Sourav Sengupta, MD, MPH

Every single day of our work lives we work with patients, many of whom have significant health issues. In helping others manage their suffering, physicians can be more primed to experience mental illness themselves. Though we have made strides in identifying these physicians, the study by Dong and colleagues indicates we have not found them all.

One of the biggest things that health systems can do to help physicians with suicidal thoughts is better understand their problems in the working environment. The results may be upsetting, but it is hard to create action plans unless you know what is causing the emotional or physical illness in the first place. 

Health systems may want to follow the example of the Accreditation Council on Graduate Medical Education, which requires that trainees be given time off during their clinical workdays to access mental health services when they are needed. This removes the burden of finding a mutually acceptable time for an appointment outside of the standard workday and is a great example of a systemic intervention to take some of the load off physicians struggling with emotional challenges. Another good program that helps physicians with emotional difficulties is the Office of Clinician Support at Boston Children’s Hospital, which has a psychiatrist, nurse practitioner and therapist dedicated to promoting the emotional wellness of its staff. Emotional wellness programs need to be prepared to address the heightened confidentiality that physicians have in seeking out these services.

Clinicians who may not have access to these types of programs may find referrals from their nearest academic medical center’s psychiatry department chair. While this last approach does put more on the plate of the physician who is emotionally struggling, I have found that when people ultimately do connect with a therapist, they get enormous amounts of support. Colleagues are very interested in supporting physicians that are struggling since they intuitively understand the stressful nature of the job.

Other things that can be done individually to help physicians experiencing emotional distress include checking in and gently broaching the subject of their emotional health in a nonjudgmental way. For example, ask if there is anything you can do to help or offer them the opportunity to let them talk about what they're experiencing. Though these approaches usually make a tremendous impact in the long run, you must be prepared in the short term for some ambivalence or resistance by the person who's struggling. It's very, very hard for any individual to acknowledge that they're having a difficult time, even more so for physicians.