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Note: This is a copy of a commentary that ran in yesterday's regular Sorry Works! newsletter. We received strong, positive feedback about the column and decided to run a special newsletter solely dedicated to this issue.
Below is a rather startling column from last week's Newsweek which discusses the problem of physician suicide. In short, the article says that 300 to 400 physicians take their lives annually - approximately one doctor per day. Sad and scary numbers.
There are many reasons doctors kill themselves. We are at Sorry Works! believe one of the major reasons for this sad trend is that physicians - and nurses - are often left to suffer silently and alone following adverse events and medical errors. In fact, the current deny and defend culture encourages providers to ostracize their colleagues.
"Don't talk to Dr. Smith.....you might get dragged into a deposition or worse!"
As we wrote in a recent newsletter, providers are the 2nd victims of medical errors. Not only are impacted providers prone to depression and suicide, but studies have also shown they are more likely to commit additional errors, furthering increasing liability exposure for themselves, their colleagues, and their institutions and insurers.
This sad situation is one of the primary reasons Sorry Works! is working so hard to change the thinking on the med-mal crisis from a legal problem to a customer service crisis. Forget about the legal stuff, do right by your customers post- adverse events, and things will work out in the end. However, by operating in a Sorry Works! environment the opportunity is presented to take care of providers who are the 2nd victims. In fact, great disclosure programs have support and counseling systems built-in for providers who have been involved in medical errors. Disclosure programs encourage communication, empathy, and support, and since you're an open book you don't worry about all the legal stuff - and you also don't worry about providing support for colleagues involved in errors.
"Want to depose me or have me testify? Fine. I'm a good person who has done the right thing all along. We've taken care of the patient and family and we taken care of our colleagues. I have nothing to hide, and the chart, the records, and my colleagues will back me up."
As prominent med-mal plaintiff's attorney Al Schwartz said at the recent Chicago Patient Safety Meeting he has no desire to examine the type of witness quoted above in the courtroom.
Just because a doctor or nurse makes a mistake doesn't mean they're a bad person - but the current system has treated them as such. Time to support these providers so they can learn from mistakes and move on with their careers and lives. These people need help - lots of help: Make it happen with Sorry Works!
UPDATE:
A strong Sorry Works! supporter wrote in after yesterday's column to say that suicide among patients is a major adverse event in hospitals. Indeed, patients and families suffer greatly from disease and medical errors, and they need support too. Sorry Works! can change the culture so that everyone - patients, families, and providers - receives the emotional support they need.
For information on Sorry Works! resources including the new Sorry Works! Book visit this link:http://www.sorryworks.net/booksoon.phtml
Doctors Who Kill Themselves
Every year, between 300 and 400 doctors take their own lives - roughly one a day. No other profession has a higher suicide rate
David Noonan
NEWSWEEK
Apr 19, 2008
I've met a lot of doctors over the years. I've interviewed them, watched them operate, observed them with patients and just plain hung out with them. Some were friendly, others cranky. Some were arrogant, others humble and selfless. As a group, they have impressed me with their confidence, intelligence and dedication to helping people in need. From the outside, the doctor's life seems a rich and rewarding one. And surely it is. But a new documentary, "Struggling in Silence"(airing next month on public- television stations), explores a dark side of the profession - the little-known and rarely discussed problem of depression and suicide among physicians. The unsettling truth is that doctors have the highest rate of suicide of any profession. Every year, between 300 and 400 physicians take their own lives - roughly one a day. And, in sharp contrast to the general population, where male suicides outnumber female suicides four to one, the suicide rate among male and female doctors is the same.
"Undiagnosed and untreated depression is the culprit here," says Dr. Charles Reynolds, professor of psychiatry at the University of Pittsburgh School of Medicine, who appears in the film and was co - author of a 2003 paper (one of the few) on physician suicide, published in The Journal of the American Medical Association. While the rate of depression over a lifetime is basically the same for male physicians and the general population of men-about 12 percent- the doctors' suicide rate is 1.4 times higher. Female docs have double the rate of depression and 2.3 times the rate of suicide compared with the general population of women. (Some studies report equal rates of depression for women doctors; others report even higher suicide rates for physicians.)
So why aren't depressed docs seeking treatment for a common illness that millions of Americans have learned to manage with therapy and readily available medications? Because they worry-not without reason- that if they admit to a mental-health problem they could lose respect, referrals, income and even their licenses. Because, despite the steady increase in the number of women in the field, medicine is still very much a macho profession; physicians are supposed to be the strong ones who care for the sick, not the sick ones who need to be cared for. "I did not want it to go on my medical record that I had been treated for depression," says Dr. Robert Lehmberg, 60, whose moving account of his struggle with the condition-and the stigma it carries-is featured in the film. "Once I got treated, I realized how foolish all that was."
Lehmberg, a former plastic surgeon, now a fellow in palliative care at the University of Arkansas, did not become suicidal. But doctors who do are at increased risk, in part, because they have access to lethal drugs and know how to use them. (Docs have a high ratio of suicide completions to attempts.) Some depressed physicians also have substance-abuse problems, another major risk factor for suicide.
One way to address physician suicide, says Reynolds, is to focus on medical students and residents, since depression often starts in young adulthood. Medical schools across the country have launched programs that, among other things, guarantee students who seek help that it will not appear on their records. "What we're trying to do is say to these kids, 'Get help, get well, stay well'," Reynolds says.
The goal of "Struggling in Silence," and of the new Web site doctorswithdepression.org (both the work of the American Foundation for Suicide Prevention), is to raise awareness, prevent suffering and even save some lives. There could be a bonus as well. "If we teach doctors to recognize depression in themselves," says Dr. Paula Clayton, the foundation's medical director, "they will recognize it in their patients." And then everybody will feel better.
FOR SORRY WORKS! RESOURCES, INCLUDING THE SORRY WORKS! BOOK PLEASE VISIT THIS LINK:http://www.sorryworks.net/booksoon.phtm
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