Editor鈥檚 note: This story includes the mention of suicide and its impact on a community. If you or someone you know is suicidal, you can reach the national suicide hotline at 800-273-8255.
About 400 doctors die by suicide in the United States each year. That鈥檚 the size of a medical school鈥檚 graduating class.
Dr. Steven Reid, 68, said those 400 physicians translate to roughly 1 million U.S. patients who lose their doctors annually.
Yet the retired Gainesville neurosurgeon said the general public doesn鈥檛 recognize this problem.
Reid started , a nonprofit organization that works to uncover and resolve the circumstances causing the high rate of physician suicide, in 2018 as a project for his retirement. Losing seven colleagues and his father to suicide, he said he felt he had a unique perspective.
鈥淚f you randomly were to look into an exam room in a doctor鈥檚 office anywhere in the country, the doctor is about twice as likely to die by suicide than the patient in front of him or her,鈥� Reid said.
Reid said there鈥檚 a culture in medicine that expects perfection from doctors. There鈥檚 a belief that if doctors takes time off from their practice, they鈥檙e dumping their responsibilities onto colleagues, he said.
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Throughout Reid鈥檚 training, from internship to his graduation from the neurosurgery residency program, he said he took only one day of sick leave. In terms of mental illnesses, speaking about being depressed or burned out is 鈥渢aboo in the culture,鈥� Reid said.
Doctor Lifeline is looking to change that culture.
鈥淚 think depression needs to be recognized and destigmatized,鈥� he said. 鈥淚 think that there shouldn鈥檛 be any cultural cost for a young physician to say, 鈥楬ey, I鈥檓 really depressed.鈥欌��
But the reality is there are many reasons those in the medical field decline to share their mental health issues. Reid said the fear of a documented illness influencing their licensing, referrals and ability to get insurance causes some to suppress the truth.
Dr. Mariam Rahmani, 40, said people should treat mental health care like regular health care. The psychiatrist said licensing for physicians to practice shouldn鈥檛 ask, 鈥淒o you have any mental health conditions that impair your ability to work?鈥� but instead should ask, 鈥淒o you have any health conditions?鈥�
Health includes mental health, Rahmani said.
鈥淭he implicit message is that physical illnesses are different than mental illnesses,鈥� said Rahmani, an assistant professor with the UF Health Department of Psychiatry. 鈥淚 think some of the stigma was perpetuated by those medical licensing questions.鈥�
Competitive. That鈥檚 one word to describe the medical field. Rahmani said it puts pressure on a lot of people. When she attended medical school, she said the grading scale consisted of the plus-minus system, However, many institutions today have switched to a pass-fail system. She said this is significantly better.
When you鈥檙e competitive, you compare yourself to those around you, she said. And unfortunately, Rahmani said, the addition of a mental illness exacerbates imposter syndrome.
鈥淚 think there also is a lot of fear that they might be discriminated against,鈥� she said. 鈥淒iscrimination, retaliation and not getting opportunities because others might underestimate their ability because of having a mental illness.鈥�
Most of those who enter medicine do so because 鈥渢hey feel that they have a mission to help their fellow man,鈥� Reid said. He said there is a mismatch between what people going into medicine expect and what it鈥檚 become.
He said this creates tremendous emotional dissonance as their occupational expectations are not met.
鈥淭hey find themselves in this kind of industrial assembly line that modern medicine has become, where the main function of the doctor is to check the right box and to make money for the corporation that they are employed by,鈥� Reid said.
Rahmani echoed a similar statement, saying insurance companies ask her to change prescriptions so the company can pay less, rather than trusting her clinical expertise. She said her primary concern is the patient 鈥� not herself or the insurance company.
So deeply rooted in their practices, doctors鈥� own woes are so often forgotten.
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Rahmani said some insurance companies only cover doctors鈥� psychiatric treatment at the hospital where they鈥檙e employed. She said this raises concerns about privacy and confidentiality, making physicians, medical students and other health care providers reluctant to get help. Some institutions even limit free counseling sessions through their employee assistance program, making the resource ineffective, she said.
This leaves a looming sense of helplessness, Reid said.
鈥淚 think physicians find themselves in situations that are just emotionally untenable, egregious situations where they feel that there鈥檚 no other alternative,鈥� he said.
Due to the effects of COVID-19, Reid said there is already a prominent physician shortage.
Reid said there needs to be detoxification of the environments where physicians practice; physicians should be allowed to be physicians.
鈥淚 think if the public doesn鈥檛 wake up and recognize that things must change, we鈥檙e going to find that we are going to be severely lacking physicians,鈥� Reid said.
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