Most of us wish our health care system served us better. We pay too much for too little care. Often, we take our frustration out on our doctors. But our doctors may be in worse shape than we are. I know. I was in medical school and saw what we do to our doctors. They work ungodly hours. Medical training is more like a perverse military boot camp than a training for care and compassion. Medical students are often bullied and shamed. I could see the true face of the profession I was planning to go into. I dropped out of medical school and went into social work. Before I could leave I had to see a psychiatrist. “You must be crazy to leave medical school and give up a 4-year-full-tuition fellowship,” I was told. I knew I’d be crazy if I stayed. Leaving saved my life. Others are not so lucky.
Did you know…
- High doctor suicide rates have been reported since 1858. Yet more than 150 years later the root causes of these suicides remain unaddressed.
You’d think that a problem going on this long would be addressed before now. But it has taken a doctor to come out of the closet and tell the truth about the most serious medical crisis no one want to talk about.
“I’ve been a doctor for 20 years,” says Pamela Wible, M.D., “At 46, I’ve never lost a patient to suicide. But I’ve lost friends, colleagues, lovers — all male physicians. Four hundred physicians per year are lost to suicide, according to a Medscape report. I was determined to find out why.”
- Physician suicide is a public health crisis. One million Americans lose their doctors to suicide each year.
About 400 doctors commit suicide each year, according to studies, though researchers have suggested that is probably an underestimation. Given that a typical doctor has about 2,300 patients, under his or her care, that means more than a million Americans will lose a physician to suicide this year.
- We lose way more men than women. For every woman who dies by suicide in medicine, we lose seven men. Suicide is a tragedy, no whether it’s a man or a woman who dies, but when a problem effects one gender and seven times the rate of the other, we need to pay attention. If women were dying from a problem at rates seven times higher than men there would be an outcry of rage and action would be taken.
But we still treat men as if we were less important than women. Suicide is the ultimate expression that life has become so heavy we want out. The suicide rate for men in all professions is four to fifteen times higher than it is for women and increases with age. In my book, The Irritable Male Syndrome: Managing the 4 Key Causes of Depression and Aggression, I talk about the fact that men express depression different than women. Men act out in anger. Women turn their pain inside. Here are questions to ask to better assess depression in men.
- “Happy” doctors die by suicide.
Men are masters of keeping our feelings inside. We want to be tough, show we can handle our pain without complaining. We smile even when our hearts are breaking. If you’re a woman who wonders, “Why do they do that? I want my man to express his feeling.” I can tell you two things. First, we’ve been trained from the time we were children not to cry or complain and to be tough. Second, although women say they want us to let our feelings out, they’ve been trained to believe that “real” men are strong.
I still remember numerous occasions where I let my feelings out and shared my fear and weakness with a woman and she withdrew from me and later confided, “It scared men when you acted weak. I realized how much I rely on you to be strong.” We have to change the conditioning that both women and men feel that tells us that “men need to be tough and keep his complaints to himself.” Men aren’t the only ones to maintain this stereotype. Women play a role as well and can help in changing it.
- Doctors neglect their own problems.
Doctors have many of the same problems that we all have. They have marital problems. They have aging parents that need care. Their children act out and have problems in school. They have debts to pay and worry about conditions at work. But many work 100 plus hours a week and are immersed in the pain of their patients. They don’t have time to deal with their own problems.
When I was in medical school, I never took time to deal with my own anxiety and depression. I was too busy studying. Once you become a doctor you think the misery is over, but working conditions don’t get much better. In her interviews with doctor, Dr. Wible concluded, “Spending so much time at work actually leads to divorce and completely dysfunctional personal lives.”
- Fear of being sued keeps doctors fearful and worried.
Current medical practice only allows doctors to see patients for ten or fifteen minutes. I’ve seen doctors get fired because they were taking too much time with patients and not seeing enough in a day. When we have assembly line medicine, we make more mistakes. Making mistakes is human. We all make them. But when a doctor makes a mistake, or a patient thinks they made a mistake and hires a lawyer, the doctor risks being sued for malpractice.
Whether they win or lose, they are publicly shamed in court, on T.V., and in the newspapers. I know many doctors who live with the weight of having hurt a patient that they were trying to help. Shame is a heavy weight to carry and many doctors break down under that weight.
- Blaming and shaming doctors increases their suicide risk.
The working conditions in medical schools and later in medical practice are inhumane. Yet, doctors are blamed and shamed if they don’t function at a high level of competency (and make money for their institutions). If they break down or burn out, they are seen as inadequate. If they make a mistake they risk being sued for medical malpractice. If they seek help, their competency is even more threatened so they are caught in a terrible bind. “If I complain, I’m shamed. If I reach out for help, I’m shamed. It’s better to shut up and keep my nose to the grind stone.” Suicide is too often the result.
For many, the only way out is to get out of the profession, or hang until death do we part. “When doctors are punished for occupationally induced mental health conditions (while underlying human rights violations are not addressed),” says Dr. Wible, “they become even more hopeless and desperate.”
When are doctors are becoming hopeless and desperate, our own health and well-being suffers.
Dr. Wibel not only reports on the problems, but is offering solutions. We can develop better ways to train doctors. We need real health care that benefits the patient and doesn’t kill the doctors. Check out what she has to say about an ideal medical practice.
Thanks for the timely reminder to have compassion for the primary care givers and specialists in our lives. Health care has come to a crisis point for everyone and no one is immune to the stress-producing effects.
Dianne, You’re welcome. We often bemoan the “heath care” system, but forget that doctors are in it and don’t often have the power to change it. All of us together can bring about the changes that will truly make it healthy for everyone who is part of it.