Yes, this is a difficult subject to discuss, but we must. I have known two outstanding allergists that have taken their own lives during my career. It is estimated that at least one physician in the U.S. each day dies from suicide. We are talking over 300 physicians in one year. That does not count medical students, where suicide is the second most common cause of death. Data suggests that physician suicide is 2 to 3 times higher than in the general population.
Physician suicide has a double peak: during the training years of residents and fellows and in late-middle age. Physicians have more attempts and higher success in suicide than the general population, with males being 40% higher than the general male population and females a whopping 130% higher than the general female population.
Recently, Medscape released a report entitled Physician Suicide Report: The Tragedy of the Profession. I found it very disturbing and eye opening. Over 13,000 U.S. physicians were surveyed in developing this report. Let’s look at some of their findings.
In assessing depression in physicians, they found 21% of the respondents depressed. Of those, 24% had clinical depression and 64% had colloquial depression, which was defined as feeling down, blue, and sad. When asked if they ever felt suicidal or attempted suicide, 9% had suicide ideation and 1% had attempted suicide. Again, these numbers are much higher in than the general population. In breaking down by gender, 11% of females and 9% of males had suicide ideation. Suicide attempt was 1% for both.
Medscape did break down suicide ideation among specialties. The highest was pathology at 13% followed by general surgery and oncology. Allergy/Immunology was at 6%, with the lowest seen in nephrology at 2%. At least we were in the lower third of specialists.
As we see with burnout, it is important that we practice resilience strategies for our happiness and mental health. In this survey, the most common one cited was spending time with family/friends. This comes back to the concept of work/life balance. I think this is a difficult concept, especially for the older physician. Recently I did a “Meet the Professor” on burnout and wellness at the Aspen Allergy Conference. There was an interesting discussion between an older allergist having trouble with younger allergists’ work ethic and the younger allergists stressing the importance of work/life balance. Even though I fall under the category of an older allergist, in this case, I must agree that the younger allergists are correct. Without work/life balance, there is a definite increase in burnout, depression and suicide.
When asked by Medscape if the physicians told anybody about their thoughts of suicide, millennials (ages 27-41) equally told a friend or family member, while boomers (ages 57-75) more likely talked with a therapist. Generation X (ages 42-56) equally reached out to a family member or therapist. Most disturbing was that 44% of boomers, 38% of Generation X’ers, and 34% of millennials did not talk with anyone.
This gets back to the whole reason that I wrote this column. We have to reach out to our colleagues if we are concerned that they are suffering from depression or contemplating suicide. Remember “if you see or hear something, say something.” Mental health is just as important as physical health. We need to assist them in getting help. You may know that, throughout the United States, there is a new 988 Suicide & Crisis Lifeline. It has with it a network of over 160 crisis centers that provides 24/7 service via a toll-free hotline that can be reached with the number 9-8-8. It is available to anyone in suicidal crisis or emotional distress. Let’s reach out to our colleagues so we don’t hear about the loss of another allergist to suicide.
