Burnout Plagues MDs, but They Won’t Get Help
by Sharon Kirkey
The Ottawa Citizen
September 6th, 2005
The stigma of mental problems or drug abuse keeps many doctors from getting assistance.
A cardiologist is paged to the emergency room one night. His partner has been struggling for an hour to get a pacemaker inserted into a patient with a dangerously slow heartbeat. He drives to the hospital, slips the pacer wires into a vein beneath the collarbone and expertly guides them into the heart. It takes him under three minutes. Graeme Cunningham wonders how fast he could have done it had he been sober.
An anesthetist hangs bottles from an intravenous pole at the head of an operating table. One contains fentanyl, a narcotic he will secretly administer into his rectum during surgery. Using a drug that way works as fast as if he were to inject it into a vein, says the addiction specialist who eventually treats him. "There are so many blood vessels to absorb it."
A family doctor pulls a plastic bag over his head and seals it around his neck with tape. Then he injects himself with an overdose of morphine.
know how to commit suicide. They know what works, and what doesn't, says
Dr. Michael Kaufmann, medical director of the Ontario Medical
Association's Physician Health Program. It is, he has said, the most
"tragic irony": the very people trained to save lives have the hardest
trouble saving their own. Nearly half of doctors who responded to a
Canadian Medical Association survey reported being in an advanced stage of
burnout. About 50 doctors in
suggest one in 10 doctors in
think that a group of educated people who have learned about psychiatry at
some point in their training would be more open to the idea. That's not
the case," says
The New England Journal of Medicine says the combined results of 25 studies show male doctors are 40 per cent more likely to commit suicide than men in general. Female physicians are 130 percent more likely to take their lives than other women, and the staggering suicide rate gap begins as early as the first year of medical school.
Suzanne Killinger-Johnson leaped in front
of a moving
"It's denial. 'This can't be happening to one of us or if it could happen to them it could happen to me.' They might be afraid if they acted they were commit ting professional homicide,' which they aren't."
The Canadian Medical Association has launched a Physician Health and Well-being Program with outreach programs an lectures to medical students and doctors. But Dr. Cunningham worries the sickest doctors are falling off the radar. "The very sick, very shamed, very secretive doctors who do not turn up at wellness reviews, who do not go to alumni retreats ... because (drug and alcohol addiction) is a disease of secrets," says Dr. Cunningham, past president of the Ontario College of Physicians and Surgeons and director of addiction services at Homewood Health Group in Guelph, Ont., Canada's oldest and largest inpatient program for addicted doctors.
If they get help in time, prognosis is excellent. "In the case of the doctors we monitor, over 80 per cent experience stable remission of their substance use disorder over the long term - after five years monitoring -and go on to live very healthy, balanced, productive lives," Dr. Kaufmann says.
sickest, Dr. Cunningham, a recovering alcoholic, was collapsing in
emergency rooms and having seizures on the ward. "Nobody said
anything." Born in
Dr. Cunningham says the last thing to go in a sick doctor's life is his or her work. Dr. Michael Myers isn't so convinced. "I don't think physicians are functioning as well in the workplace as they say they are. I bet a number of their patients will say he seems a bit tuned out, or he snapped at me last week, or he looks different to me, he looks thin and stressed."