Physician burnout and suicide is a growing public health problem, with 1 in 15 physicians having suicidal thoughts. Studies consistently show that physicians are more likely than non-physicians to experience work-related stressors prior to suicide. Yet the exact nature of these stressors was unknown.
To better understand and characterize the occupational stressors that contribute to physician suicide, researchers at UC San Diego Health examined death inquest accounts of 200 physician suicides collected by a national database between 2003 and 2018. Using natural language processing and thematic analysis – tools for extracting and interpreting report data – the team was able to identify key issues that contribute to work stress and suicide among doctors.
The study, published on June 29, 2022 in Suicide and life-threatening behavior, identified six general themes in the reports. These included inability to work due to deteriorating physical health, employment-impairing substance use, interaction between mental health and work-related problems, relationship conflicts affecting work, legal and increased financial stress.
“We often overlook the physical health of our healthcare workers, but poor health can lead to difficulty performing work tasks, which then leads to job stress and mental health issues,” the author said. correspondent Kristen Kim, MD, resident physician in psychiatry. at UC San Diego Health.
The authors outlined several short- and long-term solutions for health care systems to consider.
In the short term, they highlighted the need to improve physicians’ access to primary care services, minimize their scheduling issues, and address their concerns about confidentiality. Kim encouraged healthcare workers to use resources such as UC San Diego’s Healer Education Assessment and Referral (HEAR) program, which provides access to confidential mental health counseling and a recently endorsed by the US Surgeon General’s Advisory on Health Worker Burnout.
In the long term, the authors called for broader structural and cultural changes to address work stress and poor personal care by physicians.
“Medicine’s unspoken culture encourages self-sacrifice, deferred needs, and deferred rewards,” Kim said. “We always want to put our patients first, but healers can only heal optimally if they themselves are the first to be whole.”
The authors emphasized the importance of cultivating a sense of safety and community among physicians. They also suggested that health care systems and medical schools provide additional personal finance education and legal support.
“There’s a lot of work to do,” Kim said, “but identifying and acknowledging the problem is always the first step toward a solution, and that’s exactly what we’re doing.”
Co-authors include Gordon Y. Ye, Nicholas Kos, Sidney Zisook, and Judy E. Davidson of UC San Diego, and Angela Maria Haddad of the Autonomous University of Guadalajara.