Physicians News Health news for doctors and patients.
Chaos and disruptions in medical care have had one tragic and destructive effect that no one is addressing: the deaths of more than 2,000 physicians by suicide since Obamacare was passed by means of strong-arming and bribery.
Physicians in general have a higher rate of suicide than other professional groups and the general public. Women physicians’ suicide rates are reported to be up to 400% higher than women in other professions. Male physicians’ rates are 50% to 70% higher.
Why are more physicians seeing suicide as their only option? The rising rate since the 2010 Affordable Care Act was passed points to the added regulatory and financial pressures from Obamacare as major factors:
- need to see more patients per hour to make ends meet
- lower payments, longer delays in being paid, and declining patient visits due to higher co-pays and deductibles
- financial stress, a known trigger for suicide, intensified by a 40 % to 50% decline in practice revenues as overhead costs go, forcing many primary-care physicians to close up their practices
- increasing administrative and paperwork burden, which takes time away from patient care, without the satisfactions of helping patients
- more generalized “one-size-fits-all” protocols demanded by insurance and government “guidelines”
- more forms, reports, and regulations that no one understands, but with huge financial penalties and even prison time for making mistakes
- demonization of “greedy doctors” by insurance companies, government, and media.
Doctors have always been at higher risk of suicide than other professions for several reasons:
- pressures of responsibility for patients’ lives
- fear of making mistakes that might cost a life or trigger a malpractice suit
- fear of losing one’s medical license and livelihood
- long hours, time away from families on nights and weekends
- high rates of unrecognized or untreated depression, alcohol or substance abuse, and divorce due to all of the above
Doctors are human too, and have feelings. I think other critically overlooked factors in the rising suicide rates since 2010 include:
- the increasing sense that doctors are just a “cog in a wheel,” interchangeable with those having less training and expertise
- feeling unappreciated by patients, who toss them aside like an old toy when insurance plans change
- frustration with patients who dismiss medical recommendations if “it is not covered by my insurance”
- loss of autonomy, control, and independence as faceless insurance clerks, bean-counters, licensing boards, and government agencies dictate how, where, and when medicine is to be practiced, with no knowledge of the patient in question.
Physicians are also often their own worst doctors and feel they can handle their own health issues and stress. There is the ever-present social stigma about seeking mental health treatment, but for physicians this is magnified by the fear of being penalized and having their medical license jeopardized if they seek treatment for depression or stress. We encourage others to seek mental health professionals if appropriate, but most physicians are afraid to do so themselves because such treatment must be reported on each medical license renewal application, increasing the risk of losing one’s license and livelihood.
Physicians also fear losing hospital privileges if treatment for depression is disclosed. Hospital administrators increasingly use mandated psychiatric treatment as a bullying tactic to remove independent-thinking, patient-focused physicians from hospital staff.
All of these problems, especially the feelings of loss of control and loss of autonomy in one’s medical decision-making, have escalated dramatically with the ever-increasing regulatory burdens under Obamacare.
A death by suicide is devastating to families, leaving emotional scars that may never heal. Physicians’ family members often have significant support to help with grief and shock, but very little attention is paid to the needs of patients, especially older patients who often have profound feelings of loss, and little support to help them through unexpected loss of a trusted physician upon whom they depended.
Most doctors go into medicine truly committed to helping people who are ill and in pain. Today, doctors are under siege with outside forces preventing them from doing the very thing that means the most: taking care of patients. The sensitive and compassionate ones have an even harder time dealing with denials of care they know their patients need.
The toll on doctors—and then patients—is getting worse daily. Insurance and government bureaucrats had best remember: at some point, we ALL will be a patient—that includes YOU.
WARNING: dead doctors cannot save your life.
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Elizabeth Lee Vliet, M.D. — 2014 Ellis Island Medal of Honor recipient — is a preventive and climacteric medicine specialist with medical practices in Tucson AZ and Dallas TX.
So many lies, so little time. You link to what you imply is proof doctors have to see more patients, but that’s not what’s in the story. It’s about doctors wanting more money for the same work. In fact, the PPACA has both reduced the number of patients doctors see AND increased the revenue they’re collecting, while cutting medical bankruptcies in HALF. https://www.cnbc.com/2015/10/06/obamacares-md-effect-no-patient-rush-but-more-money.html
Your headline would be equally true and equally deceptive if it read “Physician Suicide Rates Have Climbed Since Slavery Abolished.”
—There is the ever-present social stigma about seeking mental health treatment
Your prejudice is duly noted.
I regret you feel that way, and hope you can get over it.
It is not her prejudice, Harold. She is speaking of a wider prejudice in the medical profession. For a doctor, there is very much a stigma about seeking mental health treatment, and as she said, it can jeapordize one’s career and medical licensing. Doctors are held to a much higher standard than the general public, and with good reason, but they are still only human and need to be able to seek treatment when needed. Your comment was unkind and inappropriate…”get over it?” Indeed.
Liz, although your sharing of all of the insights in this article are invaluable, I do want to know the source of your assertion that there have been “deaths of more than 2,000 physicians by suicide since Obamacare was passed”, which sets the title for the article, “Physician Suicide Rates Have Climbed Since Obamacare Passed”. Was it by any chance my article, Physician Suicide (http://emedicine.medscape.com/article/806779-overview)?
As that article notes, it is notoriously difficult to obtain accurate statistics on physician suicide, both because physicians know how to kill themselves in ways that seem natural, and because the physician reporting the death may be shielding a colleague’s reputation or protecting a family for reasons of insurance coverage.
Are we more aware of the problem of physician suicide? Perhaps, because of highly publicized suicides of several residents in training in NYC and related opinion pieces and activism by families and several physicians.
Are we aware that physicians are less satisfied with their lives than in former generations? Yes, due to many surveys and several resultant publications regarding burnout rates, chemical dependency, medical errors and malpractice litigation stress, and sadly, that physicians’ children do not seem to want to enter the profession.
And of course there are entire organizations such as yours, the AAPS and the new NBPAS springing up to counter significant incursions on physician autonomy and our choice of method of assuring continuous competence. So obviously, there are many indications that the stressors you mention are increasing and may be reaching a crisis level. But none that I know of that specifically indicate that physician suicides have increased since the passage of the ACA.
So I would still like to know the source of the assertion that forms the crux of this article.
Having said that, the estimate of 400 annual deaths by suicide per year has been floating around for so many years that it has become a sort of mantra. By that estimate (if correct), 2000 deaths by suicide since 2010 is possibly about average.