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It’s Not Okay

President’s Paragraph

by Shanna Combs, MD, TCMS President

This article was originally published in the September/October 2022 issue of the Tarrant County Physician. You can read find the full magazine here.


On June 23, 2022, the Tarrant County medical community lost an amazing physician, who died by suicide.  He was a remarkable person whose work touched so many lives—he was always willing to help others.  He is greatly missed by all who knew him.     

Unfortunately, physician suicide has become an all-too-common occurrence in the United States.  

• Approximately 300–400 physicians die by suicide each year in the U.S.

• Among male physicians, the suicide rate is 1.41 times higher than the general male population.  

• Among female physicians, it is even more pronounced at 2.27 times higher than the general female population.1  

As terrible as this sounds, there is hope.  Physicians who are proactive about their mental health are able to take better care of their patients as well as have more resilience in the face of stress.  However, this is not so easy to accomplish.

There is already a stigma associated with mental health, and it is made even worse for physicians due to the concern of needing to report a diagnosis to our medical boards, licensing organizations, as well as to credentialing offices in the hospitals and health systems we work in.  We as physicians also have difficulty taking care of ourselves in general, let alone when it comes to mental health, as we are the healers and must be perfect.  

The truth is, being a physician is hard.  We train for many years to be able to do the work that we do.  We often share our war stories about medical school and residency, but when it comes to the deeper struggles we have, we tend to keep those to ourselves.  We push them down and hide behind a smile (or a mask) and continue to pretend that everything is okay.  

But it’s not okay.

We as a profession need to start taking care of ourselves and looking out for our colleagues.  It is okay to tell someone when you are struggling and to seek out help when you need it.  A psychiatrist friend puts it best—“Everyone needs a therapist.  I have one.”  At some point we all learned the physiology of the human body, and of the brain specifically. Sometimes that brain needs a little extra help from chemistry, and that is okay as well.  If you have a thyroid problem, you do not put up a fight about taking a thyroid pill. The same goes when our brain chemistry needs a little help.  We also need to reach out to one another, to check in and see if our colleagues are really doing okay and if they need any help or support.  It’s okay to not be okay, but we need to recognize this and seek out the help we so desperately need, and to help our colleagues obtain the help that they need.

We also need to work from an advocacy standpoint so that physicians can seek the help that they need without the fear of needing to report their illness.  All other aspects of medicine and healthcare are taken care of in a private manner between a physician and a patient.  Why should mental health be any different?  Until this changes, no number of wellness programs, resilience building, etc., will be able to fix the problem.  

I encourage everyone to seek help when needed and to reach out to our colleagues, partners, and friends.  We have worked tirelessly to get to the point we can practice medicine, and those around you want you to stay here.

References
1John Matheson, “Physician Suicide.”  American College of Emergency Physicians. Accessed August 3, 2022. 

https://www.acep.org/life-as-a-physician/wellness/wellness/wellness-week-articles/physician-suicide/#:~:text=Each%20year%20in%20the%20U.S.,times%20more%20often%20than%20females

Mental Health Resources

National Suicide Prevention Lifeline
1-800-273-TALK (8255)
Available 24/7

Crisis Text Line
Text TALK to 741-741
Available 24/7

Physician Support Line
1 (888) 409-0141
Open seven days a week,
7:00am – 12:00am CST
Psychiatrists helping their U.S. physician colleagues and medical students navigate the many intersections of our personal and professional lives. Free and confidential. No appointment necessary.

Emotional PPE Project
emotionalppe.org
The Project connects healthcare workers in need with licensed mental health professionals who can help.