Addressing Physician Suicide

At the 19th Annual Chicago Orthopaedic Trauma Symposium, Dr. Pamela Wible presented data and findings from studying physician suicides. You cannot imagine my excitement! Am I crazy to be excited about physician suicide? These events are devastating to me! Rather I am excited that my friend and colleague Dr. Matthew Jimenez invited Dr. Wible to his annual course to share her ever expanding experience with perhaps one of the most challenging topics in medicine. I am excited that our profession may be starting to listen and heed what she is uncovering. In this article, I’d like to examine some of Dr. Wible’s findings and how we can use them to raise awareness, and hopefully prevent future physician suicides. 

What Factors Lead to Physician Suicide?

First things, first – I have always argued that suicide can be both irrational and rational. What causes physicians to take their own lives? From studying over a thousand documented cases of physician suicide, Dr. Wible has discovered several potential causes and/or risk factors. Here are a few of her very important findings which I find very relevant to surgeons:

  • Many physicians know a colleague who has committed suicide. On top of that, those who are affected are not allowed to grieve. What if we demanded time, resources, and opportunities for our colleagues to grieve?

  • “Happy” Doctors commit suicide too. Physicians who appear to be happy and well-adjusted are not exempt from the dangers of burnout and suicidal thoughts. Many physicians are experts at disguising their emotions and putting on a good face. If we don’t know who is overwhelmed, suffering, or risk of choosing suicide from their outward appearance, what if we assumed we are all at risk?

  • Patient deaths & mistakes haunt physicians. When a doctor makes an honest mistake, or loses a patient (even if it wasn’t their fault), they are often haunted by it for the rest of their lives. What if we focused on adult learning theories such as growth and constructive feedback rather than punishment and controlling of others.

  • Physicians experience post-traumatic stress and can develop symptoms of PTSD. While early research suggests that we experience secondary stress through our patients’ traumatic events, I have observed that we experience our own significant primary stress as victims of bullying, physical, mental, emotional and sexual abuse, and the patient death and patient harm.

  • Malpractice suits can have a serious impact. Everyone makes mistakes. But when a physician makes a mistake, they are quite publicly shamed in court and in the media. What if the majority of lawsuits result from a misunderstanding rather than a mistake?

  • Ignoring the problem only makes it worse. Sweeping physician suicides under the rug is only going to make the problem worse.

lifeline

Preventing Physician Suicide

There will be additional lost lives. However, I don't think it will be in silence. These issues are real. Now that people are listening we need to continue to highlight possible solutions.  Here are some of the simple steps we can all take to help prevent physician suicides:  

  • Expect mistakes and train for them

  • Work to prevent bullying, such as stepping in to defend or deflect

  • Encourage physicians to either seek mental health care or utilize confidential coaching resources

  • Set up a “Buddy” system for all physicians

  • Build a life outside of your practice with friends and family

  • When it comes to whistleblowers and bullies, don’t remain silent. At least have a private conversation of potential support.

  • Talk about physician suicide openly and amongst our peers

If you or a colleague have any of the risks for burnout or suicide, please contact Pam,  another coach, or me. If you or a colleague you know is having suicidal thoughts, please reach out now for help. 

Suicide Prevention Lifeline

American Foundation for Suicide Prevention

Physician and Medical Student Depression and Suicide Prevention

Pamela Wible, MD

Source: 33 orthopaedic surgeon suicides. How to prevent #34.