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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Burnout and depression, stress in and out of the office, and the ravages of the COVID-19 pandemic have contributed to many physicians feeling despair and hopelessness, which can contribute to having suicidal thoughts.
Medscape surveyed more than 13,000 physicians who were frank in sharing their experiences about what led them to consider suicide, how they handled those thoughts, how they try to stay mentally healthy, and how they help colleagues who are going through a dark time.
(Some totals in this presentation do not equal 100% due to rounding.)
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
About a fifth (21%) of physicians overall said they were depressed. Of those, 24% noted clinical depression and 64% said they had colloquial depression.
"I am constantly depressed and looking for a way out!!" –Neurologist
"I have little joy in performing the job that I believe I was born to do. The lack of professional satisfaction spills over into my personal life. Now, not only am I tired of work — I'm tired of life." –Emergency physician
Before the pandemic, a team at Penn State College of Medicine conducted simple screenings for depression in multiple hospital systems. Those screenings pointed to a 10% rate of major depression among physicians. "Now, we're seeing a 30%-33% depression rate," says Daniel Shapiro, PhD, vice dean for faculty and administrative affairs, and professor of medical humanism, at the Penn State College of Medicine (Hershey).
"When patients go on ventilators, it's often true that they don't come off them," says Shapiro. "So physicians are witnessing terrible tragedy, which is a painful way to practice."
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Around 1 in 10 physicians said they had thought about or attempted suicide. Recent studies have shown that the rate of suicidal thoughts among physicians is higher than in the general population (7.2% vs 4%).
The rate of suicidal thoughts among physicians has declined since Medscape's 2019 National Physician Burnout, Depression & Suicide Report, when 14% of physicians reported having suicidal thoughts; the rate rose to 22% in 2020 but dropped this year. The rate of physicians attempting (but not completing) suicide has remained steady over the years at 1%.
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Fairly similar percentages of men and women have contemplated suicide.
"It is possible that a 'silver lining' of this terrible crisis is to normalize physicians receiving help for mental health issues," says Patrick Ross, MD, a critical care physician at Children's Hospital of Los Angeles, who had contemplated suicide during the early stages of the COVID-19 pandemic when anxiety, loneliness, and other stressors were crowding in on him. A colleague encouraged him to seek professional treatment, which helped him greatly.
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
This year, pathologists, general surgeons, and oncologists were among the specialist groups with higher rates of suicidal thoughts.
It is important to understand risk factors for each specialty and how they interact with a physician's personal risk factors "that might create a 'perfect storm' leading to suicidal thoughts," says Michael F. Myers, MD, professor of clinical psychiatry at SUNY Downstate Health Sciences University in Brooklyn, New York.
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Boomers who chose to disclose their suicidal thoughts often confided in a therapist, while millennials frequently turned to a family member. One ob/gyn respondent wrote, "So far, the suicidal thoughts are rare and fleeting; my husband and close friends have provided a safe outlet and offered support with healthy coping strategies."
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
"You wouldn't expect a physician to set their own broken leg or perform surgery on their own internal injury, and you can't fix your broken mind with your broken mind. You need someone else to help you, and allowing yourself the vulnerability of seeking help actually comes from a very deep strength," says Andrea Giedinghaden, MD, assistant professor in the Department of Psychiatry at Washington University in St. Louis School of Medicine.
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Sharing such thoughts doesn't happen often, but a very slightly higher percentage of female than male physicians said someone had confided in them regarding suicidal thoughts.
One contributing factor may be, according to some studies, that women are often better listeners than men and have a significantly stronger preference for listening.
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Some respondents described taking a colleague to the emergency department, personally facilitating an appointment with a mental health specialist, and even accompanying the colleague to his or her first appointment. Some gave practical help — for example, by lightening the colleague's workload to relieve stress. Many, especially psychiatrists, counseled the colleague.
"There is no 'cookbook' approach…when a fellow physician tells you he or she is having suicidal thoughts, but I do recommend a formula," says SUNY Downstate's Myers, author of The Physician as Patient (American Psychiatric Publishing, 2008). "Start by thanking the colleague for sharing the information: 'I'm sure that wasn't easy but I appreciate that you respect me enough to share this. Let's talk more.' Then ask what you can do to help, which cuts down on the sense of isolation that colleague may feel."
Sometimes, just unburdening yourself brings relief, according to Myers. "In milder cases, the colleague might say, 'I don't know if I need to see a therapist but I do need to talk about it,' in which case you can offer to meet and talk again. You can also encourage them to talk to a family member or friend."
If you think a colleague is at risk for self-harm, don't just recommend professional help or give a list of names, Myers says. Help set up the visit or personally call the psychiatrist or therapist, or walk the colleague to the ER.
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Overall, female respondents tend to be slightly more involved than their male counterparts in these situations.
"Don't be afraid of saying the word 'suicide,'" says Perry Lin, MD, assistant clinical professor at Ohio University Heritage College of Osteopathic Medicine, and national co-chair of the Physician Suicide Awareness Committee of the American Association of Suicidology. "There is a fear in the public that if you say the word, the person is more likely to do it or they'll start thinking about it. But it's probably running through their head already, over and over again. Having that conversation, recognizing they're in pain and suffering, and helping them get the help they need is the important first step."
"I can't tell you how many suicidal doctors have said they are so grateful for friends and colleagues whom they reached out to, who took them seriously and helped them through that journey," Myers says. "Many have said, 'I'm so glad I spoke to her because I'm not sure I'd be alive otherwise.'"
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Younger respondents more often felt that medical schools and healthcare organizations should be held responsible. With each subsequent age group, fewer physicians felt that the institution bore the ultimate responsibility.
"A generational trend that I've seen is that more younger trainees have been in [mental health] care themselves already. They view it as less stigmatizing and expect that their training programs will offer that care," says Penn State's Shapiro. "Interestingly, I have also seen some state medical societies pay for free mental health care for physicians, and those societies are largely run and funded by boomers."
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
An encouraging sign is that well over half of respondents reported taking steps to maintain their happiness and mental health. Frequent responses to "other" included religious practices/prayer, reducing work hours/working part-time, and spending time with pets.
"Close and intimate relationships are the single most protective factor for our mental health," says Peter Yellowlees, MBBS, MD, chief wellness officer for UC Davis Health and professor of psychiatry at University of California, Davis. "Isolation and loneliness are very important stressors, and we know that about 25% of the population reports being lonely."
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
"When we look online, we often see stories of physicians who have died by suicide but we don't always see a repository of survival stories, which by far outweigh the deaths," says Ohio University's Lin. "People who say, 'I've been where you are and I've made it to the other side and it gets better' encourage suicidal individuals to recognize that suicide is not the only solution."
Some of these resources are particularly valuable because they offer support from a fellow physician who is intimately familiar with this territory. Lin also recommends more "traditional" help, such as employee assistance programs or therapists recommended by the insurance company. "Be sure you know what local resources are available in your community and your health system, since most health systems have some sort of safety net in place." That way, if you need it or a colleague turns to you for help, you have the information at your fingertips.
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
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A Tragedy of the Profession: Medscape Physician Suicide Report 2022
Batya Swift Yasgur, MA, LSW | March 4, 2022 | Contributor Information
Physician Burnout & Depression Report 2022: Stress, Anxiety, and Anger
Physicians had a rough year in 2021, with many feeling more burned out and stressed than they ever have before. Here's what more than 13,000 doctors had to say.Medscape Features Slideshows, Jan 2022
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Batya Swift Yasgur, MA, LSW
Reporter, Medscape Business of Medicine
Disclosure: Batya Swift Yasgur, MA, LSW, has disclosed no relevant financial relationships.
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