Your surgeon may be contemplating suicide

I wrote last year in USA Today about the impact of physician burnout.  Not only do doctors suffer, but so do their patients.

Burnout starts early in residency, with entering interns having a depression rate of 4%, similar to the general public.  But after the first year of residency, that number balloons to 25%.

Now, another study adds fuel to this disturbing trend.

A paper published in the Archives of General Surgery looks at the prevalence of physician burnout in surgeons:

In a national survey, one in 16 surgeons reported contemplating suicide, researchers reported.

An increased risk of suicidal ideation was linked to three factors: depression, burnout, and the perception of having made a recent major medical error …

… But only about one in four of those who reported thinking about taking their own lives sought psychiatric or psychologic help.

The rate of suicidal ideation in surgeons, at 6.3%, was almost double of that in the general population (3.3%).

Physician burnout is a phenomenon that’s often ignored. The practice environment is deteriorating, with increasing time pressures and worsening bureaucratic burdens. Little of this is addressed in the national health conversation, or in the recently passed health reform law.

As more doctors burnout and quit medicine, patients will suffer.  It’s certainly not an ideal situation as more than 30+ million newly-insured patients will be looking for physicians to care for them in the coming years.

And for the physicians who stay, burnout will impact the care they give to patients — including a decrease in empathy and an increase in medical errors.

Burnt out doctors feel they have little recourse. In the Archives study,

  • Only 130 surgeons — 26% of those who had recent suicidal thoughts — had sought psychiatric or psychologic help.
  • Among the 501 doctors who reported suicidal thoughts, 301 said they were reluctant to seek help because of worry that it could affect their medical license.

That’s unacceptable. Hospitals need to better recognize the signs of burnout and increase the support they give to depressed physicians.

Another consideration would be to better monitor work hours to ensure proper work-lifestyle balance. Today, doctors in training are strictly regulated to ensure they work no longer than 80 hours a week. Once they graduate and practice in the real world, that oversight ceases. There is nothing to prevent doctors from working days at time, which can happen at an understaffed, rural hospital, for instance.

The same zeal that goes into limiting residents’ work hours should be applied to doctors in the real world, to ensure their workload doesn’t drive them to burnout and potential suicide.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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  • Consumer Pat

    I believe you are overstating the problem when you talk about 30 million patients entering the health care system. First, they won’t all enter at the same time and secondly many if not most, can be evaluated by a PA or NP. Better utilization of PAs and NPs will be a major asset to the incoming increase in medical visits.
    One solution might be to decrease medical school from 4 years to 3 years and this will help with the financial burden medical school graduates take with them as they begin practice.
    Of course health care is going to change…it must. Those who say the ‘best and brightest’ will no longer be attracted to medicine may be correct, but many everyday health problems do not require the services of the ‘best and the brightest’.

    • Catherine Hintz

      I agree with Pat, 100%. It is happening throughout this business module health system minus the “care. Of all the professions, physicians that tried to become businessmen 30+ years ago, you would think physicians would realize this just isn’t working. Maybe an MBA should have been required to practice medicine, too. The best of the best are being poisoned by debt, that many won’t have paid-off when their children are entering college. It’s outrageous. I’ve known physicians working extra hours just to keep their medical insurance! without ever having had a claim against them! Now, they are suffering burn out – and considering suicide – like dentists, psychiatrist/psychologists, airline pilots, air traffic controllers and the list goes on – and add nursing which has almost 50% leaving the profession by retirement or career changes, because of the ridiculous hours, nurse-patient ratios. . . .

      • Kevin

        I’ve said in the past, partly facetiously, that an MBA was needed prior to medical school. At the very least, docs need to be armed with some business courses prior to graduating.

        Kevin

  • guest

    Catherine, many doctors may be paying off their loans when their children enter college because the interest rate of their loans pales in comparison to what they can make with their money. Our loans in med school are 6.8% (a little higher with the loan origination fee) but stocks yield around 10% each year for the long haul. (In its history, including stock market crashes and bull markets, the S and P 500 has yielded something like 10.5% each year) Thus, it behooves the intelligent investor that has a LONG period of time to invest to place money in the market.

    However, the debt is crazy high for med school. Ideally, debt would be inconsequential and our salaries would be reduced so that our total net worth without debt would be the same as with the loan burden.

  • Catherine Hintz

    It just doesn’t feel right that the physician will be paying off his school loans and his children’s school loans at the same time.
    I’m hoping they have a good financial manager and not someone fleecing them like Bernie Maydoff.
    Most of them seem to be living paycheck to paycheck.
    I can still remember when the fee for an office visit was $4 for a solo general practice physician, but cost of living and “standard of care” technology is relative.