Category: Physician Suicide - Beyond The Body

Beyond The Body

The Ongoing Issue of Physician Burn-Out and Ineffective Interventions to Address It

12/17/2016

It is no surprise that resident physicians are at risk of burn-out and depression as they face new levels of responsibility, higher demands, and more 24 hour call shifts once they graduate from medical school. While the debate around limiting work hours continues, more focus is being placed on helping new doctors cope with such stressors. However, while multiple institutions have tried implementing various initiatives to help their physicians combat stress, often the problem still remains of doctors coming forward to ask for help and support in the first place.

"Two major studies in the past month, one from the Mayo Clinic and one in the medical journal the Lancet, looked at various ways institutions have tried to deal with doctors’ fatigue, emotional exhaustion (a.k.a. burnout) and extraordinary depression rate: 29 per cent, versus 12 per cent of the general population.

The Mayo clinic study found hospitals had the most success with organization-wide changes like regular psychological screening, leadership training for supervising doctors and bi-weekly group dinners where residents can vent to peers who understand.

The Lancet paper, which reviewed previous studies, found pretty much all burnout-reduction programs were equally, and not very, effective. On average, they reduced burnout rates from 54 per cent to 44 per cent, as measured by a standard psychological test.

And that’s assuming those who have a problem admit it."

To read the full article, click here:
http://www.metronews.ca/…/…/05/doctor-diagnosis-burnout.html

1 in 4 Medical Students Have Experienced Depression

12/12/2016

Mental health issues among medical students is not a new concept. Many of us are aware that those in the medical profession, including med students, are at increased risk of burnout, depression, and suicidal ideation due to a multitude of factors including sleep deprivation as well as high stress and demands. However, recently a new systematic review and meta-analysis published in JAMA reveals that approximately 1 in 4 medical students experience depression; a rate thats higher than the general population.

Specifically the review which analyzed studies from over 43 countries revealed "the overall prevalence of depression or depressive symptoms among medical students was 27.2%, and the overall prevalence of suicidal ideation was 11.1%. Among medical students who screened positive for depression, 15.7% sought psychiatric treatment."

To learn more about the study, check out:
http://jamanetwork.com/journa…/jama/article-abstract/2589340
http://www.cbc.ca/news/health/medical-students-medicine-mental-health-depression-suicide-1.3883935

Code Lavender: Rapid Support For Medical Staff

10/2/2016

Many of us who work in a hospital environment are familiar with emergency codes including Code Red, Code Blue and even Code White. But does your hospital happen to have a "Code Lavender"? A few hospitals in the US have begun employing this new code as a way to provide urgent care to patients, families, and more especially nurses and physicians who are in need of emotional and/or spiritual support. Physician burn-out, grief, or stress ... now there is a code for that!

At the Cleveland Clinic in Ohio, the Code Lavender Program has been operating for over 8 years, and provides holistic care services for both their patients and employees. In addition, they also have a rapid response team which can provide more intensive and immediate support for those who are struggling with stress, burnout, grief and loss while on the job.

"Within 30 minutes of a call, the Clinic’s team of holistic nurses arrives at the unit in need to provide Reiki and massage, healthy snacks and water, and lavender arm bands to remind the nurse or physician to take it easy for the rest of the day...

The Healing Services Team employs holistic methods that include spiritual support, counseling and therapeutic massage. Bringing together conventional medicine and alternative remedies, the Clinic also offers employees yoga classes, weight loss programs and mindfulness training."

To find out more about this program, click the link below:
http://www.huffingtonpost.com/2013/12/02/the-amazing-way-this-hosp_n_4337849.html

Resiliency Training Starting To Roll Out Across Canadian Medical Programs

9/18/2016

With increasing evidence shedding light on the high rates of burn-out, depression, and suicide among medical students, residents, and new physicians, there has been a new focus on better training our new generation of physicians for dealing with the emotional and psychological strain and stress of medical training.

Recently, an article was published by Macleans, which reviews some of the new resiliency programs being offered to medical students and residents at programs across the country.

To find out more, click here: http://www.macleans.ca/education/new-curriculum-addresses-mental-health-for-young-doctors/

A Resident Shares Her Story of Depression in Residency and Advocates For Increased Action For Physician Wellness and Support

8/23/2016

In this must read article for all current and soon-to-be residents, Dr. Elisabeth Poorman describes her own experience of developing depression while starting work as a new physician. She also highlights other studies, including her own survey of other physicians, to further demonstrate how mental health struggles are not uncommon among those in the medical profession, and despite residency programs and hospitals giving increased attention to "physician wellness and self-care", there are still multiple barriers to finding and receiving adequate support.

At the end of the article, Dr. Poorman also provides some excellent suggestions that may work to better equip new physicians with the help and services they need to address their mental health issues, in addition to helping them build resiliency, one of the biggest keys of all.

"By the end of my first year of residency, I knew I was in trouble.

I was overwhelmed by the 15-hour days, the unbearable sadness of the tragedies I witnessed, my feelings of impotence and my fears of making a mistake.

My life was my work and everything else seemed to be falling apart: my physical health, my relationships, my ability to sleep after months of night shifts.

Yet, I came to work every day. I completed every task. And then I'd go home each night and cry. An administrator pulled me aside one morning: “How’s it going?” she asked.

I began to sob. “Well, get yourself together and get ready for the day,” she said. I dried my tears off in the bathroom and readied for the rest of my 12-hour shift...

... In writing this piece, I've come to realize that we continue to treat mental health disorders in medical training and practice as the exception. But in reality, mental health disorders in residency are the rule, and those who never experience them are the exception. And though it is common, it should not be dismissed as “normal.” We should not tell trainees, as I was told by numerous colleagues and my own providers, that “this is just residency.” I had clinical depression, and it was very treatable once I was able to get adequate care."

For the full article, click here:
http://www.wbur.org/commonhealth/2016/08/19/depression-resident-doctor?utm_campaign=npr&utm_content=20160821&utm_medium=social&utm_source=facebook.com&utm_term=nprnews

A Resident Speaks Up About Resiliency

8/8/2016

A resident speaks up about how her hospital and residency program handled physician wellness and building ‪‎resiliency‬ after the third internal medicine resident died by ‪suicide‬. She also offers suggestions on how our healthcare system should really be supporting their learners. A powerful ‪‎must read‬ for all ‪‎med students‬ and residents alike ...

"At that noon conference, we found out that one of our fellow residents had committed suicide by jumping from the hospital housing building. This intelligent, dedicated, accomplished young physician was the third internal medicine resident in our 22 square mile city to perform this act with identical detail in just under 2 years. We were dismissed to return to our pagers.

We picked ourselves up, literally, from sobbing piles on the bathroom floor and answered our pages. The work did not stop."

For the full article, read here:
http://news.doximity.com/entries/4120720

Physician Suicide - Why Doctors Kill Themelves

3/24/2016

In her TEDMED talk posted just earlier this week, Dr. Pamela Wible, a family physician and self-described "specialist in physician suicide", shares stories and letters from physicians around the world all of whom have either contemplated, attempted, or died by ‪suicide‬.

Through these stories, Dr. Wible points to medical training and our culture of medical ‎education‬ as one of the culprits of the shocking numbers of physicians suffering from mental illness and suicidal ideation. Through her talk, Dr. Wible hopes to bring more light to this issue and encourage our learning institutions to bring about change in the medical classroom, so as to benefit the mental well-being of both our new physicians, as well as their future patients.

"Sleep deprivation is a torture technique. Fear as a teaching tool just teaches us to be afraid. I can help doctors, though there’s one group I can’t help—patients. From all over the country they write me, begging me to find them caring doctors. How can we give them the care we’ve never received?"

A Physician Discusses Physician Suicide Following The Loss Of A Friend and Colleague

3/18/2016

An anonymous physician shares a deeply personal account of losing a close friend and fellow physician to ‪‎suicide‬. While reports continue to surface of physician deaths by suicide, this story in particular has a powerful impact on readers, highlighting the stresses that can lead to physician burnout and depression, the barriers to doctors seeking help, and ultimately the impact one's death has on loved ones ...

"I became good at managing the stress, though, and by this, I mean suppressing the negative feelings. Physicians are good at delayed gratification. We are good at telling ourselves we are living “normal” lives when anyone living outside of medicine would never consider our existence normal. We tell ourselves it is normal because compared to residency, it kind of is in a perverse way. It works for a while, and many are able to do it their whole careers, but some can’t. I was good at it right up until the point that I wasn’t.

Being a doctor can feel very confining at times. There is an upfront investment of time and money that is greater than most professions. The “real job” often doesn’t start until your early 30s (if you have gone straight through college, medical school, and residency) and at the end of training, you have walked so far down the path it’s all you know. What if it’s not what you expected? What if you hate it? What if it’s no longer fulfilling? The chronic stress of being a physician can manifest itself as depression, anxiety, failed relationships, substance abuse or even suicide. I’ve seen all of these scenarios up close either in myself or others."

For the full article, click here: http://www.kevinmd.com/blog/2016/03/many-physicians-will-lose-suicide.html

Resident Physician Mental Health Issues and The Issue of Confidentiality

1/15/2016

"Imagine you are an ambitious new worker at a powerhouse institution. Your job performance is soaring, but you frankly work like a dog. Your weeks top out at 80 hours, you get maybe a single 24-hour block of time off every 7 days, you work weekends, and you often work up to 30 hours straight in one stint, sleep at work, and eat exclusively from food options in the building. You rarely see the sun, your mother currently has to take care of your cat for you, and you are home so infrequently you cancelled your Internet and cable."

Sound familiar? For many new physicians and residents, this is the road working in the medical profession can frequently take. However, the problem of such a scenario is that it is the perfect environment to become overwhelmed, stressed, and eventually burnt out and becoming depressed, or even suicidal.

On the bright side, many residency programs and medical facilities are working hard to focus on resident wellness and put in place services to support their learners and staff. However, as this article points out, often these supports tend to be offered at the resident's home school or hospital, leading to fears and worries related to confidentiality. What is needed instead, as the physician who authored the article points out, are supports and mental health professionals to talk to who are not affiliated with their colleagues or place of employment.

Do you agree? Would you feel comfortable seeking mental health support at your place of employment?

For the full article, click here: http://www.kevinmd.com/blog/2015/12/dont-poop-eat-mental-health-services-young-physicians.html

Doctors Are Human Too

1/6/2016

In this ‪must read‬ article for ‪med students‬, residents and physicians alike, a ‪surgeon‬ describes her experience with developing burnout and ‪depression‬ on the job, and the immense difficulties she faced in trying to recover while working and even in taking a leave of absence from her job. More so though, the anonymous surgeon calls for all of us in the medical field to remember that we are human and that we need to care for ourselves first before we have the ability to care for our patients.

"The result of burnout is depression. Mine was a deep, dark hole that sucked all the life out of me. I wanted, more than anything, to feel again — joy, sadness, anger, anything. I couldn’t look after myself. And, I certainly couldn’t look after patients. But, that was what I was forced to do. I told my chief of staff I was struggling and needed time off. They told me they would try to find a locum to cover my on-call responsibilities.

But, in the meantime, I was to carry on. Despite medications, my depression continued and worsened. It was exacerbated by work...

I am pleased to see the increasing awareness of physician burnout and availability of resiliency training. But, it’s not enough. It’s time to change physician work hours, so we have time to recover from the stress and emotional trauma. It’s time to trust our colleagues to look after our patients evenings and weekends when we’re not on call. And, it’s time to applaud physicians that don’t go to work when they are sick and build a system with enough human resources to fill in the gaps. Greater manpower makes it easier to fill in the gaps when those left behind aren’t already exhausted themselves. Working exhausted and stressed to a breaking point is unacceptable. It’s not just us that suffer. It’s our families, our friends, and our patients."

For the full article, click here: http://www.kevinmd.com/blog/2016/01/surgeon-loves-job-killing.html