By Suicide: Lessons Learned From Their Families and Others Who Cared. Myers recently spoke with HealthLeaders recently about what healthcare leaders can take away from his experience. The transcript below has been lightly edited.
HealthLeaders: You've indicated that many physicians suffer from untreated mental illnesses. Are suicides caused by these underlying conditions, extreme work pressures, or both?
Myers: It's a combination. It's important that we understand that despite the fact that practicing medicine is very stressful, it always has been. Normally, if a doctor is feeling his or her usual level of resilience, he or she can get through quite a lot.
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They will even often say, "I'm used to working hard, the threat of lawsuits, sometimes losing patients—but right now I'm a mess and I need help because I'm afraid I'm going to hurt myself."
I wish more doctors feeling like that would go for help.
HLM: To what extent does stigma keep doctors from getting help?
Myers: I found that for 10% to 15% of the families I interview, their departed loved one had not received any help at all. They had catastrophic fears they would lose their job, they would lose their medical license, their malpractice insurance, hospital privileges, and their patients.
Are these fears over the top? Yes. But there is a bit of truth in some of them having to do with medical licensure when questions are asked that are outdated, such as, "Have you ever suffered from a psychiatric illness?"
So it's one of my initiatives through this book to emphasize that when doctors do go for help, it's extremely important for those who look after doctors be very sensitive to these worries that physicians have about stigma.
It's hard enough to not feel well, but to be living with an illness that you feel ashamed of is very sad. It saddens me, too, when I learn of so many physicians who went from feeling ill to killing themselves without any intervention from a primary care doctor, internist, psychiatrist, psychologist, pastor, nobody.
And the care available works. A lot of these illnesses in psychiatry are treatable, but we need to make it easier and safer for doctors to get help.
HLM: What can healthcare leaders do to help promote physician resilience?
Myers: One is to just be knowledgeable about this subject and not be in denial. Within your physician work force, most will be fine; but like in any group, there are others who are more vulnerable.
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Accept that and ensure your system allows for people to take medical leave if needed without feeling they're letting down their colleagues.
Additionally, in organizations where doctors feel included, like they're part of a family, as corny as it may sound, it really does mean something.
This is the way we strive to treat our patients. Why not our doctors?
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.