One of the medical newsletters I receive describes the suicide of a 33 year old surgeon near the completion of his training. The sad story of this death was taken from an article that appeared in Time Magazine – Why The Toxic Treatment of Doctors Needs to Change. The authors of the piece are the mother of the deceased physician and one of his former teachers, a professor of surgery at Stanford. I cannot imagine the sadness that the mother of the late physician must feel, but the article makes some statements that are important and deserve further scrutiny. First, do doctors exist in a toxic environment? The article presents no evidence that they do.
Medicine is said to be the profession with the highest suicide rate of any occupation in the US. It is commonly stated that about 400 US physicians kill themselves every year. Though when you actually try to find the data to support this claim they are not readily available. Data are available for physician suicide in the UK. There the suicide rate in women doctors is higher than the national average but lower among male doctors.
The article which initiated this post was subtitled The harsh culture of medical training is taking a toll on young physicians. But it presents no evidence to support this claim. In fact medical training is much less demanding than it was one or two generations ago. Trainee hours are limited and the master-serf relationship between professor and student has long been abandoned. Drawing a sweeping conclusion from one or even a few cases is a sure path to error. If one looks at the overall health of America’s physicians it appears to be better than average.
Medicine is indeed a stressful profession. Its very nature demands that it be so. Do you want a doctor who doesn’t take the life and death nature of his calling very seriously? If doctors do indeed have the highest suicide rate in the country the reasons are not readily apparent. They are certainly worthy of investigation, but such study should precede alterations in medicine’s course of instruction. The profession has frequently changed its curriculum based on impression rather than fact. Doing so always makes it worse.
The high suicide rate in doctors, a generally healthy population, may reflect no more than that medical training makes a physician more adept at doing himself in when depression or some other adverse event occurs. One needs to know how often suicide is attempted versus how often it succeeds to resolve this hypothesis. Suicide is a complicated business. The anguish felt by loved ones is of course understandable, but it is not a substitute for rational analysis.