NY doctor’s suicide reveals tragic trend among physicians
Dr. Lorna Breen, an emergency department physician, died by suicide last week after caring for COVID-19 patients in
New York. Her tragic death is sadly part of a grim reality: The suicide rate among physicians is among the highest of any profession and double that of the general U.S. population.
The suicide rate among physicians is 28 to 40 per 100,000, according to a 2018 study of doctor suicides conducted by Dr. Deepika Tanwar, of the psychiatric program at Harlem Hospital Center in New York. He found that about 400 doctors commit suicide each year.
The deaths of these doctors are silent and rarely reflected in the news — until now with Breen’s passing.
My colleagues and I are well equipped with N-95s, goggles, and suits to protect ourselves from this highly contagious virus. Unfortunately, we are ill-equipped to battle depression, burn-outs, and in some circumstances, suicide.
It starts in the early phase of training in medical school. A 2016 article in the Journal of American Medical Association reports roughly one in four medical students have depression or depressive symptoms, while one out of 10 have suicidal thoughts. Students are burdened by overwhelming debts while in constant fear of not matching into a residency program.
Despite the odds, we are all determined to become great physicians: to heal with our hands and calm with our words. Yet, we graduate medical school into a different environment from our mentors. Recent data published in 2019 revealed that interns (first-year doctors) only spend 13% of their time with direct patient care, while 43% is allocated to the electronic medical record.
In residency, one in three training doctors experience burn-out, a condition characterized by chronic interpersonal stressors. This is a public health crisis. Undoubtedly, the statistics are alarming, but barriers to receiving care is another sobering truth. As physicians, the mental health stigmata are real, and many are barred from receiving help due to time commitment, lack of qualified providers, and confidentiality. Ultimately, we are not immune to the diseases we have been taught to treat.
Soon, the coronavirus pandemic will resolve. “Thank you” letters, healthcare hero videos, and 8 p.m. applauses will dissipate. What will remain are the physicians, nurses, and healthcare allies caring for the sick in our community.
I debated the timing of writing this article in fear that it would marginalize the attention from our healthcare heroes. However, we must honor our physicians lost to fighting coronavirus, like Dr. Breen, by helping to save future doctors.
The first step is to acknowledge a fundamentally flawed health system in which physicians are forced to operate in. This health system produces an overwhelmingly high risk of mental illness in comparison to the general population inflicting long term moral injuries.
Next, we must dismantle barriers for physicians from receiving care. For example, the Florida license application asks about mental illness in the last 5 years impairing the ability to practice medicine. This intrusive inquiry discourages physicians from seeking care in fear of potential repercussions.
An article from the Mayo Clinic Proceedings found that 40 percent of physicians surveyed were reluctant to pursue medical care in fear of reporting mental illness on their medical licensure.
Additionally, we must allocate time for physicians to seek medical care. Residents can work up to 80 hours a week with a mandated 4 days off each month. This leaves limited time to seek medical care. My residency program grants one wellness day each academic year for personal medical care. This is an important initiative that should be implemented and expanded across all residency programs.
As communities rebuild from this pandemic, we must acknowledge the front-line heroes in our communities who have to strive to care for our critically ill populations. Let us afford health care workers the ability to seek mental care without retribution and unite to combat physician suicide.