One in 16 U.S. surgeons consider suicide: survey

NEW YORK (Reuters Health) - A considerable number of U.S. surgeons struggle with thoughts of suicide, according to a new survey that highlights burnout and past medical errors as possible reasons.

Researchers found more than 6 percent of surgeons had thought about killing themselves within the past year. Among those aged 55 to 64, the number was three times higher than the national levels for that age group.

“What we are seeing through this work is that there is a high amount of burnout and stress among America’s physicians, with potentially serious consequences for both physicians and their patients,” said Dr. Tait Shanafelt of the Mayo Clinic in Rochester, Minnesota, whose findings appear in the Archives of Surgery.

“It isn’t necessarily that having thoughts of suicide endangers patient health,” he added, “but some of the same root causes, particularly burnout, do appear to have a strong relationship with quality of care.”

In a survey published last year, Shanafelt’s team found surgeons who reported high degrees of emotional exhaustion on the job also had higher odds of making major errors when they dealt with patients.

They used the same survey, based on responses from more than 7,900 physicians, for the current study.

While younger surgeons had rates of suicidal thinking that were similar to those in the general population -- between 6 and 7 percent -- those older than 45 were at increased risk.

At 55 to 64 years, for instance, 7 percent of surgeons had considered suicide in the past year, compared to about 2 percent of the general population.

Only about a third of the surgeons who received the survey responded, but Shanafelt said that was unlikely to influence the results much.

Doctors who felt burned out, or said they’d made a “major medical error” in the past 3 months were more prone to suicidal thoughts.

While depression also played a role, it didn’t explain the effect of burnout.

“We’ve known for some time that physicians are at a greater risk for suicide than other professions, although why that is has never really been understood,” Shanafelt told Reuters Health.

Married surgeons, and those working in large university-based medical centers, were at lower risk for suicidal thoughts.

The new findings also show that only a fourth of the troubled surgeons had sought professional help -- most said they hadn’t done so out of fear that they would lose their medical license.

Instead, some chose to self-prescribe antidepressants or have friends do it for them, Shanafelt said.

According to the National Institutes of Mental Health, there were about 11 suicide deaths per 100,000 Americans in 2007.

“We fear for the ‘80-hour work-week’ generations of surgeons now coming into practice,” two surgeons at the University of Pittsburgh commented in the journal.

“We are human, to err is inevitable, and suicide is not the right answer for those tormented by the expectation of perfection.”

SOURCE: and Archives of Surgery, January 17, 2011.