COMMENTARY

'On a Roof Looking Over the Edge': Why Physicians Commit Suicide

Brandon Cohen

Disclosures

December 11, 2014

And the perspective of a foreign doctor offered at least some evidence that there were other ways of producing competent physicians:

I am a UK doctor and I do not have any memories of my training at medical school or in hospital being traumatic. Of course there were stressful times around exams and long hours, but I have always felt I was being treated as a human.

But life is not always rosier after training has been completed. Many doctors used terms like soul-destroying and enslaved to describe their plight, feeling crushed by the administration of a large hospital or feeling unappreciated by the public they serve.

A primary care physician wrote:

It is time to bring the humanity back into medicine. Instead it seems like we are headed the other way. There is sometimes too much emphasis on the bottom line by employers and insurance companies. And also at times too many oppressive rules in clinics, hospitals, state regulations, etc.

An internist agreed and added:

We are getting crushed by the current medical environment. Health systems that employ us do not care about us, only what we can generate for them in the way of dollars . . . I am surprised that the number of suicides isn't higher.

A psychiatrist spelled it out in desperate prose:

I'm exhausted working 12 to 14 hour days. Electronic medical health records are a big part of it. The demands on doctors and nurses are unsustainable. I can't see how it won't collapse. And compassion? It does not exist for these people. Those who care the most—the idealists—are hurt the most. [It's] competitive backbiting. Don't challenge the status quo. You will pay for it.

Quite a few doctors mentioned religion, specifically Christianity, as a solution to depression. One psychiatrist wrote:

Those who learn to find solace in the Christian religion and . . . use prayers to occupy the mind when in distress . . . will not be taking [their lives].

But other physicians took exception to this way of thinking:

If you are one of those with faith in God, please practice the tenets of your faith, do not blame the victims for being different from you, but love thy neighbor as thyself, be gentle and be supportive.

There were some commenters, however, who had little use for all this talk of emotional problems and potential palliatives. Wrote an ob/gyn:

"I am a doctor in Mosul, Iraq, actively practicing since1977. What stress [is there] in the USA?"

And a radiologist opined:

What I get from this article is that these are psychologically weak individuals who shouldn't have been admitted to medical school to begin with.

But this sort of attitude was quickly rebutted by a number of others, such as one doctor who wrote, "Wow. I do believe that this is exactly the hostile communication [that leads to suicidal ideation.] I pray that you are not practicing."

The final word goes to a physician with a simple question:

I want to be whole and healthy so I can lead my patients in the same direction. Why should we settle for anything less?

See here for the full discussion of this topic.

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