Dr. Michael Weinstein, a trauma surgeon at Jefferson Health in Philadelphia, has suffered from depression for much of his life. Although he has received treatment throughout his two-decade career, Weinstein never discussed it with his colleagues, fearful they would perceive him as weak. “It was something I hid because of the associated stigma and also lack of awareness that many people in the profession would potentially be having similar types of issues,” he said.
Then, in 2016, it got worse. Seemingly out of nowhere, he fell into a deep depression. It was so bad, he began to contemplate suicide. His wife forced Weinstein to see his primary-care physician, who convinced him to take a leave from work and admit himself to a psychiatric facility, where he underwent electroconvulsive therapy.
“I needed someone to tell me to stop working. It was the fear of telling people I couldn't do this anymore, it felt like a sign of weakness or my own failing,” Weinstein said.
The fear he felt to discuss and seek help for his suicidal thoughts is believed to be common among physicians and the major reason why experts believe doctors experience higher rates of suicide than the general population. Questions on medical licensure applications about past and current mental health conditions discourage physicians from seeking help out of fear they'll lose their jobs. Additionally, a pervasive culture ingrained since medical school—where physicians are told to be strong and put the health of their patients before themselves—only adds to the pressure.
“There is almost this macho culture that you might find in law enforcement and the military that physicians can relate to—that you have to tough it out,” said Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention who has written extensively about physician suicide.
Physician suicide has been a problem in healthcare for decades. Studies dating back to the 1920s show that physicians suffer from suicide at high rates. Physicians with mental health conditions have long been discriminated against and suicides have often been kept hidden from colleagues and the public.
The difference in the past few years is that the industry is responding. Recent concerns around burnout have pushed organizations to rethink how they approach physician well-being, which has led to more action around how to deal with physician mental health concerns and suicide.
“I think burnout has opened the door to deal with the entire portfolio of psychological problems with clinicians,” said Dr. Thomas Nasca, CEO of the Accreditation Council for Graduate Medical Education. “It has made it acceptable to have these discussions. It's a real opportunity for us to begin to fix these problems.”