Apr 10, 2019
In this episode of the MDedge Psychcast, Sidney Zisook, MD,
gives a Masterclass lecture on physician suicide and Dr. RK talks
about what can be spoken into existence.
If you have ideas, suggestions, questions for Dr. Norris or Dr.
RK, or feedback for the show, please email us at email@example.com. You can also
follow us on Twitter @MDedgePsych.
By Jacqueline Posada, MD
Suicide in general population increased by 30% since 1999. The
suicide rate was 14 people in every 100,000 up from 10.5 people per
100,000 in 1999.
- 400 physicians die per year. However, there is not great data
collection about profession-specific suicide
- Suicide is the leading cause of death in male residents and the
2nd leading cause of death in female residents
- This represents a serious loss of the medical profession as
well as the thousands of patients who lose their physician as
factors for physician suicide
Physicians tend be contentious, perfectionistic, and compulsive.
They are able to cope with delayed gratification, and this may lead
to a false sense of ability to cope with all obstacles, without
- Medicine presents physicians with many obstacles such as the
deaths of our patients and human frailty. Human imperfection and
physician failures are juxtaposed against these traits listed
and genetic risk factors:
Past suicide attempt and presence of mood disorder
- Untreated depression is an especially high risk for physicians
as they may leave their mental illness untreated due to stigma
- As of 2017, 32 of 48 state licensing boards continue to
question doctors about their mental health history.
- There is increased risk of
suicide with the presence of the long arm version of the serotonin
transporter gene and history of childhood trauma
Physicians identify electronic medical records (EMR) and increased
documentation demands as contributing to burnout and less job
- EMR means that doctors feel like they spend more time with
records than face to face with patients. With EMR there is less eye
contact and direct connection with patients so it’s hard to foster
- Physicians feel the stress of increased use of technology and
connectivity via cell phones and the need to “keep up”
As a profession we are starting to talk about physician suicide;
acknowledgment of the issue can lead to change.
- ACGME and other workplaces are starting to integrate physician
wellness into curriculums and culture.