Physician Suicide Prevention: Self-care and Seeking Help
By: Wm. Chris Woodward, DO
The first question I ask new
medical students: “what is the
most important thing you can
do for your patients?” Typical
answers are empathy, listening,
compassion, talking to my patient,
educating my patients among
others. The correct answer, in my
opinion, is “take care of yourself!”
If you haven’t eaten, slept, showered, had free
time, exercised, or emptied your bladder then you will
not be at your best.
A sleep deprived, hungry, and emotionally drained
physician is at risk of making medical errors. Our main
concern in medicine is patient safety so our ill-health
potentially impacts our patients. Lack of self-care is a
patient safety issue.
Although there will be times when you cannot leave a critical
clinical situation; most clinical encounters, both inpatient
and outpatient, are not critical. You can take a break!
You may believe that to be a good physician
you must sacrifice your health, your emotional
needs, your family, your friends, and a life
outside of medicine. This is not true. You
can and must have a work/life balance. It’s
obviously essential for your own survival and
your patient’s safety.
If inadequate self-care becomes a chronic pattern, then
that practitioner is at risk of depression and suicide.
Every year 300 – 400 Physicians complete suicide. We
lose one of us every day. This is more than twice the rate
of US adults. In the US general population, men are more
likely to complete a suicide than women. In contrast
there is gender parity in medicine. Depression is more
prevalent in female physicians than would be predicted
based on population data.
Depression still carries stigma. “It’s a lack of will power.”
“You’re a weak person.” “You are (or going to be) a
doctor. What excuse do you have to be depressed?”
Many reasons trigger depression but ultimately, it’s a
medical condition caused by pathophysiologic processes.
Depression viewed from this perspective is
like Diabetes, Hypertension, Arthritis and
many other chronic diseases that can be
In 2014, I became depressed. Feelings
of helplessness and hopelessness quickly
progressed to intrusive thoughts of hurting
myself and eventually to suicidal ideation. I
shared these thoughts with my therapist who
immediately arranged for hospitalization.
That admission, along with medication and
counseling may have saved my life.
I freely talk about this time in my life to let other Health
Care Professionals know that you are not alone and there
is help. It also reminds me that I’m human and need help
from time-to-time. Asking for help is not weakness; it’s
strength. When I’m at my best, I can be of maximum
service to others. When I’m not, I may be a threat.
On day one of a rotation, I tell medical students the bad
news: “you are human and are prone to all the mistakes
and afflictions humans suffer.” This includes chronic
diseases, severe injuries, mental health issues, death
at a young age from a terminal illness, alcoholism, and
addiction. You are not super-human. You are fallible. You
will make mistakes. You will do great things for others.
First you have to accept that you are an imperfect
Homosapien. Accepting our humanness with humility
acknowledges that we have limitations.