In my first job out of residency, I worked with another new physician. Let’s call him Bill. Bill was a warm, caring and generous, but highly anxious, person. He worried about everything: every patient he took on, every decision he made, every lab that was even remotely out of range. My partners and I also suspected there were things going on in his personal life that were troubling him but we wanted to remain professional. We didn’t want to pry or to make him feel uncomfortable. We figured he was just like many of us… trying to sort out his new role as physician, finding a way to make it fit into his life. Then one day Bill didn’t show up for work. We contacted his family, who lived out of state, and they hadn’t heard from him. Later that day, Bill’s body was discovered in the river.
In our last all provider meeting, we discussed the new regulations requiring health care providers to have a certain number of hours of training regarding suicide. As the requirements and options for training were being laid out, I couldn’t help but think of Bill and of our medical profession as a whole. The figures are frightening. The equivalent of nearly 2-3 medical school classes of physicians die by suicide each year. Male physicians are about 1.5 times and female physicians about 2.5 times more likely to die by suicide than the average person. Not only do we need to undergo training for suicide risk detection and prevention for our patients, but, it seems, we desperately need it for ourselves as well.
The role we have chosen for ourselves is difficult. It has many rewards, of course, but it also can take its toll on self and family. As a group, we tend to be harder on ourselves than we are on others. We hold ourselves to sometimes unrealistic and unhealthy standards. We are excellent at delayed gratification and dedication to others before self. We want to please and have a hard time saying no. We put our lives and families and finances on hold to complete our training and to build a practice, only to be met with what sometimes feels like a lack of appreciation for our efforts. And the ultimate goal of our calling, the development of a close and caring relationship between doctor and patient, is eroded by the seemingly endless administrative duties which are taking over our day-to-day lives. And if we do ultimately feel like medicine is not the right place for us, we often feel stuck – without other skills, saddled with huge debt, and lacking time to pursue other options.
We need to begin to care for ourselves as we care for our patients. We would never suggest that our patients work 60-80 hour weeks, skip meals, get too little sleep, defer family time for more hours at work, take only a few weeks of maternity or paternity leave, etc. This is not a humane way of living and it is unsustainable. We need to support each other as coworkers and in an organizational capacity in pursuing quality of life in the workplace and at home. Our emotions – all of our emotions – are not weaknesses. They are part of what makes us human. We need to acknowledge this as a profession and work to get rid of the stigma that surrounds mental health issues in healthcare providers. And, finally, we need to be there for each other if one of us is struggling.
Some of us worry that reaching out for help would be an admission of weakness or would signal to others an inability to practice in the best interest and safety of our patients. So we don’t reach out. Many of us have long office hours and spend more hours after work completing charting and don’t see a time to be able to attend counseling sessions. So we don’t reach out. But we have to find a way to break down these barriers to care. Below are some of the resources available to us that are confidential and will work around our hectic schedules, we just have to be willing to get started.
None of us can travel this road alone. If you are struggling, please reach out and let someone help you. After all, wouldn’t you do the same for another in need?
· The Spokane County Medical Society (SCMS) Foundation offers a Wellness Program which is staffed by psychiatrists who specialize in treating medical professionals. There is complete privacy and confidentiality (providers are referenced by number only and providers can either choose to go to the psychiatrist’s office or there is a separate room with a separate entrance at the SCMS offices that facilitates anonymity). For SCMS members, the 1st 8 sessions are free. Sessions are contracted at lower rates for non-members. Mental health providers are available 24/7 by pager and can be reached at 509-720-6000 (if not immediately available, a message can be left which the recording states will be returned within 10 minutes). You can find out more about the SCMS Foundation programs at www.spcms.org.