Why Medicine Leads the Professions in Suicide, and What We Can Do About It

A study reported earlier this month revealed that among US professionals, physicians have the highest suicide.
A study reported earlier this month revealed that among US professionals, physicians have the highest suicide.

Earlier this month, 1 of us visited a prominent US medical school to give a lecture on the topic of burnout and how physicians can find more fulfillment in the practice of medicine. Sadly, that very day, a fourth-year medical student there took her own life.

The problem was not personal failure. She had recently matched into a competitive residency program at one of the nation's most prestigious hospitals. Yet apparently, she still found the prospect of the life ahead more than she could bear.

This is hardly an isolated incident. A study (Brodsky B, Tanwar D, 2018) reported earlier this month at the annual meeting of the American Psychiatric Association revealed that among US professionals, physicians have the highest suicide rate. According to the researchers, the suicide rate in medicine is more than twice that of the general population, resulting in at least 1 physician suicide per day in the US In fact, the actual number is probably higher, as the stigma of suicide results in underreporting.

The news gets even worse. There is good reason to think that when it comes to distress among physicians, suicide is only a particularly noticeable indicator of a much larger problem. For every physician who attempts suicide, many others are struggling with burnout and depression. One recent survey found that 42% of US physicians are burned out, with rates of 38% among men and 48% among women. Such distress manifests in other ways, such as alcoholism, substance abuse and poor patient care.

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High stress, but high rewards

From 1 point of view, these findings are not surprising. Medicine has long been recognized as a stressful profession, characterized by competitiveness, long hours and lack of sleep. Many physicians work each day with the knowledge that a mistake could lead to the death of a patient, as well as the frustration that, despite their best efforts, some patients will elect not to comply with medical recommendations and others, despite doing so, will still get sicker and die.

And yet physicians seem to have much to be grateful for. Compared to Americans in other lines of work, they are highly educated and well compensated. They enjoy a relatively high level of respect and trust. And their work provides them with regular opportunities to make a difference in the lives of patients, families and communities. They are privileged to care for human beings in some of their most memorable moments, such as in birth and death, and they may occasionally save someone's life.

Test pilots

Why then might suicide rates among physicians be so high?

While there are undoubtedly many factors, ranging from problems in the health care system to individual circumstances, the recent death of novelist Tom Wolfe at age 88 has inspired us to look at the problem from a different perspective. The author of numerous works of both fiction and nonfiction, Wolfe's best-selling book was 1979's “The Right Stuff,” which chronicled the early days of the US space program.