Saturday, November 07, 2009

Physician, Heal Thy Profession

I just stumbled upon this link: When Doctors Kill Themselves.
The unsettling truth is that doctors have the highest rate of suicide of any profession. Every year, between 300 and 400 physicians take their own lives—roughly one a day. And, in sharp contrast to the general population, where male suicides outnumber female suicides four to one, the suicide rate among male and female doctors is the same. (Newsweek)
Interestingly, it was written in April 2008 and not at all in response to the Ft. Hood incident yesterday. It reminded me of my thoughts from earlier today while listening to WWL talk radio. I guess because the gunman hadn't been deployed yet, it didn't occur to the callers or the host that occupational stress might have played a role -- at least not during the 45 mins. of the show that I heard.

There are obviously other factors involved (so do not go the hell off in my comments section about me being a "liberal/socialist" apologist for terrorists who hate America, or about Muslims, or tea bags, or big government, or whatever), but as a mental health professional, my first reaction was to wonder what stress military psychiatrists and psychologists, as well as civilian ones working for the VA, must be under. It's no secret that the soldiers returning from war have experienced serious psychiatric illnesses, and that the VA system is stretched very thin right now and, by extension, so are the doctors.

I wouldn't be surprised if being a doctor played a significant role in leading this psychiatrist to such a low point in his life. Physician suicide vs. going the hell off and killing others are two different things, but the two scenarios share some of the same causes.

Article on physician suicide:
they worry—not without reason—that if they admit to a mental-health problem they could lose respect, referrals, income and even their licenses...

...physicians are supposed to be the strong ones who care for the sick, not the sick ones who need to be cared for. "I did not want it to go on my medical record that I had been treated for depression," says Dr. Robert Lehmberg, 60, whose moving account of his struggle with the condition—and the stigma it carries.

Article on the Ft. Hood shooting:
The consensus at Walter Reed, Casscells said, was that Hasan was sent to Fort Hood for "a fresh start" after a difficult time at the medical center.

Hasan received a poor performance evaluation there, the Associated Press reported, quoting an official who spoke on condition of anonymity. While he was an intern, Hasan had some "difficulties" that required counseling and extra supervision, according to Dr. Thomas Grieger, who was the training director at the time...

...The military will look at all this closely and decide if there is any mental or physical illness, whether this is just a lonely guy with a remote personality who got a bad officer evaluation report and lost the confidence of his peers...

...Our focus was on the doctors to dig deep and do all they can for these guys (troops) and to have one of our own do this is personally crushing.

Healthcare providers, especially doctors, are supposed to "push through it" and perform perfectly no matter what is going on, an expectation that's hard to argue with since they're responsible for human lives. Still, at a certain point and with enough pressure, something's gotta give.