Tragically, some physicians respond in the most self-destructive manner possible. As early as 1858, British researchers noted a higher suicide rate among physicians, compared to the rest of the population. This holds alarmingly true today. Male physicians are 70 percent more likely than other men to kill themselves. For women doctors, the risk is even greater: the suicide rate is 250 percent to 400 percent higher than that of other women. (One possible reason for this, among others, is that physicians’ medical expertise makes them more likely to succeed.)
More commonly, desperately stressed-out docs quit medicine or fantasize about quitting. “I was contemplating going down and getting a job as a waitress,” recalls Wible. Haley says that had there been some other field he could’ve switched to that would allow him to maintain his standard of living when he was burned out, he may have left.
A physician in need
But most, it seems, simply live their lives in quiet desperation. In December, the American College of Physician Executives (ACPE) released the results of its survey of 1,200 physicians on their perceptions of physician morale. Respondents readily admitted to experiencing fatigue (77.4 percent) and emotional burnout (66.7 percent). Indeed, six in 10 said they had considered leaving medicine.
But only about a third acknowledged experiencing family discord or depression, and fewer than 5 percent of docs confessed to having had suicidal thoughts or to abusing drugs or alcohol.
Our hunch is that these latter figures are higher in reality than in the ACPE’s survey. But who could blame physicians for their reluctance to admit they’re deeply troubled? What doctor, held to a nearly unattainable standard, would admit she’d turned to four double scotches (or worse) every night to ease the stressball in her gut? Not many, especially since license renewal can come into question for a physician who has sought treatment for substance abuse or a mental illness, to say nothing of the professional stigma (and potential legal consequences) if such treatment, or even the admission of a past problem, should become public.
The ACPE survey reflects another reason to believe physician morale is even lower than most doctors will admit: Respondents were much more likely to suspect serious problems in their colleagues than to acknowledge the same problem in themselves. More than 35 percent suspected peers of substance abuse, for example, but only 2.9 percent would come clean about their own problems. In actuality, physicians may not see the reality in either themselves or others. The real figures likely fall somewhere in between.
Re-lighting the fire
Pfifferling insists that there is hope and help. Much of it comes from within. Here’s what to do if you’re feeling burned out:
Talk about it. Only one-third of you share your feelings with other doctors, reports the ACPE survey; that’s not enough. Do it for your own good, and that of your patients.
Take care of your health. Paradoxically, doctors tend to skip routine healthcare for themselves. About one-third of physicians have no regular source of care, states the AMA. Also, most believe that good or bad health is largely up to chance — fatalism that flies in the face of preventive health measures. This laissez-faire perspective causes many physicians to skip screenings for breast, colon, and prostate cancer, and many don’t bother to get flu vaccines. Take time to take care of yourself, but not by yourself. Doctor, see your doctor.
Get a hobby. Way back before you became a doctor, what did you like to do? Sports? Art? Globe-trotting? Are these still of interest? Whatever “it” is, do it, and do it regularly.
Educate yourself about yourself. Yes, you are certainly well-educated medically, but that’s a pretty narrow focus. Take some time to learn what’s available to help you learn about yourself. A seminar. A good self-help book. Tivo Dr. Phil if that’s what you’d like. But get inside your own head a little bit.
Gigi Hirsch, CEO of MD Intellinet, a career-counseling firm for physicians, says doctors fall into four types:
