The Alarming Rise of Physician Suicide

The recent suicide of another successful orthopedic surgeon highlights the issue of high suicide rates among physicians. Thomas Fishler, M.D. of Sonoran Orthopaedic Trauma Surgeons in Scottsdale, Arizona, was like many other doctors who have completed suicide in that he showed no warning signs to his medical colleagues. A fellow orthopedic doctor commented upon hearing of his death, “I would never have guessed in a million years that Tom would take his life.”

Orthopedic trauma surgeon and physician coach Jeffrey Smith, M.D. blogged about his colleague, “Tom and I did not talk much about emotions. We had talked more about the challenges of practice and integrating efficiencies in practice, and his strengths in this area were why I had reached out to Tom to be on the panel for the annual meeting breakout session. I will share those with others next week. Tom was a great guy and a great surgeon. He was very caring, and I don’t think he would have intended this to hurt his patients, colleagues, mother or daughter.”

Breaking the Silence

Mental health issues remain stigmatized in a professional community where objectivity is expected and fears of losing licensure often prevent seeking help. Doctors may feel that taking time off or revealing depressive symptoms are not options.

Edward M. Ellison, M.D., executive medical director/chairman of the board of Southern California Permanente Medical Group and chairman of the board and CEO of The Southeast Permanente Medical Group, wrote in a recent editorial that “beyond the anxiety, depression, insomnia, emotional and physical exhaustion, and loss of cognitive focus associated with physical burnout, an estimated 300-400 U.S. physicians take their lives every year.” Dr. Ellison referenced suicide rates among doctors is 40% higher for men and 130% higher for women than the suicide rates among the general population.

Another advocate around this issue, Pamela Wible, M.D., gave a keynote at the 19th Annual Chicago Orthopaedic Symposium. She presented research “discovered from investigating more than 1000 doctor suicides—and specifically the suicides of 33 orthopedic surgeons.” Dr. Wible also discussed the lack of warning signs due to physician fears of professional ramifications.

A Case for Burnout Prevention

The World Health Organization’s (WHO) recently classified workplace burnout as an International Classification of Diseases diagnostic code. WHO is currently developing evidence-based practices to promote mental wellness in the workplace.

In a recent piece in OTW, “Physician Burnout: Its Costs and Treatment,” we explored a research study on the costs of physician burnout. “Estimating the Attributable Cost of Physician Burnout in the United States” was published in the Annals of Internal Medicine. In the study, researchers from the National University of Singapore, Stanford University School of Medicine, American Medical Association, Atrius Health, Mayo Clinic, University of North Carolina Physicians Network, and Harvard Business School estimated that physician burnout costs the United States healthcare industry roughly $4.6 billion annually.

The researchers suggested benefits to physician health, patient care outcomes as well as the fiscal impact on the healthcare industry through implementing wellness programs to reduce burnout.

Lead author Shasha Han, M.S., of the National University of Singapore and co-authors referenced a 2018 study in which 10 U.S. CEOs of prominent healthcare organization called physician burnout a public health crisis and called for a larger discussion on solutions. Han and colleagues suggest that highlighting the financial impacts of physician burnout may lead healthcare organizations to be more willing to invest in wellness policies aimed at burnout prevention.