Most physicians, nurses, and medical students know or have known a physician who has attempted suicide or died by suicide, according to results of a recent Medscape poll. The poll, published on May 23, found that 65% of physicians, 41% of nurses/advanced practice registered nurses (APRNs), and 38% of medical students said they knew or know a physician who has tried or completed suicide. In some cases, the responder knew the physician only slightly; in some cases, very well. The poll was taken in light of a report published in May that showed that, with one completed suicide every day, US physicians have the highest suicide rate of any profession. Also in May, reports emerged that a fourth-year student at New York University's Langone Medical Center in New York City and a psychiatry resident at NYU Langone Health died by suicide within a week of each other. When asked what they thought contributed most to physician suicide, respondents' top three answers were burnout, depression, and stress. Physicians rated all three factors similarly; 32% said the top reason was depression, followed by burnout (31%) and stress (28%). An emergency medicine physician who commented on the poll said some factors other than those listed in the poll play an important role. He wrote: "[A] VERY significant factor in physician suicide, namely substance abuse, is not mentioned or is lumped into 'OTHER.' Neither is interference by medical regulatory bodies [mentioned], which can immediately truncate or terminate physicians' ability to earn a livelihood, clearly a substantial contributor to despair and probably also to suicide in individuals who measure their self worth by their ability to earn a living." The poll received responses from 661 physicians, 136 nurses/APRNs, and 61 medical students. Unaddressed Emotions, Relentless Pace Answers by all providers showed heightened concern about the numbers of physician who end their lives. Seventy-five percent of physicians, nurses, APRNs, and students answered that they were very concerned or extremely concerned about the numbers. Only 3% of all the providers combined answered that they were not at all concerned. Some comments showed frustration with the profession. One reader commented, "Physicians and medical schools need to take the practice of medicine back. In the 80's and 90's physicians sold out to insurers who played them into slowly relinquishing control for monetary and other incentives. By the time they realized what was happening it was too late and the last of that old guard was shown the door in this decade because they could or would not adapt to the 'fast food' medicine model used today." A doctor who commented on the story about the prevalence of suicide wrote, "[T]he pace of the job is, at times, something of which most people cannot understand. I am not referring to the speed at which you must make decisions, but at the rate you must digest and move past many of the most emotional experiences you are faced with. I have had times when I had to break the worst possible news to a patient/their family, preside over the demise of a chronically ill child, hold the hand of a dying patient who had been all but abandoned by their family, and in the next minute be expected to move on to the next appointment, next admission, next meeting, perhaps to be chastised for not being as cheerful or punctual as reflected on my patient satisfaction survey." While there's no consensus on what causes physician suicide or what evidence-based solution will reduce the numbers, there is broad agreement that answers must be found. Physicians who die by suicide often have untreated or undertreated depression or other mental illnesses, which highlights the need for early intervention, experts at the recent American Psychiatric Association (APA) 2018 annual meeting said. The suicide rate among physicians stands at 28 to 40 per 100,000, more than double that in the general population, according to recent study results presented at the APA meeting. Source
