Already, overworked physicians kill themselves at twice national rate
Vincent was a jubilant elementary-school boy, the kind who played pranks and made people laugh. When he reached high school, he maintained his outgoing nature but also matured into a kindhearted and sensitive young man. As a student, athlete and artist, he always strove for perfection. He was an all-around good kid, according to his mother.
But then Vincent went off to medical school. Forced to work or study more than 80 hours a week, he had trouble sleeping. He lost a lot of weight. He stopped joking and laughing.
As a surgical resident, Vincent had qualms about saving a rapist who was injured while trying to escape from the scene of his crime. Another day, Vincent was shaken when two car accident victims brought to the ER looked like his mom and aunt, who often rode together without seat belts.
Vincent became disillusioned. The stress of the medical profession was too much for him to handle. Two months after starting his surgical residency in New York City, at the age of 25, Vincent hanged himself with a belt in his closet.
Dr. Pamela Wible told Vincent’s story at the 2014 American Academy of Family Physicians Assembly in Washington, D.C., to highlight the problem of physician suicide.
About 300 to 400 physicians kill themselves in the U.S. each year, according to the American Foundation for Suicide Prevention. Physicians have the highest suicide rate of any profession and are more than twice as likely as the average American to kill themselves.
Experts note common diagnoses among doctors who commit suicide are depression, bipolar disorder, alcoholism and substance abuse – the same factors that generally lead to suicide in the population at large. But what is the impetus that drives so many doctors to take their own lives?
Three University of Oxford researchers performed a psychological autopsy study of 38 physicians who died by suicide in England and Wales from 1991 to 1993. The researchers found that 25 of the 38 doctors had significant problems at work before they died. Of the 25, eight felt overburdened by their volume of work, six suffered from long work hours and six felt unable to cope with the responsibilities of their jobs.
Some physicians and medical students have offered anecdotal explanations for the high suicide rate in their profession. Pranay Sinha, a physician in his first year of residency at Yale-New Haven Hospital, wrote in the New York Times that he and other medical students experienced “fatigue, emotional exhaustion, and crippling self-doubt” at the beginning of their residencies.
Sinha said that once medical students become real doctors, their workload suddenly increases.
“Most fourth-year medical students are expected to take care of four patients at a time,” he said. “But within a month of graduation, without any additional training or practice, we are required to have a comprehensive understanding of up to 10 patients on any given day.”
Sinha wrote that his first two months were filled with “severe fatigue, numerous clinical errors (that were promptly caught by my supervisors), a constant and haunting fear of hurting my patients and an inescapable sense of inadequacy.”
A 2008 study published in the Annals of Internal Medicine examined the relationship between suicidal ideation and burnout, defined as emotional exhaustion, depersonalization and a lowered sense of personal accomplishment.
The study of more than 4,000 medical students at seven schools found that half of all students experience burnout while in medical school. Approximately one of every nine students reported having suicidal thoughts while in school. The researchers found a correlation between student burnout and subsequent thoughts of suicide.
Written by Paul Bremmer
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