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bananas

(27,509 posts)
Fri Sep 5, 2014, 01:14 PM Sep 2014

Why Do Doctors Commit Suicide?

"Physicians are more than twice as likely to kill themselves as nonphysicians (and female physicians three times more likely than their male counterparts)."

http://www.nytimes.com/2014/09/05/opinion/why-do-doctors-commit-suicide.html?src=me&ref=general

Why Do Doctors Commit Suicide?
By PRANAY SINHASEPT. 4, 2014

NEW HAVEN — TWO weeks ago, two medical residents, in their second month of residency training in different programs, jumped to their deaths in separate incidents in New York City. I did not know them, and cannot presume to speak for them or their circumstances. But I imagine that they had celebrated their medical school graduation this spring just as my friends and I did. I imagine they began their residencies with the same enthusiasm for healing as we did. And I imagine that they experienced fatigue, emotional exhaustion and crippling self-doubt at the beginning of those residencies — I know I did.

The statistics on physician suicide are frightening: Physicians are more than twice as likely to kill themselves as nonphysicians (and female physicians three times more likely than their male counterparts). Some 400 doctors commit suicide every year. Young physicians at the beginning of their training are particularly vulnerable: In a recent study, 9.4 percent of fourth-year medical students and interns — as first-year residents are called — reported having suicidal thoughts in the previous two weeks.

Hospitals and residency programs recognize the toll residency takes on the mental stability and physical health of new doctors. In 2003, work hours were capped at 80 hours a week for all residency training programs. Residents are provided confidential counseling services to help cope with stress. My residency program offers writing workshops and monthly reflection rounds. We have a wellness committee that organizes social events such as bonfires on the beach and visits from therapy dogs.

But despite these efforts, people still fall through the cracks. While acute stress, social isolation, pre-existing mental illness and substance abuse may be obvious factors to consider, we must also ask if there are aspects of medical culture that might push troubled residents beyond their reserves of emotional resilience.

<snip>

22 replies = new reply since forum marked as read
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Why Do Doctors Commit Suicide? (Original Post) bananas Sep 2014 OP
Not surprising tazkcmo Sep 2014 #1
I wonder why the overkill on the hours is needed treestar Sep 2014 #2
Exactly. The 80+ hour work week endangers the resident AND patients. SunSeeker Sep 2014 #3
Cheap labor Kelvin Mace Sep 2014 #5
They do real work. Ash_F Sep 2014 #10
It's to reduce the supply of doctors so they can charge more bananas Sep 2014 #14
Some are not prepared outside academia life to deal with Historic NY Sep 2014 #4
They are probably watching doctors' salaries plummet. The Stranger Sep 2014 #6
My Dasia a doctor, my wife is a surgeon... dangin Sep 2014 #7
Is there a lot of pressure from senior medical staff? Rozlee Sep 2014 #9
If course dangin Sep 2014 #12
80 hour workweek is insane musiclawyer Sep 2014 #8
Yeah. 60 would be manageable. cui bono Sep 2014 #21
Doctor suicide attempts are probably more likely to be fatal ThoughtCriminal Sep 2014 #11
Doctors should know better. DamnYankeeInHouston Sep 2014 #13
is there any justification for the extreme hours besides hazing and cheap labor? yurbud Sep 2014 #15
I think it's a culture of sadism magical thyme Sep 2014 #16
Where? Didn't this practice exist before Mengele? yurbud Sep 2014 #18
I think there are religions that have some sadistic underpinnings magical thyme Sep 2014 #19
Because every patient complains about the long wait for the provider. Aristus Sep 2014 #17
... magical thyme Sep 2014 #20
I remember you telling me about that. Aristus Sep 2014 #22

tazkcmo

(7,300 posts)
1. Not surprising
Fri Sep 5, 2014, 01:18 PM
Sep 2014

I worked for USAA for a while but had to quit because listening to the accounts of unemployment, disabilities, illnesses and death became to much for me, among other reasons. It's hard to maintain an emotional barrier while at the same time care for the folks you're dealing with. I feel for them.

treestar

(82,383 posts)
2. I wonder why the overkill on the hours is needed
Fri Sep 5, 2014, 01:29 PM
Sep 2014

Is it really of educational benefit, or just macho posturing? It seems like they need to revamp their programs.

SunSeeker

(51,523 posts)
3. Exactly. The 80+ hour work week endangers the resident AND patients.
Fri Sep 5, 2014, 01:39 PM
Sep 2014

Just make it a 40 hour work week. They can always lengthen the residency period by a year to compensate, if necessary.

 

Kelvin Mace

(17,469 posts)
5. Cheap labor
Fri Sep 5, 2014, 01:47 PM
Sep 2014

New doctors cost WAY less money, especially when you work them like dogs. And if some patients dies, or newbie doctors off themselves, no great loss.

Profits, baby, profits.

Update: Just went and did some checking at various sites and interns are paid anywhere from $35,000 to $50,000 a year and are "forbidden" by law from working more than 80 hours a week, which works out to $8.41-$12.01 an hour (no overtime).

Ash_F

(5,861 posts)
10. They do real work.
Fri Sep 5, 2014, 04:57 PM
Sep 2014

Basically the same work as full-fledged doctors.

As the other poster mentioned, it is cheap labor.

When low wage "trainees" are doing real work, there is going to be abuse.

Historic NY

(37,449 posts)
4. Some are not prepared outside academia life to deal with
Fri Sep 5, 2014, 01:45 PM
Sep 2014

the day in and day out grind of medicine and "dealing with people". They begin to think they can medicate themselves as a block. They then medicate just to get through. I've had three friends all Dr's with distinguished careers, emergency medicine finally did them in. One OD'ed, one ended up a crackhead even with multiple interventions he lost his license, one drank himself to a stuper. Physician heal thyself, has meaning .

The Stranger

(11,297 posts)
6. They are probably watching doctors' salaries plummet.
Fri Sep 5, 2014, 02:50 PM
Sep 2014

First the insurance companies came for the lawyers,
And the doctors sided with the insurance companies against the hated lawyers,
Finally, the insurance companies came for the doctors . . .

Or something like that.

dangin

(148 posts)
7. My Dasia a doctor, my wife is a surgeon...
Fri Sep 5, 2014, 04:04 PM
Sep 2014

I worked at a major medical center for 12 years in close contact with hundreds of doctors and students. The 80 hour work week for residents is quietly ignored in the specialties that need the work load. But still it is vastly better than the 120-140 hours residents put in from the 60s to the late 80s, and yes I realize that the week only has 148 hours in it.

My wife was slammed the first 10 days of her internship. She walked in the door crying the entire first week, and lost 20 pounds the first month.

What did she have going for her. Me. I held her, made her dinner and got her to bed.

The thing about medical students are some of these people are massively unprepared for life. They have been in education their whole life and when the ugliness, the blood, the shit,(literally) and the exhaustion sets in, they can see no way out.

Interventions at the hospital are only so effective. Residency programs should start shuttling the singles and the odd ducks into communal living arrangements where they have support.

And for gods sake. Don't let doctors marry doctors. For every one couple that makes it, ten implode. You can't each work 100 hours per week and expect the rest of life to handle itself.

These are special people doing important work. They need all of our support, just like we need them.

Rozlee

(2,529 posts)
9. Is there a lot of pressure from senior medical staff?
Fri Sep 5, 2014, 04:48 PM
Sep 2014

Starting as a young RN way back in the day, we always heard the saying, "Nurses eat their young," usually referring to the way many older nurses were unsupportive, unjustly critical and judgmental of new nurses. It wasn't a common occurrence, but it certainly wasn't rare either. I'm just wondering if younger medical staff are pressured that much from older established medical professionals.

musiclawyer

(2,335 posts)
8. 80 hour workweek is insane
Fri Sep 5, 2014, 04:11 PM
Sep 2014

60 hours a week should be the goal. That leaves headroom for extra hours in the event of emergencies. That is plenty to learn the profession ....

cui bono

(19,926 posts)
21. Yeah. 60 would be manageable.
Sun Sep 7, 2014, 02:53 PM
Sep 2014

80/week for that long a period is not good. I've been on several jobs where the last 2-3 months of the project I've worked 100 hrs/week but I don't have other people's lives in my hands when doing it, and I'm paid some nice overtime for it. It's grueling to say the least but I also know it will end soon. I don't think I'd want to do it anymore and have picked different projects accordingly.

ThoughtCriminal

(14,047 posts)
11. Doctor suicide attempts are probably more likely to be fatal
Sat Sep 6, 2014, 01:11 AM
Sep 2014

I don't want to minimized the stress factor, but for every fatal suicide there are 11 attempts. For doctors, I would expect that the likelihood of death is much higher than normal because of their medical training and access to drugs that can do the job effectively.

Also, doctors facing terminal illness are probably more aware of what to expect.

DamnYankeeInHouston

(1,365 posts)
13. Doctors should know better.
Sat Sep 6, 2014, 12:41 PM
Sep 2014

Insane hours is not healthy for health care workers and is dangerous to their patients.

 

magical thyme

(14,881 posts)
16. I think it's a culture of sadism
Sat Sep 6, 2014, 11:01 PM
Sep 2014

seriously. And I have ideas about where that sadistic streak came from.

 

magical thyme

(14,881 posts)
19. I think there are religions that have some sadistic underpinnings
Sun Sep 7, 2014, 02:28 PM
Sep 2014

not to the degree of Mengele, of course, but in their treatment of underlings, lessers and "sinners." They have been heavily involved in the health care system from the get-go.

There are certain policies and practices that are entirely unnecessary, and potentially damaging, that are foisted upon patients and workers alike. Punishment for workers who voice a legitimate complaint (say, reporting a co-worker for sexual harassment) can be something like forcing them onto 13 hour night shifts.

Aristus

(66,294 posts)
17. Because every patient complains about the long wait for the provider.
Sun Sep 7, 2014, 10:57 AM
Sep 2014

And then once you're in the exam room to address the complaint they scheduled the exam for - ('cough' or 'knee pain', etc. ) they drag out a laundry list of other time-consuming issues.

"Oh, one more thing...well, two actually. Hey, can you take a look at this? How about this? And this? And this? You can? How long is this gonna take?"

That hasn't made me want to commit suicide, but two or three times a day, I find myself trying to figure out a way to tunnel out of the clinic like Steve McQueen...

 

magical thyme

(14,881 posts)
20. ...
Sun Sep 7, 2014, 02:32 PM
Sep 2014


I've been pushed to the brink twice. Once in school, just the sheer exhaustion and realizing I'd been conned into a debt hole that I will not climb out of in this lifetime.

And the 2nd time when I complained about sexual harassment by a lab assistant, who told a brain-damaged janitor that I was going to have meet him for a cup of coffee and shared personal information with him. I was stalked for a year as a result of that...and forced to work 13 hour night shifts with all of 2 nights of training (and after I'd told them in the job interview that I thought I might be able to work a night shift in an emergency, but my health issues precluded my ever doing it on a regular basis).

Aristus

(66,294 posts)
22. I remember you telling me about that.
Sun Sep 7, 2014, 05:11 PM
Sep 2014

It helps me put my troubles into perspective. I never had to undergo what you have been faced with...

right back!...

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