Doctors can appear superhuman. They’ve made it through the gauntlet of medical school and residency. They make more money than most people. Statistically, they’re healthier.
But there’s a dark side to the profession that has been largely veiled — even from doctors themselves: They are far more likely to take their own lives.
Alarms go off so frequently in emergency rooms, doctors barely notice. And then a colleague is wheeled in on a gurney, clinging to life, and that alarm becomes a deafening wakeup call.
"It’s just freakin...it’s devastating," says Kip Wenger, recalling a 33-year-old physician who died by suicide in 2015. "This is a young, healthy person that has everything in the world ahead of them.”
Wenger, a regional medical director for Knoxville-based TeamHealth, says she was a confident doctor who worked with him in emergency rooms all over Knoxville and died in one of those same ERs.
One of the unavoidable dangers of being a doctor is knowing exactly how to kill yourself and having easy access to the tools to do it. There are stories of anesthesiologists found in a hospital, hooked up to an IV of fentanyl. Without being too explicit, Wenger says his colleague died from multiple "stab wounds." She also used numbing agents in order to die more painlessly.
“She wrapped herself in a blanket, and she got a Bible," he says. "She wrote a note on the door to her best friend. ‘If you come here, don’t come in the door. Call Kip or call Peter and they’ll know what to do.' And that’s how she checked out.”
This young doctor had confided in a few coworkers about recent relationship struggles, but nothing that affected her work. And then she became part of the grim statistics.
“She was very strong-willed, strong-minded, an independent, young, female physician," says emergency doctor Betsy Hull, a close friend. “I don’t think any of us had any idea that she was struggling as much personally as she was for those several months.”
Addressing An Uncomfortable Reality
Female physicians are at least twice as likely as the general population to take their own lives. The suicide rate is about 50 percent higher for male physicians. And emergency doctors are some of the most at risk.
This death in 2015 sparked some deep soul searching for her employer, one of the largest ER staffing companies in the country.
“A few of these things happened that were just so sobering," says TeamHealth co-founder Lynn Massingale. "People don’t stab themselves to death. Young people don’t stab themselves to death.”
It’s been an uncomfortable topic to address. No patient wants to be cared for by someone having suicidal thoughts. And a 2018 study from Mayo Clinic finds disenchanted doctors are more likely to make mistakes.
But TeamHealth held listening sessions and realized that burnout was rampant. To start, they began encouraging doctors to work less. Massingale says the company average is now close to 40 hours a week — though there’s no avoiding nights and weekends in the ER.
The company also started a new protocol for one of the most stressful times in a physician’s career. When doctors are sued, they’re paired with someone who has been there.
"We can’t change the facts. We’re not coaching you to change your memory," Massingale says. "But we can help you deal with the stress of that.”
And TeamHealth is trying to reduce some bureaucratic headaches. A significant portion of the required corporate training has been deemed optional. And the company began spending millions of dollars a year to hire scribes who follow around ER physicians and enter information into sometimes finnicky electronic health records.
Technology has become a real source of stress in a career that comes with lots to worry about, even beyond dealing with patients.
Jeff Zurosky, who is an ER director at Parkwest Medical Center in Knoxville, says he’s concerned for his youngest doctors who start out with a mountain of med school debt, eager to pick up as many shifts as possible.
“I tell them: Be balanced. Don’t overwork yourself. Spend time with your family. Stay married, if you can.”
Yet to some in the medical community, the problem is far more fundamental than "burnout." Pam Wible doesn’t even like the term, since it puts the burden on physicians, as if they just have to find a way to cope. The family practitioner from Eugene, Oregon sees it all starting in medical schools. Entrenched ideals, like muscling through long hours on little sleep, are hard to break.
“These people who have been previously abused are now the teachers," she says. "They’re teaching the next generation of doctors.”
Too Close To Call For Help
And when physicians do want help, the industry makes it especially difficult. Wible says they can’t go see a psychiatrist without jeopardizing their medical license.
"I know a lot of them," she says. "They’re having to sneak out of town, pay cash and use a fake name to do it. Why are we putting these people in such a situation?”
Wible has collected more than 900 stories of doctor suicides and set up an anonymous helpline. She’s inspired more physicians to share their experiences, like an emergency doctor licensed in Ohio.
“You don’t focus on the 99 you save," he says. "You end up focusing on the one that you lose.”
The one he lost was 19 years old and came in with the flu, but tests didn’t show anything unusual. He sent her home. She returned in cardiac arrest. When he found out she died, he went to a dark place — despite no history of depression.
“Like all doctors, you put that superman cape on and you think you can get through it,” he says.
The family filed a complaint. And being told he might lose his job pushed him over the edge. He swallowed a lethal overdose. But the police found him, and got him to a hospital where he had to be revived.
This ER doc had treated untold numbers of suicidal patients but never saw himself in their place.
“I didn’t know I was at higher risk of suicide than the average person.”
WPLN is not naming this doctor because his malpractice insurer is concerned about opening him up to more lawsuits. But he says he wishes he could speak more freely, thinking it might encourage physicians to seek out help sooner than he did.