Opinion

Physicians Suffering in Silence

Recently, the medical community learned the news of another tragic and arguably preventable physician’s suicide — another person who fell victim to the stoic culture of self-sufficiency, white-knuckling, and suffering in silence amid the throes of the pandemic. It’s an alarming trend that is happening increasingly more often to our nation’s healers.

Dr. Scott Jolley’s story hit close to home since it’s eerily similar to that of my sister-in-law, Dr. Lorna Breen. Lorna was a celebrated New York City emergency room physician who tragically died by suicide after treating confirmed COVID-19 patients, contracting the virus herself and returning to an overwhelming work environment while fighting to care for patients. Dr. Jolley needed help. Lorna needed help. And neither of them was able to get it in time.

In the year since Lorna’s death, my wife and I have played many roles we never expected or anticipated. Through our work with the Dr. Lora Breen Heroes’ Foundation, helping grieving families share their stories with the world is an incredible honor. It’s cathartic but also heartbreaking to learn of so many other families who face the unmanageable grief we’ve experienced.

Time and time again, I have had confidential conversations with medical professionals and their families who have expressed the fear of stigmatization, judgment from others or even worse, potential loss of their medical license when seeking mental health assistance.

Of all occupations and professions, the medical profession consistently lingers near the top of fields with the highest risk of suicide. Pre-pandemic, there were reports of 300-400 physicians annually reported to have taken their lives. Anecdotally, the numbers were likely far higher then, and they are feared to be even higher now. Studies have shown that suicide is likely underreported due to a lack of systematic approaches to reporting and assessing the statistics. And that’s precisely the problem.

There are many reasons why these figures could be underreported or kept under a guise. Some conjecture that it would be a public relations nightmare for medical institutions if word got out that conditions were so toxic, so pervasive, that those who needed help couldn’t seek it for fear of reputational or licensure harm. Others say it’s reflective of America’s competitive nature and aversion toward seeking help. Either way, this has got to stop.

If a child breaks a bone or comes down with an illness, a parent wouldn’t think twice about going to a doctor and seeking professional medical help. The same goes for an adult — even a health care professional by trade — who seeks medical care for an obvious malady. However, with far more sensitive and less visible issues — like those involving burnout, anxiety, burnout, or depression – adults, and especially medical practitioners, are considerably less likely to seek help.

The understanding and concern toward health and wellness seem to morph to shame and judgment when one needs help with mental health and well-being. As one reporter recently put it, “Medicine is, ironically, a profession that punishes some doctors for getting mental health care.”

Although medical boards and the institutions themselves insist upon patient confidentiality when providing medical care, the stigma and belief persist that these inherent laws and protocols do not apply to the doctors themselves. Part of this belief is substantiated by the requirement by medical boards in dozens of states for physicians to disclose a diagnosis or whether they sought treatment for a mental illness. Such disclosures can prompt a demand to appear before a state board, a petition for medical records or even a psychiatric evaluation. In the worst of scenarios, boards can restrict doctors from practicing medicine or even cause them to lose their licenses.

I’ve received notes directly from current and former medical practitioners articulating some of the hidden challenges they face on a day-to-day basis. As one physician put it, “After years of working with colleagues and residents, I know this is the rule and not the exception. We white-knuckle it until we are drowning. Too often people look back and say, ‘They seemed fine.’ Of course, we’re not fine.”

If this past year is reflective of some of the challenges on the horizon for our medical community and caregivers, I implore others to be on the lookout.

Like our army veterans who come home from the horrors of war and try to assimilate back to “normal” life, our front-line health care workers have experienced similar trauma. As we know with PTSD, it’s not until after the stimulus is removed (in this case, COVID) that we will begin to see the long-term mental effects this virus has had on our health care community.

Fortunately, action is already being taken to address some of these newfound challenges. Since its introduction last summer, the Dr. Lorna Breen Health Care Provider Protection Act has garnered strong bipartisan support. If passed, the legislation would be the first of its kind to allocate specific funds towards grants for training students, residents, or health care professionals in evidence-informed strategies to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders. It would also provide research funding to study the causes of burnout in the profession and establish more accurate figures on the precise numbers of physician suicide.

This legislation would be pivotal for the signal of support it would send to the health care provider community and for establishing momentum in systematically changing the policies and state-level requirements that encourage those suffering from treatable mental health problems to stay silent.

If Lorna’s and Dr. Jolley’s deaths are reflective of one of the most pervasive problems plaguing our medical institutions, let’s not let their deaths be in vain. Now is the time to give back to the heroes who have given so much to us throughout the pandemic. Help is out there. Please know we are here to give it.

 

J. Corey Feist, Dr. Lorna Breen’s brother-in-law, is chief executive officer of the University of Virginia Physicians Group and co-founder of the Dr. Lorna Breen Heroes’ Foundation. 

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Correction: Dr. Scott Jolley’s surname was misspelled.

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