Suicidal thoughts plague one in 16 surgeons

About 60% with such ideation don't seek help out of fear it would affect their medical licenses, a new study says.

By Tanya Albert Henry — Posted Feb. 4, 2011

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One in 16 U.S. surgeons had a suicidal thought in the past year, but just 26% sought help from a mental health professional, according to a study in the January Archives of Surgery.

About 60% of surgeons who thought about suicide told researchers they were reluctant to reach out for treatment because they were concerned that it would affect their medical license. Physicians' worries are probably reinforced by the fact that 80% of state medical boards ask about mental illness on initial licensure applications, and 47% inquire about it on renewal applications, according to the study, commissioned by the American College of Surgeons Committee on Physician Competency and Health (link).

"Requests for information about treatment for psychiatric problems by hospitals, clinics and malpractice insurers may also perpetuate physicians' concerns, independent of the efforts made by licensing boards to address this issue," the study's authors wrote. "Other factors, including a professional culture that discourages admission of personal vulnerabilities and places a low priority on physicians' mental health, may also be barriers to seeking professional help."

Other findings from the anonymous survey of 7,905 members of the American College of Surgeons in 2008 show:

  • Older surgeons were more likely to report suicidal thoughts, with surgeons 45 or older having 1.5 to 3 times the rate of suicidal thoughts of the general population. That's despite being highly educated, nearly universally employed and overwhelmingly married, all factors known to reduce suicide risk in the general population.
  • A physician's perception of having made a major medical error in the past three months led to a threefold increased risk of suicidal thoughts.
  • Distress, depression and three areas of burnout -- emotional exhaustion, depersonalization and low personal accomplishment -- were strongly associated with suicidal thoughts.

"Additional studies are needed to evaluate the unique factors that contribute to the higher rate of [suicidal thoughts] among surgeons in conjunction with efforts to reduce surgeons' distress and eliminate barriers that lead to underuse of mental health resources," the study concluded.

Burnout risks

Meanwhile, two papers in the January issue of Anesthesiology found there is high risk for burnout among physicians at the beginning and end of their careers.

In a study that surveyed medical personnel in a perioperative unit, researchers at Vanderbilt University School of Medicine in Nashville, Tenn., discovered that physicians, especially residents, are at a higher risk of burnout than nurses and nurse anesthetists (link).

Physicians had lower job satisfaction and personal support, as well as higher cynicism and emotional exhaustion. That was especially true among residents.

A second study in Anesthesiology from researchers at Northwestern University Feinberg School of Medicine in Chicago found that about half of the 102 anesthesiology department chairs surveyed showed evidence of burnout -- 28% met the criteria for high burnout, and another 31% were in the moderately high burnout category. Also, 28% reported an extreme likelihood of stepping down from the position in one or two years (link).

Low job satisfaction and reduced self-reported support from spouses or significant others significantly increased the risk for burnout, the data showed.

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