Over the past 20 years, the US suicide rate among 16 to 64 year olds has increased by 40%. In this percentage, doctor suicides are hidden – the completed ones.
In the past year alone, we as a country lost about one doctor a day.
Medical students and doctors share the same mental health problems as we do: depression, anxiety, loneliness, and alcohol and drug abuse – now the stresses of medical school, the pressures of long hours and the making of weighty decisions about their patients’ health are mounting. And for good measure, add the fatigue and bitter helplessness of battling an invisible virus over the past year. These are the ingredients for a toxic mental health cocktail.
Too often, doctors fail to seek help with their mental health problems because they fear the stigma associated with mental illness could derail or endanger their careers. Michael F. Myers, MD understands this. For the last 20 of his 35 years in the practice, Dr. Myers a unique practice; He only treated medical students and doctors. In an interview with Medical Daily, he said he had been reminding his colleagues in psychiatry and psychology for years that they fail to grasp the precarious form some frontline doctors find themselves in.
“[As psychiatrists and psychologists] We need to do a better job so that it is easier and safer for our colleagues to come to us for help, ”said Dr. Myers, author of the memoir, Becoming a Doctor. “Some of them die from treatable diseases. I am really worried about that. “
It should worry all of us. But, said Dr. Myers, we can actually help.
As the Covid pandemic continues to scorch the planet, it has become more and more urgent to help doctors manage burnout and depression. A study conducted by the Yale School of Public Health on February 5 found that nearly a quarter of the 1,096 healthcare workers surveyed had evidence of post-traumatic stress disorder. The study published on PLOS One also found that around half of those surveyed could have an alcohol disorder.
A 2018 literature search by MEDLINE and PubMed found that between 2008 and 2018, “the suicide rate among doctors (28 to 40 per 100,000) was more than double that of the general public (12.3 per 100,000). That’s about one suicide a week.
And doctors achieve their goals more efficiently than the general public because they know drugs and are likely to have access to what they want. How much more efficient than the general public? Male doctors, 40% more, and female doctors, even higher.
The January 2020 Medscape National Physician Burnout & Suicide Report surveyed 15,000 physicians in 29 specialties and found that 21% to 24% felt “suicidal” depending on age. Two percent said they had attempted suicide. The survey was compiled before the pandemic.
This makes Medscape’s 2021 report all the more intriguing. When 12,000 respondents across 29 disciplines were surveyed, the report found that 13% of doctors said they felt suicidal and 1% had attempted suicide. These are significantly lower percentages from the previous year and during the pandemic, a petri dish against burnout and depression. What gives?
“It is possible that the pandemic has given doctors a purpose that many struggled with before Covid-19,” said Dr. Myers.
Last spring, when New York was the country’s Covid-19 epicenter, New York State University (SUNY) in Brooklyn ran support groups for doctors. Dr. Myers is a professor of clinical psychiatry there. Many of the doctors present said they no longer felt burned out. ”
“Their very sick Covid patients needed their expertise and training even though the death rates were so high and most of their patients were dying,” he said. “They felt like they were practicing medicine when they were trained. So I wonder if this newfound vitality that we are all together could have reduced suicidal thoughts, at least in this cohort of doctors. ”
In the 2021 Medscape report, doctors in three specialties most closely linked to Covid, critical care (51%), infectious diseases (49%), and pulmonologists (48%) said they were either burned out or depressed. These percentages – infectious diseases (45%), intensive care (44%), pulmonology (41%) – increased slightly compared to the previous year.
The 2021 survey also found that between 33% and 37% of doctors said they had talked to a therapist about burnout. However, 20% refused to speak to a therapist because they did not want to risk disclosure. Of those surveyed, 79% said their burnout or depression started before Covid-19, while 21% said they started after the pandemic.
A witness of a trend
Decades before these studies, Dr. Myers witnessed the suicide trend in real time. He saw the toll that the culture of perfectionism in medicine took on medical students and doctors, and how reluctant many were to seek professional help. Fear of losing a medical license led to many other ways to deal with it.
They often relied on colleagues to prescribe confidential medication. Others treated themselves, hoping anything that worried them would go away. Dr. Myers decided to close his general mental health practice and become a doctor.
“I wanted to set up a pure medical practice as a safe place,” said Dr. Myers. He made it clear to the patient that he “would keep a file on them” because it was a medical practice.
“But I will respect all the rules regarding confidentiality and your privacy,” he said. “I’ll make sure you don’t run into people you know in the waiting room. My notes are all handwritten and my files are all locked. “
His patients have spanned the medical spectrum. He retired from private practice in 2008 and became an ombudsman at SUNY Downstate Health Sciences to investigate student complaints. He noticed a change in medical culture. Gone are the days when doctors cursed students or surgeons who throw instruments. Many medical schools now offer courses in stress management and professional behavior. Overall, the atmosphere in the medical school is “pretty good”.
When Dr. Myers told friends and colleagues that he was writing a memoir about his years of treating medical students and doctors, they wanted to know why? After all, he had already published a book on why doctors die by suicide.
“I said I really wanted to get the message across that doctors are people too,” he said.
This message was not only intended for the public. It was for doctors too. The message: become a patient.
Dr. Myers does.
“If I don’t feel good, I don’t start treating myself,” he said. “I’m going to my doctor. I put myself in his or her hands. “
Patients can also help their doctors. If he or she seems stressed, tired, or baffled, mention it, nothing heavy, just a friend, hey Doc, are you okay?
Better yet, send a card or email to say thank you.
“When I had a really bad day, I would close the door for 10 or 15 minutes and open the draw and start reading old thank you cards my former patients had sent me over the years,” said Dr. Myers. “I’ve heard so many doctors do this. It reminds them that they are good at what they do. This is their humanity that comes through. It’s like an e-hug during the pandemic. “