Suffering in Practice: Getting the Help You Need (Part 2)

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The relationship between depression and medical errors is bidirectional, meaning depressive symptoms may lead to more medical errors in practice and medical errors may lead to the development of or worsened depressive symptoms. In other words, physician well-being is critical to patient care.

As common as stress and burnout are in healthcare, the reluctance to access mental health treatment is equally ubiquitous. A recent study surveyed more than 12,000 physicians across over 29 specialties found that 47% of physicians report that burnout and depression have had a significant impact on their lives.1 Of the physicians who endorsed symptoms of burnout and depression, 36% of them reported that they get easily frustrated with patients and 15% reported making mistakes they would not normally make. The relationship between depression and medical errors is bidirectional, meaning depressive symptoms may lead to more medical errors in practice and medical errors may lead to the development of or worsened depressive symptoms. In other words, physician well-being is critical to patient care.

Polling data suggest that half of female physicians believe they meet the criteria for a diagnosis of a mental illness and 38% of male physicians report feelings of burnout and depression.2 Sixty six percent of professionals never received mental health treatment, largely due to concerns relating to stigma and repercussions from licensing boards.3 An analysis of 52 medical licensing boards reported that 90% of state medical boards have licensing forms that include questions about mental health.4 Though these questions are intended to keep patients and physicians safe, they result in physicians subverting their mental health concerns. Physicians hold themselves to high standards, meaning mental health issues are often perceived as weaknesses. On licensing board applications, mental health issues may receive greater scrutiny than physical health issues or other conditions. That creates legitimate concern that disclosure may impact the ability to practice medicine or damage professional reputation.

With the ongoing impact of the COVID-19 pandemic, it is more important than ever for physicians to have access to quality, non-stigmatized mental health care. There are programs that specialize in addressing stress and burnout in the medical field and they are skilled at addressing this stigma in the context of professional identity and licensure concerns. The Emotional PPE Project and Therapy Aid Coalition have searchable databases of confidential mental health service providers. If you need immediate help, you can call the Physician Support Line at 1-(888) 409-0141 for anonymous support.

While psychotherapy is an effective way to address burnout, there are important institutional changes that can be implemented to reduce workplace stress. For example, healthcare organizations can set realistic expectations for physicians regarding patient load, working hours, boundaries, and managerial support. Healthcare organizations can also provide a safe, non-punitive space for physicians to recognize and discuss mental health needs in medicine to normalize stress and burnout in physicians. Individually, there are tools you can use to prioritize self-care and fight fatigue by taking breaks when necessary, finding healthier ways to cope with stress, and leaning on your colleagues for support. Mental wellness for physicians is a complex issue comprised of individual and systemic components that reflects your commitment to your own health and the highest standard of care for your patients.

References:

  1. Medscape. (2021). Death by 1,000 Cuts: Medscape National Physician Burnout and Suicide Report 2021. Retrieved from https://www.medscape.com/slideshow/2021-lifestyle-burnout-6013456
  2. Medscape. (2018). Medscape National Physician Burnout and Depression Report 2018. Retrieved from https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235#11
  3. Gold, K., Andrew, L., Goldman, E., & Schwenk, T. (2016). “I would never want to have a mental health diagnosis on my record”: A survey of female physicians on mental health diagnosis, treatment, and reporting. General Hospital Psychiatry, 51-57. doi: 10.1016/j.genhosppsych.2016.09.004.
  4. Polfliet, S. (2008). A National Analysis of Medical Licensure Applications. Journal of the American Academy of Psychiatry and the Law, 369-374. Retrieved from: http://jaapl.org/content/jaapl/36/3/369.full.pdf