An endocrinologist has made a personal plea for action to tackle suicide in the medical profession, after three of her doctor colleagues took their own lives.
Pressure cooker work environments and inherent personal traits of doctors such as perfectionism have combined to create a “perfect storm” driving “horrifying” rates of doctor suicide, according to Dr Ann McCormack, a staff specialist in endocrinology at St Vincent’s Hospital Sydney, in a new Perspective article published in the MJA.
“Over a matter of months, two female junior doctors committed suicide at our hospital, and more recently, suicide entered my inner circle with the death of one my close male colleagues. Such stories are not unusual in our profession,” Dr McCormack writes.
Dr McCormack notes Australian studies that show that one in five medical students have experienced suicidal ideation in the past year, and female doctors having suicide rates 2.3 times higher than the general population.
“I do not claim any expertise in this field, but what seems clear to me is that inherent traits in the individuals who choose a career in medicine and often create excellent doctors, also set them up for high rates of distress,” she says.
In addition to individual factors such as “maladaptive perfectionism” and poor resilience there are many dysfunctional elements in medical culture contributing to the problem, she says.
Work-life balance is known to protect against burnout but is “poorly practiced and modelled”.
“There is a subtle undertone rampant within the medical fraternity, in which late-night emails, missing a child’s school concert, publishing multiple articles and not taking annual leave become unvoiced indicators of a truly committed doctor”.
The fierce competition between doctors for limited training places means that fear of failure is a constant threat and is eroding the supportive culture of collegiality, she adds.
Dr McCormack suggests system-wide changes are needed in medicine, such as:
- Doctors need to be kinder to themselves and extend compassion towards the struggles of both junior and senior colleagues;
- Medical students should be selected using sophisticated aptitude testing, not just academic performance
- Doctor wellbeing programs should be mandated, including peer support networks;
- Workforce planning should avoid the growing bottleneck at the advanced training level;
- Collegiality should be built back into medical and health workplaces.
She highlights the example of the Mayo Clinic’s Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) groups, which have shown reduced burnout among participating physicians.
“We have recently established a Women in Medicine group at St Vincent’s Hospital. It is hoped that such informal meetings will create an environment where concerns can be voiced without fear of repercussion, where healthy support can be provided and authentic mentor relationships given space to evolve,” she concludes.
Dr McCormack’s call to action comes just weeks after medical college president broke his silence over his suicide attempt 30 years ago in an article published in MJA Insight.