If you or someone you know is scheduled for surgery, there is a chance the surgeon may have had suicidal thoughts recently. According to a new report in the Archives of Surgery, about 6 percent of surgeons said they had suicidal thoughts in the previous year, but only about 25 percent ever got professional help.

Suicide among physicians is higher than the general public

For many years, the suicide rate among physicians has been higher than that among other professions. A recent article in Psychology Today noted that one unusual fact about suicide rates among physicians is that it is equal among male and female doctors, while among the general population, suicide rates among men is about four times higher than among women. Between 300 and 400 physicians commit suicide each year.

At Mayo Clinic in Rochester, Minnesota, Tait D. Shanafelt, MD, and colleagues conducted an anonymous survey among members of the American College of Surgeons in 2008. The 61-question survey covered career satisfaction, self-perceived medical errors, practice characteristics, and demographic information, and also utilized tools to identify burnout, mental and physical quality of life, and symptoms of depression.

Of the 7,905 surgeons who responded (86.7% males), 1,163 (14.9%) had had suicidal thoughts at some time in their lives, and 501 (6.3%) said they had had suicidal thoughts within the previous 12 months. Of the 501 surgeons, only 26 percent (130) sought help from a mental health professional. Antidepressants were used by 461 surgeons (5.8%) within the past year. Of these, 41 (8.9%) prescribed the medication for themselves, 34 (7.4%) got a prescription from a friend, but most (358, or 77%) got a prescription from a professional.

Most surgeons (301 of the 501, or 60.1%) said they did not seek help because they were concerned about their medical license. Eighty percent of state medical boards ask about mental illness on an initial licensure application, and nearly half inquire on renewals, but the focus for most boards is whether the mental health condition is impairing the surgeon’s abilities and not merely on the presence of the condition.

Surgeons with suicidal thoughts were more likely to be older (age 45 and older), and this group had 1.5 to 3 times the rate of suicidal thoughts when compared with the general population. While being married and having children were associated with a lower likelihood of entertaining suicidal thoughts, divorced surgeons had a higher risk.

The study’s authors note that the risk of depression among physicians is similar to that of the general public, and so this study “suggests that other factors may contribute to the increased risk of suicide among physicians.” Although access to lethal drugs may be a factor, “the influence of professional characteristics and forms of distress other than depression (e.g., burnout) are largely unexplored.”

The survey results showed that surgeons who perceived they had made a major medical error in the previous three months had a threefold increased risk of suicidal thoughts when compared with surgeons who did not perceive such an error.

The study’s authors stress that more studies are needed to evaluate the factors associated with the higher rate of suicidal thoughts among surgeons and efforts need to be made to reduce the contributing elements and hurdles to mental health care for these surgeons.

SOURCES:
Psychology Today, August 1, 2009
Shanafelt TD et al. Archives of Surgery 2011; 146(1): 54-62