Doctor suicide: Three risk factors cited by Palm Beach Gardens psychiatrist

June 03-- Jun. 3--Long before medical students see their first patient, they pledge to follow the Hippocratic Oath -- which includes the phrase we lay folks all recognize: "First, do no harm."

But within the medical community, there's a reality that the rest of us rarely hear about it: Far too many doctors and medical school students are harming themselves -- fatally.

Statistics show that physicians die by suicide at a rate more than twice that of the general population.

So alarming has the rate of physician suicides become -- especially among young, unestablished doctors -- that independent filmmaker Robyn Symon (who says "I come from a family of physicians") was moved to create the 2018 documentary "Do No Harm" to shed light on the issue.

In the critically acclaimed 85-minute film, Symon interviewed more than a dozen prominent physicians, educators and advocates nationwide, as well as a fourth year medical school student who survived a suicide attempt and the parents of a medical school student who died by suicide.

Among the takeaways Symon found most troubling: that the culture in medical schools and for residents working in hospitals is often rife with "bullying, assembly line care, sleep deprivation from working dangerously long shifts, and witnessing daily trauma and death without the ability to get emotional help for fear of jeopardizing their careers."

As psychiatrist Dr. Darrell Kirch, outgoing president and CEO of the Association of American Medical Colleges (AAMC), said in the film, "This qualifies, in my view, as a pandemic. A problem of not just enormous magnitude for the profession, for all of us as physicians, but it's a problem for patients."

Indeed, what Symon found "most shocking is the link between sleep deprivation and the staggering rate of medical errors -- which turns out is the third-leading cause of death (250,000 annually) in the U.S behind heart disease and cancer."

South Florida psychiatrist Dr. Lindsay Israel -- the medical director of SuccessTMS in Palm Beach Gardens, which treats depression via non-narcotic transcranial magnetic stimulation -- cites a few factors she believes contribute to doctors being at increased risk for suicide:

1. The potential professional consequences of seeking help for mental health issues. "Doctors know that within the medical community, licensing boards may view them less favorably if they disclose their own mental health struggles," says Israel. "I've had patients who were doctors use pseudonyms and not go through their health insurance providers, paying out of pocket in order to remain anonymous."

That there's such a stigma about admitting to an emotional or mental health issue within the physician community is especially ironic because those same physicians certainly wouldn't stigmatize their own patients for seeking help with similar conditions.

Israel believes, just as filmmaker Symon does, that the profession needs a cultural shift in how it approaches the mental health of its members.

2. Always needing to project a veneer of authority and invulnerability. "From medical school on, doctors are trained to have this infallible public persona -- both with patients and colleagues," explains Israel. "The fact of the matter is, doctors are human and potentially fallible. But the pressure to suppress any feelings of self-doubt, guilt, shame or other emotions can become toxic if doctors aren't provided a safe and supportive environment in which to express them."

3. Crushing financial debt. Sure, this is an issue facing virtually all recent college graduates -- but for obvious reasons, it's even more pronounced for medical school graduates, who can find themselves a half-million dollars or more in debt before starting their careers.

"Medical school debt is why fewer and fewer of today's graduates will ever be able to start their own practices," Israel says. "The financial pressures young doctors face are enormous."

And its unknowable how many people who would otherwise pursue a medical career don't because of the prohibitive cost. That leads to an even more troubling fact that will affect all of us: According to the AAMC, by 2030 -- when all baby boomers will be older than 65 -- the U.S. is projected to have a physician shortfall of up to 120,000.

4. Access to lethal medication and expert knowledge in how to end one's own life. As Israel has learned, "When doctors attempt suicide, they tend not to miss."

What this all means is that the healthcare industry is long overdue in recognizing -- and dealing with -- the fact that when it comes to their own mental health, we can't simply rely on another old proverb: "Physician, heal thyself."

___

(c)2019 The Palm Beach Post (West Palm Beach, Fla.)

Visit The Palm Beach Post (West Palm Beach, Fla.) at www.palmbeachpost.com

Distributed by Tribune Content Agency, LLC.