COMMENTARY

A Conspiracy of Silence on Physician Suicide

A Call for a Physician Safety Movement

Hello and welcome. I'm Dr George Lundberg, and this is At Large at Medscape.

We talk a lot about patient safety, albeit perhaps not enough. But who talks about physician safety? Another young resident physician recently jumped off a 33-story building in New York City to her death.[1] Her body goes to the medical examiner's office, whose job is to officially determine the cause of death (presumably blunt force trauma) and the manner of death (homicide, suicide, accidental, undetermined). But who performs the psychological autopsy, the institutional autopsy, the sociologic autopsy, the supervisorial autopsy, the autopsy of the failed support network? Who performs the root-cause analysis of this suicide? Who apologizes to the corpse and the survivors and those people, institutions, and other supporters who have invested so much time, effort, and resources into this accomplished physician who is suddenly gone, forevermore unproductive? Where is the early warning system to prevent such catastrophes from being repeated? Where is the study of "near misses"—unsuccessful suicide attempts or serious suicidal ideation by physicians? And where are the interventions when they really matter? I propose a physician safety movement. It can begin as an initiative, just as the patient safety movement started more than 25 years ago.

Physician burnout is rampant. Physicians seeking early retirement seem epidemic. Psychiatric drug use by medical students and young physicians is rife.[2] Enough American physicians to fill the graduating classes of two medium-sized medical schools are lost annually to suicide.[3]

Where should the physician safety movement be nested? The obvious answer is: in all branches of organized medicine. Perhaps an added function within impaired physician programs could include 24/7 troubled physician hotlines to seek help. Hospital medical staffs, student health offices, residency programs, and employee assistance programs all should have a role.

It is time to change the culture of "let's blame and shame the physician" to a culture of valuing and nurturing, prevention, intervention, and treatment as needed.

That's my opinion. I am Dr George Lundberg, at large at Medscape.

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