Saving a Female Doctor's Life: Thinking Outside the Box

February 21, 2018

Although the figures are old, data showing that women physicians die by suicide at rates 2.27 times that of women in general are very puzzling—and disturbing.1 Being female is not a protective factor against suicide in doctors. Further, most studies of factors that might put doctors at risk of suicide—burnout, genetic loading, a previous suicide attempt, unrecognized and untreated psychiatric illness, personality disorder, knowledge of how to kill oneself, availability of means, stigma, and more—tend to be generic, with any difference in gender being small or inconsistent.

But an article by Gold and colleagues2 got me thinking. In a national anonymous survey of female-physician-parents on Facebook, almost 50% of respondents believed they had met criteria for mental illness but had not sought treatment. Their reasons included the belief that they could manage independently, limited time, fear of reporting to a medical licensing board, and the belief that diagnosis was embarrassing or shameful. Although male physicians advance the same arguments for not seeking help, is there something “masculinist” about the house of medicine? More specifically, starting in medical school, do women become socialized to adopt “macho” attitudes and behaviors? To acknowledge symptoms of anxiety, weariness, or despondency is equated with weakness, inferiority and fraudulence. In other words, you don’t really deserve to be in the “club.” The modus operandi becomes “you suck it up” and put your nose to the grindstone and don’t complain. This is not only wrong­–headed, it’s dangerous.

MORE: Saving a Male Doctor’s Life: What About an App?

Let me take this one step further. If an ailing woman physician decides to seek help, is she confident that she will receive value-free treatment? That her therapist, irrespective of gender, will not judge her via a sexist lens? Will the psychosocial determinants (as opposed to the biological ones) of her illness be uncovered, validated and treated with good psychotherapy? Does she fear, especially if she sees a psychiatrist, that she’ll be prescribed medication and the professional and personal stressors will get short shrift?

One other question. As mental health professionals, we’re committed to treating the psychiatric illnesses that drive suicide in vulnerable individuals. When that individual is a female physician colleague, what can we do to ease her fears, promote engagement, ensure safe passage, and save her life? I invite your comments and suggestions.

References

1. Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). The American Journal of Psychiatry. 2004;161(12):2295-2302.

2. Gold KJ, Andrew LB, Goldman EB, Schwenk TL. “I would never want to have a mental health diagnosis on my record”: a survey of female physicians on mental health diagnosis, treatment, and reporting. General Hospital Psychiatry. 2016;43:51-57.

Dr. Myers is Professor of Clinical Psychiatry and immediate past Vice-Chair of Education and Director of Training in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, NY. He is the author of 8 books, the most recent of which are "Why Physicians Die by Suicide: Lessons Learned from Their Families and Others Who Cared" and “The Physician as Patient: A Clinical Handbook for Mental Health Professionals” (with Glen Gabbard, MD). He is a specialist in physician health and has written extensively on that subject. Currently, Dr. Myers serves on the Advisory Board to the Committee for Physician Health of the Medical Society of the State of New York. He is a recent past president (and emeritus board member) of the New York City Chapter of the American Foundation for Suicide Prevention.

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.

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