Alarms go off so frequently in emergency rooms, doctors barely notice. But when a colleague is wheeled in on a gurney, clinging to life, that alarm becomes a deafening wake-up call.
For Dr. Kip Wenger, that colleague was a friend, a 33-year-old female physician.
Wenger is a regional medical director for TeamHealth, one of the country’s largest emergency room staffing companies, based in Knoxville, Tenn.
“It’s devastating,” he said. “This is a young, healthy person who has everything in the world ahead of them.” His friend had confided in a few co-workers about recent relationship struggles, but none of that had affected her work.
The medical profession treats doctors and medical staff like highly trained endurance athletes conditioned to clock long hours, and ignore the fatigue and emotional toll of their work.
But, for many in the profession, that day-in-day-out stress can lead to crippling depression. It’s one reason doctors are far more likely than the general population to die by suicide.
Doctors with suicidal urges also know exactly how to end their own lives.
Wenger remembered his friend as a confident professional he’d worked with in emergency rooms all over Knoxville—including the one where she died. That day three years ago still makes no sense to him.
“She was very strong-willed, strong-minded, an independent, young, female physician,” said emergency doctor Betsy Hull, a close friend. “I don’t think any of us had any idea that she was struggling as much personally as she was for those several months.”
That day she became part of a grim set of statistics.
A Harsh Reality
An estimated 300 to 400 doctors kill themselves each year, double the rate of the general population, according to a review of 10 years of literature presented at the American Psychiatry Association annual meeting in May.
For TeamHealth, the young woman’s death in 2015 sparked deep soul-searching.
TeamHealth held listening sessions and realized that burnout was rampant. They began encouraging doctors to work less. TeamHealth co-founder Dr. Lynn Massingale said the company average is now close to 40 hours a week—though there’s no avoiding nights and weekends in the ER.
The company also started a new protocol for one of the most stressful times in a physician’s career: when doctors are sued. The company pairs them with someone who has been there.
“We can’t change the facts. We’re not coaching you to change your memory,” Massingale said. “But we can help you deal with the stress of that.”
And TeamHealth is trying to reduce bureaucratic headaches, including hiring scribes who follow ER physicians and enter information into sometimes finicky electronic health records.
Dr. Jeffrey Zurosky, an ER director at Parkwest Medical Center in Knoxville, said he’s concerned for his youngest doctors who start out with a mountain of med school debt, eager to pick up as many shifts as possible.
“I tell them: Be balanced. Don’t overwork yourself. Spend time with your family. Stay married, if you can,” Zurosky said.
Yet to some in the medical community, the problem is far more fundamental than burnout. Pam Wible doesn’t even like the term since it suggests physicians just need to find ways to cope. The family practitioner from Eugene, Ore., said it starts in medical school. Entrenched ideas, like muscling through long hours on little sleep, are hard to break. Wible calls it abuse.
“These people who have been previously abused are now the teachers,” she said. “They’re teaching the next generation of doctors.”