Physician Health

1
Physician Health

• Rhode Island Board of Medical Licensure and
  Discipline
• December 2003

2
Depression and suicide

• 1858 higher rate of suicide amongst physicians in
  England
• 1960s depression identified as a major risk
  factor
• Particularly high rate amongst female physicians

3
Healthy behaviors amongst physicians

• Declining mortality rates for cardiovascular
  disease, pulmonary disease and cancer compared to
  general population
• Depression and suicide stand out by contrast

4
Suicidality

• Depression is a major risk factor
• Depression is poorly detected by physicians
• 40 see their primary care physician within one
  month of suicide
• Increased attention to depression amongst
  physicians may have beneficial effects to
  detecting and treating depression amongst
  patients
• Alcohol abuse is a major risk factor
• Financial stress as a major risk factor

5
Epidemiology

• 13 lifetime prevalence of depression amongst
  physicians same as general population
• 20 lifetime prevalence amongst female physicians
  andsame as general population
• Residents and medical students have higher rates
  than the general population
• Similar across cultures, races and religions

6
Suicide risk

• Male physicians may have as high as 3X the
  general population risk
• Female physicians may have as high as 5X the
  general population risk
• Proportionate mortality highest for suicide
• Physicians have higher rates of suicide
  completions versus attempts than the general
  population

7
Methods

• Toxic ingestions lethal drugs
• Firearms

8
At risk specialties

• Anesthesiology
• Psychiatry

9
Barriers to care

• One third of physicians do not have a doctor
• Lack of time
• Confidentiality
• Social and professional stigma
• Cost
• Discrimination

10
Recommendations to licensing boards

• Insure nondiscriminatory practices and procedures
  asked about concerning behaviors and not
  diagnoses
• CME on physician health
• Strong linkages to organizations like the Rhode
  Island medical societys Physicians Health
  Committee