Tuesday, November 15, 2011

"The human side of physician suicide"

The title of today's post is also the title of an American Medical Association (AMA) webinar I'm participating in tomorrow afternoon.

I wish that I didn't have a reason to participate in this webinar, but a few years ago I lost a friend and physician colleague to suicide.  I wrote about my grief and anger in a piece that The Annals of Family Medicine was kind enough to publish.  I submitted what started out as just a personal journal entry to the Annals hoping to provoke change in the medical community's treatment of depression among its own. The Annals editors wisely encouraged me to add some research into my personal narrative, and thus I learned a lot about mental illness in physicians along the way.

The whole piece is available below,* but to sum up: physicians historically have stigmatized other physicians who can't keep up with the demands of our profession. For most of the US medical system's history, a psychiatric diagnosis - even when appropriately treated - had to be reported to state medical boards, who could rescind a medical license on that issue alone.  (This process still happens in some states today.)  This stigma and threat of license loss often keeps physicians with mental health issues from seeking care.  Even worse, physician mental illness has been a taboo topic in the medical community - not discussed, rarely researched, and certainly not actively combated.  Thankfully, these attitudes are beginning to thaw, but we still have a long way to go.

I had no idea what would follow from that one published narrative.  I have been tapped as an "expert" on this subject a few times, now most recently for this webinar tomorrow afternoon.  Perhaps most heartbreakingly, though, I continue to receive e-mails every few months from grieving friends/spouses/colleagues who stumble upon my article.  Their e-mails are heavy with despair and guilt, and responding to them always reopens my own old wounds.

I was quite gratified to learn that the AMA is working to break the silence on this important issue.  Indeed, the AMA president this year has made physician mental health one of his top priorities.(1) The timing couldn't have been better; with decreasing reimbursement, higher patient volumes, and increased bureaucracy, today's physicians are under an unprecedented amount of stress. (2)

Tomorrow's webinar is the third and final in the series.  Here's the link to register (it's free): https://cc.readytalk.com/cc/s/showReg?udc=fxqwubd3v67r

And, here's the link with the prior webinars in the series:
http://www.ama-assn.org/ama/pub/meded/2011-november/2011-november-pd.shtml

Please consider tuning in tomorrow afternoon; the webinars are also all being catalogued and can be listened to later if you're working or otherwise occupied tomorrow.  It's time to stop the silence and work together to care for each other as we do for our patients.

Our fallen colleagues deserve no less.

http://www.annfammed.org/content/6/3/267.full
(1) http://www.ama-assn.org/ama/pub/ama-president-blog.page?plckController=Blog&plckBlogPage=BlogViewPost&UID=0b90b13b-8074-42d2-be9a-5d263dc8c945&plckPostId=Blog:0b90b13b-8074-42d2-be9a-5d263dc8c945Post:57cd846b-50bb-4003-bd99-eecd074555a7&plckScript=blogScript&plckElementId=blogDest
(2) http://www.ncbi.nlm.nih.gov/pubmed/20851643http://www.kevinmd.com/blog/2010/10/ama-physician-health-priority.html

1 comment:

  1. It starts long before becoming a physician. The hiding of mental health issues - namely ADHD or mild depression - the hiding of testing taking anxiety, the concern of who knows what about mental health and disability services; and will they or won't they tell the adcom members; it continues into medical school hidden, secret, sacred because the knowledge of what can and will be done with that is tantamount to dream killing.

    I know. I'm just a wee premed at 47 (and doing very well in classes), and I hide everything. I'm too afraid to be seen as weak or unable even in this supposed enlightened age.

    My hope is that somehow, if I make it into medical school at 48, by the time I'm fully licensed things will change. I know too many docs who suffer. In silence and in shame.

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