Honoring and Advocating for the Life and Humanness of a Physician

To become a physician is a long and hard road. The years and decades of multiple sacrifices and delayed gratifications dating back to high school days is professionally unmatched in my opinion. The hours, occupational risks, burnout potential, and work pressures/responsibilities physicians deal with is also much more than most other professions. And humbly and transparently speaking, practicing medicine post pandemic offers its own set of challenges. To even think about losing a physician to suicide that worked so hard to get to where they are is hard to process.??

The Stats

The statistics on physician suicide are alarming. The July 13, 2022, Medscape article entitled Physician Suicide indicated that we lose upwards of 400 physicians to suicide each year. Exact numbers are not known. In fact, some hypothesize that we may lose physicians to other causes of death exacerbated by underlying mental health conditions and ideations of suicide. Hence this number could be greater sadly. Here are some other unfortunate stats:?

1. In the general population, males complete suicide four times more often than females. However, female physicians have a rate equal to male physicians;
2. Medical students have rates of depression 15 to 30% higher than the general population. Depression is a major risk factor in physician suicide. Other factors include Bipolar Disorder and Alcohol and Substance Abuse;?
3. Women physicians have a higher rate of Major Depression than age-matched women with doctorate degrees;?
4. Contributing to the higher suicide rate among physicians is their higher completion to attempt ratio – which may result from greater knowledge of lethality of drugs and easier access to means.

Adding to physician suicide risk, we already knew that physician burnout was in the primary range of the 50th to 60th percentile depending on subspecialty – even prior to the pandemic. We see the rate of medical malpractice lawsuits has increased and not due to greater medical errors or poor outcomes. We see more chronically ill and behaviorally disruptive patients coming to hospitals post pandemic. This is not just anecdotal, but beginning to be shown in empirical studies. Hence, physicians may be more at risk than most for episodes of situational and clinical depression and anxiety,?OCD, PTSD, sleep disorders/disruption, substance abuse/overuse, marital/relational discord, and other mental and behavioral health conditions and consequences, including suicide.

Remembering Those We've Lost

When you remember and reflect on a physician that has been lost to suicide, please do not think about how they died, but recognize how they lived and what they stood for in our hospital and hearts. Think about them caring for their whole family and treating patient after patient after patient. Think about their landmark legacy and the health and healing that they brought to so many, for so long. ?To me, physicians we lose, for any reason, should be honored similar to when we lose somebody who served in the military or police/fire department. These good, service folks are memorialized with a formal, family honoring service that highlights everything they offered to their team and community. Many of their fellow colleagues come from far and wide to honor these great citizens. Would love to see this for physicians as well.

Dealing with Mental Health Struggles

The modalities in which we treat behavioral and mental health issues have evolved and are effective. There are better pathways to pick the right medication, empirically-based therapeutic strategies, use genetic testing to determine optimal treatment approaches, holistic and naturopathic options, and more sensitive, interventional behavioral techniques (e.g., TMS) that are rapidly growing in utilization and positive outcomes. In my 20+ year tenure, I have seen this positive trend and it is adding hope and optimism for many.?I have also built relationships and friendships that will last a lifetime. So just the thought of one of my friends and colleagues contemplating suicide or dealing with severe depression is heartbreaking and soul crushing. I want to do everything in my, and our, power to prevent such a devastating outcome.?

Please know and advocate that mental health is health (for your pts and YOU). Addressing our mental health and well-being helps us maximize functionality, performance, and feel more fulfilled and actualized in our day in, day out activities. It’s not just problem focused, but also process and improvement focused. Behavioral health and well-being is much more understanding now. It is becoming more accepted now. It is much more performance-based and quality of life improvement now. I encourage you to tour our new state of the art, outpatient Center for Psychiatry and Well-Being on the AdventHealth Shawnee Mission campus. You will find it very modern, comfortable, and a space that is inviting and accepting. You will also find, I believe, my office spaces comfortable and inviting as well.?

Final Thoughts

I do want to share that physician suicide is very real. It has impacted our hospital in the distant past and impacted our local medical facilities and friends as well more recently. We cannot lose one more physician or provider to suicide. We cannot lose one! Well-being programs are here to improve, help, and work tirelessly to save a physician life if and when needed. There are many resources for mental health and well-being in our hospital and community. We have pathways to get physicians and providers in for support confidentially and quickly. I am just one specialized resource for physicians and providers. If we need other resources, we will find those. Talk to a friend, talk to a colleague, talk to a family member, talk to your own doctor, or please talk to/text me (my cell is 913-488-3076). Let’s normalize that asking for help is not weak, but rather a symbol of strength and efficiency. I deeply care about the well-being and welfare of this medical staff.

In closing, today, on this?National Physician Suicide Awareness (NPSA) Day, please remember a?physician that you know lost to suicide. Reflect on them fondly, remember them lovingly, and recognize we lost them way too early. Please stand up with me to enhance education, awareness, and outreach to do everything we can to mitigate and prevent physician suicide. Until next time. Be safe and well.

Sent with?C.A.R.E.,

Ravi

C.A.R.E.?stands for Compassion, Acceptance, Respect, and Empathy. It’s the foundation of how we do our work. Blessings,

Dr. Ravi Sabapathy, AdventHealth Mid-America, Medical Staff and Team Member Well-Being Director - and your?Well-Being?Advocate