Why aren’t more people talking about physician suicide?

I live in Eugene — a sweet little community with snow-capped mountains, farmers’ markets and the friendliest people around.

But a few weeks ago, one of our beloved pediatricians shot himself in the head in a public park. Earlier this year, one of our surgeons was found dead in his car from carbon monoxide poisoning.

And just before him, a urologist shot himself in the head in his backyard. Before him, a local anesthesiologist was found dead of an overdose in a closet and a family physician jumped in front of a train.

What does it mean when our healers take their own lives?

And why aren’t more people talking about physician suicide?

Maybe the real problem is that we can’t say the word suicide. Newspapers don’t like to print the word suicide, unless the family mentions it in the obituary.

In fact, when I do a Google search for the names of physicians who have committed suicide, I find no mention of the word “suicide.” When I Google “Oregon physician suicide,” I find links on physician-assisted suicide. And I guess this is the ultimate act of physician-­assisted suicide — but not the kind anyone would approve of.

Doctors have the highest suicide rate of any profession. In the United States, we lose a physician a day to suicide. That’s two to three entire medical school classes per year.

I dated two fellow medical students during my training. Both are dead. One, an internist in his early 40s, was found in a hotel room with pain pills. My anatomy class partner — a pediatric urologist in his early 30s — “died suddenly.” I’ve never found out how. Or why.

We deserve to know why our doctors are dying, why the mental health of our healers deteriorates during training, why our young medical students have a high risk for burnout, depression and suicide.

Since nobody likes to talk about suicide, I’ll start.

In the fall of 2004, I was suicidal. I didn’t have a gun or a stockpile of pills, but I could have easily acquired both.

Why was I suicidal? Situational depression. What was the situation? My beloved profession had been stolen from me. How? By bureaucrats and middlemen who had inserted themselves between me and my patients and sucked the joy right out of my career.

Fortunately, rather than kill myself or continue to hold myself and my patients hostage in a dysfunctional medical system, I held town hall meetings where I invited citizens to design their ideal clinic. I collected 100 pages of testimony, adopted 90 percent of feedback and opened our clinic one month later.

In 2005, the people in my sweet little community had created the first community-­designed ideal clinic in America.

Now, reporters fly here from all over the country to study our clinic with such happy patients and an unusually joyful doctor. Doctors don’t need to be victims of a health care system gone awry. Hundreds of physicians have opened ideal clinics nationwide. And more and more doctors are choosing to live — and love medicine.

Maybe if my dead colleagues could have experienced more joy in their careers, they wouldn’t be dead. We must investigate why our healers are harming themselves.

But if all we are told is that another doctor “died suddenly,” then the conversation ends.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Pet Goats and Pap Smears.

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  • w_km

    Sorry your experience with doctor suicide is so profound. Can’t site my source atm, but i’ve read that there isn’t a significant difference in suicide rates between doctors and other people of similar socioeconomic status…meaning higher SES is more correlated to suicide than is being a doctor. Unless this is wrong, your point seems to ask: why does anyone with a higher SES commit suicide, and why are our “healers” not immune to such trends? I’d say it’s got more to do with one’s 1 upbringing/family, 2 altered outlook/perspective on life, and 3 the choices we make based upon 1 and 2. For most doctors, I’d say it’s ultimately the 2 that contributes to suicide.

  • PamelaWibleMD

    It does not appear that we are adequately tracking physician suicide. Just from my personal experience and that of other physicians (one doctor in town lost 7 colleagues to suicide over her lifetime), I question whether our data underestimates true numbers of physicians lost to suicide.

    I asked that our state medical board track physician suicide and they did not seem interested . . . yet. I will continue to encourage this. Physician suicide is a public health issue. And given that we have the access to drugs that would make it easy for us to go “peacefully in the night,” I find it even more disturbing that many physicians choose very violent and very public daytime deaths. Of course, “physician suicide” is the triple taboo topic: Nobody likes to talk about death, suicide or certainly that our healers taking their own lives in high numbers.

    • PJT27

      Yes, physicians have a higher rate of suicide than the general public, but the highest rate of all belongs to my profession: veterinarians. I just heard about another colleague last week. I’ve been in practice 10 years and I lose someone I know about every other year, including a co-worker and a classmate so far. Remember, we’re a much smaller profession than physicians. According to a UK study we’re at about twice the suicide rate of physicians, whose rate is quite high. It’s probably because there’s no need for us to surreptitiously acquire drugs; we have euthanasia drugs on hand, often in our homes and vehicles, and we’re very good at killing things peacefully. Those of us in rural areas have guns and know how to use those, too. Oh, and overwhelming stress, especially monetary, and burnout? It’s epidemic in the veterinary profession, to a point where it’s becoming a crisis. No one cares about us, though.

      • Maura69

        As much as I love medicine and am sorry I did not complete Medical School, being a veterinarian would kill me. I love animals probably more than humans, (their love is unconditional and all they want is love in return). A human, I can explain the treatment to, but for an animal – there is no explanation. To be truthful I stopped medical school because I couldn’t treat sick babies and basically I am a wuss!

  • PamelaWibleMD

    Thanks Terry! Will check it out . . .

  • http://www.thehappymd.com/ Dike Drummond MD

    Hey Pam … thanks for naming the elephant. In my mind physician suicide is just the tip of the massive iceberg of physician burnout. With surveys consistently showing 1 in 3 doctors burned out on any given office day and the pace of change in healthcare accelerating … doctors are the canary in the coal mine of modern healthcare.

    Multiple layers of stress coupled with a training process that conditions us to be lone rangers and – heaven forbid – NEVER ask for help or admit weakness … all lead to suicide rates that are 1.5 times normal for male doctors and twice normal for female physicians.

    I have clients who consulted me for this reason, “Dike, I thought I was the most burned out doctor in our group and one of my partners killed himself last week … so I thought I would give you a call.” I am also aware of a new initiative for a wellness program at a Pac 12 university medical center that was started after an attending and medical student committed suicide in quick succession.

    Here is the key, You are NOT a superman or superwoman. Burnout, depression, over work and overwhelming stress are COMMON in the lives of physicians. When you feel like you can’t go on like this for much longer … tell someone, ask for help, take a break. This act is not an admission of weakness … it is the beginning of feeling better.

    And if you know someone who seems overwhelmed … PLEASE REACH OUT and ask them how they are doing. This is another thing that NEVER happens amongst doctors and you could be saving a live by simply asking “How are you doing?”

    Dike
    Dike Drummond MD
    http://www.thehappymd.com

    • PamelaWibleMD

      Yep Dike! And I think many docs graduate medical school with PTSD just from the training. Studies reveal the mental health of medical students deteriorates during medical school. We need to be building resilience in our docs-to-be, not wounding them through training.
      Hey man, love to send you a book. Email me your address.

      http://www.petgoatsandpapsmears.com/

      Time to celebrate the joy of being a physician.
      And model that for others.

      • LBENT

        Why didn’t we feel this way 30 years ago when I graduated? I loved my training. I loved medical school although I found it stressful. Stress doesn’t have to end in suicide. It is much deeper. It is the feeling that we are fungible, unappreciated and just in it for the money. I was up operating until 1 a.m. last night. I worked today on 4 hours sleep. I am giving up 3 days of my life traveling to a conference. I don’t need to be made to feel as if I don’t care.

  • http://www.facebook.com/deborah.munhoz Deborah Munhoz

    Regardless of the statistics- what seems important is that for too many patients and healers, the system is not working. Now seems like a really good time to have honest conversations so we can begin to create what works better for both. A system in transition is an opportunity!

  • StephenModesto

    …Thank you for your post. The necropsy is an important one…It seems upon my relfection that since the time of all the medical advances accomplished with battlefield medicine from the Civil War, medical training and hospital modeling/design has been based on a military model. There is a interesting corollary with the rates of suicide in the military/PTSD and the referred narratives of PTSD through and through out medical `training’. Why is it that ALL medical training subsumes the premise that `good’ doctors can and will work for 36-48 hrs at a time just to prove that they can `cut the muster’? This seems to be an anarchronism which has been embraced as a fraternal tradition of an initiatory hazing ritual. It would seem that there are some more anthropologically minded readers who could add or improve on this thought.

    • PamelaWibleMD

      Agree. The level of abuse that we suffer through our training is a set up for more of the same in our workplace at the hands of employers, third parties, even patients.

  • LBENT

    Thank you, thank you, thank you. This taboo subject is very important. I help women physicians in the careers and am finding more women physicians are experiencing alienation from their chosen careers. Some are targeted and are unfairly shunned; others have never ending low level hostility directed at them. The bullying in medicine, especially by hospital physician administrators, is unbelievable in some hospitals. And these are our colleagues who are doing this. We need to shine a light on this terrible situation. And by the way, I had read that women MDs commit suicide eight times as often as the men.

    • PamelaWibleMD

      I have always been amazed and saddened that so many physicians are willing to step on their own colleagues to further their own careers. I’d like to see us nurture one another, heal each other. Women physicians can lead the way by feminizing health care — bringing their maternal, loving, compassionate energy into a field that has lost its heart and soul.

  • http://www.facebook.com/MazharJhelumi Mazhar Mahmood

    Thank you, thank you and thank you very much for speaking out.Denial or pushing it under carpet will not solve this problem—————-and some one have to speak first and take a initiative.I’m glad you did.i’m picking the lead and i hope many in theire own communities will do the same—-and one,an other and an other joinig in will make a caravan.

    • PamelaWibleMD

      YES! Thank you for taking the lead in your community. Nobody seems to like to say the word suicide. We should be able to name it, say it aloud, and discuss it like we discuss gonorrhea, chlamydia, cancer, or any other topic impacting our health. No taboo.

  • Sharon

    Pam: Ditto with much gratitude for your article. So many important points here.

    As
    an RN on the sidelines, I can empathize with the added pressures of
    billing, new codes, etc. You cannot bill for many things you do; yet,
    must account for every last minute of services which may result in
    further under billing for fear of fraud [heaven forbid you are off a
    couple of minutes of your reported estimate re: the exact amount of time
    you spent face to face with someone as you spoke to several different
    billing elements at any one time during the visit]. You are expected to
    see x amount of patients / day and account for every moment….so, is
    there any bathroom time allocated in there anywhere?!!

    And,
    LBENT: Yes, on top of the above, add the feeling of: “I sacrifice
    unlimited hours and do my best to assist those under my care” while
    feeling surrounded by a seemingly pervasive negative public attitude of
    “doctors just wanting people’s money” [as if the majority of physicians,
    themselves, are benefiting from the astronomically high costs of medical
    treatment while they aren't simultaneously [and seemingly forever] indebted to paying off the horrific loans
    for all the education & training it took to become one]; or that all physicians are in
    cohoots with the pharmaceutical industries, and all they want to do is
    push their drugs, etc.

    Then top that all off with the stigmas
    re: “mental illness” [I hate the term, myself!]. The stigma is tough
    enough in the general population, but amongst physicians? I would say
    that physicians are usually too shamed and/or afraid to open up to one
    another and/or reach out for help [and, unfortunately, not always for
    unrealistic reasons].

    How to “fix” this? I don’t know, but talking about it sure is a start!