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The Facts About Physician Suicide

Posted on Thu, Apr 23, 2015
The Facts About Physician Suicide

According to the American Foundation to Prevent Suicide, roughly 300-400 doctors die by suicide each year.  Though this is only a small fraction of the approximately one million doctors in the US, the problem is important and the impact is huge.
 
If all of the physicians who commit suicide each year were primary care doctors and cared for an average sized patient panel, nearly a million patients would suddenly lose their doctor to suicide every year. 
 
The statistics surrounding physician suicide are staggering and largely unknown.  Suicide death rates among female physicians are up to 400 percent higher than other professional females.  Male physicians have a 70 percent higher risk of suicide than other professional males.   Among non-physicians, males are four times more likely to complete suicide than females.  This is not true for female physicians whose suicide completion rates are equal to their male colleagues.
 
The actual number of physician suicides may be higher than estimated for several reasons.  There is no reporting mechanism for doctor suicide and data collection can be difficult.  Dr. Pamela Wible is a family physician in Oregon who speaks and blogs about physician suicide.  She has suggested that “death certificates are often miscoded by physicians even when there is clear suicidal intent” presumably to cover up the true manner of death.
 
Though there are effective treatments for depression and useful strategies for avoiding suicide, physicians are often too worried about the ramifications of disclosing their mental health concerns to seek treatment.
 
Medical licensure and hospital staff applications often require physicians to answer specific and sometimes intrusive questions about mental health history.   Many physicians with mental health concerns fear the loss of their medical license or hospital privileges if their psychiatric issues are discovered so they either hide their treatment or avoid seeking help all together.
 
Doctors with mental illness may face many challenges when applying for insurance as well.  Not only can liability insurance sometimes be denied for doctors with depression or other psychiatric illnesses but they can also have trouble obtaining health and disability insurance.
 
Unfortunately, the old “physician heal thyself” adage is common for psychiatric conditions too.  Dr. Louise Anderson notes in her Medscape article on physician depression that “a physician whose thought processes are clouded by depression and the anticipated consequences of seeking treatment for it may honestly believe that self-treatment is the only safe option”.   Self-treatment for psychiatric illnesses is not usually very successful.
 
In order to help to reduce physician suicide, need to escalate our dialogue about it and reduce roadblocks and disincentives for physicians who need help for their mental illnesses.  We have seen for many years that ignoring the problems of depression and suicide among physicians will not make it go away.



Dr. Adam Corley is a practicing emergency physician with more than 10 years of clinical and leadership experience.  Dr. Corley currently serves as a Divisional Vice President for the West Division.   He is also the medical director for emergency services at Palestine Regional Medical Center and also serves as the medical director for several EMS services and the Anderson Co. Texas Sheriff’s Dept.  Dr. Corley lectures and writes on a variety of topics including decision science and behavioral economics, management of disruptive behavior in healthcare, conflict resolution, and healthcare leadership.

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The Reason We're All Shocked by Robin Williams' Death.

Posted on Mon, Aug 25, 2014
The Reason We're All Shocked by Robin Williams' Death.

The world was stunned this week to learn of the death of one of the most beloved comedians and entertainers of our time. Robin Williams, the talented and versatile actor who entertained us and made us laugh for decades was found dead of an apparent suicide.

I think Williams passing stands out among other celebrity deaths for several reasons.  Robin Williams was such a talented and versatile actor that most of us found some way to connect with him through his entertainment. Whether it was his stand up comedy, his voice acting, his dramatic portrayals, or his charitable work, the breath and intensity of Williams career touched the vast majority of Americans.

The term “genius” is thrown around pretty loosely these days but I can think of few people that it applies to more that Robin Williams. He was a Julliard-trained actor who burst onto our TVs as Mork and went on to find unbelievable success in just about every genre that he attempted. 

What I think bothers so many people about Williams passing is his manner of death.   The concept that the man often considered to be the funniest people in the world could be suffering from such crippling depression that eventually led to his suicide does not seem intuitive at all.

I think that the apparent juxtaposition between Williams’ comic genius and his addiction, depression, and ultimate suicide should prompt us to highlight both the reality of mental illness as well as the evolving faces of depression and suicide.

Not only is suicide shockingly common in the U.S., the demographics have changed over the past decade or so. In 2011, 38,519 people took their own life in the U.S.  Though suicide has traditionally been considered more common in the fairly young and the elderly, the percentage of 45 to 64 year olds who ended their own life increased 40% between 1999 and 2011. 

I’m hopeful that the media attention that is being focused on Williams, his mental health problems, and his suicide will go a long way towards removing the stigma associated with psychiatric disorders. Depression, bipolar disorder, and other mental diseases are common, real, and should be thought of as mental illnesses as opposed to character flaws. 

We should feel for and support our friends, family, co-workers, and patients with mental illness in the same way that we would if they had a medical or surgical disorder.  In healthcare, we should make sure that our patients feel comfortable talking about their mental health problems and concerns without fear of judgment. 

Robin Williams did an excellent job of not only being open and honest about his mental health and addiction struggles, he did it with dignity and by using his talent for comedy.  I hope that the rest of society can follow his lead and continue to push the flywheel so that we all see mental illness for what it is – a medical problem.

ABOUT THE AUTHOR

corley-pic-resized-600.jpgAdam Corley, MD, FAAEM, FACEP, is a Regional Medical Director for EmCare and practices at Brazosport Regional Health Center in Houston, TX. Follow Dr. Corley on Twitter: twitter.com/AdamCorley

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