Late on a September afternoon in 2016, I was driving back from a business meeting when I received a disturbing phone call from my physician’s office. They told me they would help me locate a new physician since mine had passed away. They gave me no details. I was perplexed. Was it a heart attack? Another illness I had not known about? An accident? Having visited this physician for over 23 years, I was not only a patient, but we had become friends. As my personal physician, he knew everything about me and truly understood all my quirks and craziness. Dear Doctor: Are You Stressed Out? I immediately called his wife and she told me my doctor had committed suicide. I was stunned. Why did this happen? He had an incredibly successful practice, was revered by his patients and had a wonderful, accomplished and loving family. As a college student, he was awarded the prestigious Morehead scholarship and had a full ride to the University of North Carolina, Chapel Hill. I put him on a pedestal, as I had for the thousands of physicians I represented over my career. Physicians were super human; invincible, I believed. They were the smartest people in the class who always blew any potential grade curves out of the water. How could such a talented, smart, loving and accomplished person commit suicide? He never shared with me that he was stressed or depressed. I never saw him in a negative light or somber mood. I was absolutely baffled. I queried his distressed wife for some clues. All she could share with me was that he had fought depression and burnout for many years. He didn’t seek help because he was afraid the state Medical Board would take his license away. How did I, a medical society executive who has devoted his career to physician professional well-being, not know about the widespread problem of physician burnout and depression? Sure, I was aware of the serious and ongoing stresses of maintaining a viable practice in today’s turbulent times, but I was embarrassed I had never delved deeper into the issue of burnout. This shocking incident was my wakeup call. I immediately went to my North Carolina Medical Society’s Board of Directors and got their blessing to begin truly investigating this problem. The statistics are staggering. A spring 2018 Medscape review of the literature on physician suicide revealed that physicians in the United States have the highest suicide rate of any profession in this country and twice that of the general population at 28 to 40 per 100,000. The last two biennial surveys of physicians by The Physicians Foundation have shown high rates of professional burnout. In 2016, the nationwide survey found 17 percent of physicians reporting that they ‘always’ felt burned out professionally, with another 34 percent saying they ‘often’ felt that way. What is behind these dismal stats? Of course, practicing medicine is an inherently stressful job, and always has been. The massive changes in our health system, dealing with electronic health records, loss of autonomy and uncertainty about the future, all contribute to burnout. But I focused in on the clue my physician’s wife had given me – her husband had not sought help for his depression and burnout because he feared losing his medical license. This led me to our North Carolina Medical Board. Working closely with the Medical Board and the NC Physicians Health Program, we identified a question on the license renewal application, which asked the applicant to disclose any medical conditions that might impair or limit ability to practice. We felt this may deter physicians who need help from seeking it. Representatives from the North Carolina Medical Society (NCMS), along with the North Carolina Medical Board and the Physicians Health Program assembled a task force to determine whether this question was indeed contributing to a reluctance among physicians to admit they were struggling with depression or burnout for fear their license renewal would be rejected. Ultimately, thanks to the work of this task force, the Medical Board eliminated the question. Now, physicians completing the renewal application must affirm a statement acknowledging the Medical Board’s expectation that they appropriately address personal health conditions, including mental health and substance use issues, without the need to disclose specific details. The hope is this will prompt physicians to seek the help they need. This is one concrete step toward addressing the problem, but we have taken others to keep shining the light on this issue. NCMS, North Carolina Medical Board, NC Physician Health Program and other stakeholder groups have come together to form the NC Consortium for Physician Resilience and Retention. The consortium works to educate physicians and organizations about physician wellness as well as develop resources to help promote resilience and retention among physicians and their health care teams. Currently, the Consortium is planning a summit of thought leaders on the subject of physician wellness for October 2018 in Raleigh, North Carolina. The Physician Wellness Summit will bring together decision-makers and influencers from the NC healthcare community to implement positive change through educational efforts and by providing a forum for physicians to share their experiences. On a national level, The Physicians Foundation has been a driving force to elevate the issue of physician burnout and to promote physician wellness to a nationwide audience. The Foundation has devoted nearly $2 million in grants and sponsorships over the past two years to address the issue. Resources devoted thus far seek to develop evidence-based, physician-led approaches that promote resiliency, foster a culture of wellness and increase professional fulfillment. The many organizations and individuals who have rallied to address this problem offers a bit of consolation after my unfortunate wakeup call two years ago. I continue to believe that physicians are deserving of our highest esteem and admiration. I have learned, though, that they also are human beings, who should not be stigmatized for responding to the extreme stress and pressures of their profession in very human ways. I am pleased with the work we’ve done to eliminate any stigma, so physicians can admit they are human. I am optimistic the steps we’re taking to educate, raise awareness and provide necessary resources will help physicians be happier and healthier so they can continue to find satisfaction in caring for their patients’ health and well-being. Source
