KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Doctors, Med Students Face Higher Risks Of Suicide

News outlets report on workforce issues for doctors, including elevated suicide risk and hesitance to e-mail with patients.

In a reported column, The New York Times reports that for "several decades now, studies have consistently shown that physicians have higher rates of suicide than the general population - 40 percent higher for male doctors and a staggering 130 percent higher for female doctors. While research has traced the beginning of this tragic difference to the years spent in medical school, the contributing factors remain murky. Students enter medical school with mental health profiles similar to those of their peers but end up experiencing depression, burnout and other mental illnesses at higher rates. Despite better access to health care, they are more likely to cope by resorting to dysfunctional behaviors like excessive drinking and are less likely to receive the right care or even recognize that they need some kind of intervention."

Researchers have a number of theories, including "the increasing social isolation of medical education, training and practice," the "tendency for doctors to be highly critical of themselves and to blame themselves for their own illnesses," and workplace harassment. "Despite the many studies, theories and, more recently, student wellness programs and confidential mental health services offered by more and more medical schools, the grim statistics for medical students have hardly budged over the last generation. Up to a quarter of young doctors-to-be suffer from depression, more than half may be experiencing burnout, and a just more than 10 percent may be harboring thoughts of suicide." Two new studies published in The Journal of the American Medical Association "go beyond incidence statistics and theoretical considerations" to search for answers, which include the stigmatization of mental illness (Chen, 10/7).

Meanwhile, few doctors are e-mailing with their patients, The Wall Street Journal Health Blog reports: "According to the Center for Studying Health System Change, only 6.7% of the 4,200-plus office-based physicians who responded to a 2008 national survey 'routinely' emailed patients about clinical matters. Most just didn't have the technology available, but even among the doctors who had email access, only 19.5% regularly emailed with patients."

While the survey didn't ask why the doctors weren't using email with patients, the brief "has a host of previously cited reasons: 'lack of reimbursement, the potential for increased workload, maintaining data privacy and security, avoiding increased medical liability and the uncertain impact on care quality.'" But doctors "working in practices that have already converted to electronic medical records were more likely to communicate with patients via email. So were physicians in HMOs or academic centers, compared to those in solo or two-doctor practices…. Other options for compensation include a set per-patient fee paid to physicians for agreeing to coordinate care using email and other means or an annual fee paid directly by patients for email access privileges, the brief says" (Hobson, 10/7).

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