Thursday, January 20, 2011

Surgeons and Suicide Ideation

Updated 3/2017-- all links removed as many are no longer active and it was easier than checking each one.

There is a new article on surgeons and the risk of suicide in the January issue of Archives of Surgery (full reference below).
The Kansas City Star’s new article on the study includes this from a colleague who was a plastic surgeon here in Little Rock when I went into practice.  He left his surgical practice a few years ago, retrained and is now in hospice care at the local VA. (photo credit)
Dr. Robert Lehmberg, 63, said it took prodding from close friends to finally get him to seek treatment for depression and suicidal thoughts several years ago. Though he feared losing his license and being stigmatized, neither happened, and he said medication and psychotherapy have greatly helped.
The article notes suicidal ideation (SI) among individuals 45 years and older is 1.5 to 3.0 times more common among surgeons than the general population (P < .02).
This study was commissioned by the American College of Surgeons (ACS) Committee on Physician Competency and Health.  It used an anonymous cross-sectional survey in June 2008. The survey included questions regarding suicidal ideation (SI) and use of mental health resources, a validated depression screening tool, and standardized assessments of burnout and quality of life.
There was a response rate of only 31.7% which resulted in 7905 participating surgeons.  Of these, 501 (6.3%) reported SI during the previous 12 months.
 Only 26% (130/501) of the surgeons with recent SI had sought psychiatric or psychologic help.  More than half [301 (60.1%)] reported the same reluctant to seek help due to concern that it could affect their medical license as Dr. Lehmberg mentions above. 
Burnout with all 3 domains of burnout (emotional exhaustion, depersonalization, and low personal accomplishment), depression, and  report of a recent medical error were independently associated with SI even after controlling for personal and professional characteristics.
The authors conclude:
Although 1 of 16 surgeons reported SI in the previous year, few sought psychiatric or psychologic help. Recent SI among surgeons was strongly related to symptoms of depression and a surgeon's degree of burnout. Studies are needed to determine how to reduce SI among surgeons and how to eliminate barriers to their use of mental health resources.

Related posts:
Doctors with Depression (September 24, 2008)
Stress and Burnout Among Surgeons – an Article Review (April 22, 2009)
Doctors With Depression (September 24, 2009)

Special Report: Suicidal Ideation Among American Surgeons; Tait D. Shanafelt; Charles M. Balch; Lotte Dyrbye; Gerald Bechamps; Tom Russell; Daniel Satele; Teresa Rummans; Karen Swartz; Paul J. Novotny; Jeff Sloan; Michael R. Oreskovich; Arch Surg. 2011;146(1):54-62.


purplesque said...

This is so worrisome- I know of a few psychiatrists who needed help but were too embarrassed to ask for it (in a setting where they knew everyone else in the city) and worried about losing their license. There must be a no-harm way out for medical professionals to get help when they need it.

Gizabeth Shyder said...

Thanks for reminding us that we are human - we all need that (it took me too long to realize it!). Similar to Dr. Grumpy's post this week that was picked up by Kevin M.D. - yes, doctors get sick. Yes, we need doctors for physical and mental ailments, even though we are doctors. Gasp! Our superhuman view of ourselves, perpetuated by those around us, can get us all in big trouble.

Chrysalis said...

I was surprised to see they listed surgeons with such a high incidence. I would have thought it would be the Primary Care Physicians who are feeling increasingly devalued, overworked and exhausted.

We do need a better system to protect these individuals that come forward for help. The demands, pressures and trouble finding balance in their lives put these people at a high risk for suicide.

SeaSpray said...

years ago I heard that it was dentists that had a high suicide rate.

It's so tragic. Interesting that surgeons working under 40hrs not as affected.

It's so tragic. If anyone contemplating suicide could just seek help. I think it's a healthy sign when one seeks help. But, I can appreciate the concern about their employment.

I feel sad thinking that people that do so much to help others ..are in need of help, but don't feel free to seek it out. And that they are so distraught/depressed that even tho they've spent their careers trying to preserve life and help others ..they feel compelled to take their own.

Hopefully this will change and through education.

I'd be one devastated patient/person if that happened to any of my docs... or anyone I know.