The high incidence of depression among physicians can no longer be ignored. Several recent reports show that every segment of the profession is at risk, from medical students and residents in training to mid-career physicians and those nearing retirement.
One study found that approximately 25% of medical students and residents suffer from clinically significant symptoms of depression (stat news.com). Another shows that both men and women are highly susceptible to depression during their internship year, but that women are at significantly higher risk than men (healthday.com). The three biggest challenges they face are (1) work-life balance, (2) dealing with time pressures, and (3) fear of failure or making a serious mistake (2016 Medscape survey).
Another recent survey shows that one in five practicing physicians intends to cut back on their work hours or leave the medical profession entirely within the next two years (Mayo Clinic Proceedings, November 1, 2017). The reasons, says AMA president D. David Barbe, are the “mounting obstacles to patients’ care [which] contribute to emotional fatigue, depersonalization, and loss of enthusiasm among physicians” (healthday.com). Although these symptoms are commonly attributed to “burnout,” there’s no doubt that a significant number of these physicians are suffering from varying levels of clinical depression, fueled by a culture of silence and denial. Those close to retirement cite another factor as a cause of depression–the fear of losing their personal identity as a physician.
The shocking reality is that 300 to 400 U.S. physicians commit suicide every year–one doctor, on average, every day. When compared to other occupations and professions, medicine is considered high-risk for death by suicide. “Many doctors continue to suffer with untreated or poorly treated depression, owing to the fear of seeking treatment in a medical environment that stigmatizes and punishes physicians with mental health issues” (Dr. Pamela Wible at medscape.com).
Because of its pervasive prevalence, physician depression requires a concerted response on multiple levels. Medical schools need to ensure that students learn coping strategies for dealing with the emotional and time demands of a medical career. Medical associations, specialty societies, and hospitals need to join forces to encourage early and appropriate treatment of symptoms of depression. State licensing boards need to address physician disability concerns with a focus on treatment rather than punishment. And, finally, the profession as a whole must find ways to “let doctors be doctors” by eliminating some of the time-consuming tasks that distract physicians from devoting quality time to patient care.