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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