Suicidal thoughts more likely to plague surgeons

Surgeons have thoughts of suicide at a rate that is more than double that of the general population, yet few seek psychiatric or psychological help because of concerns that doing so will affect the status of their medical license, according to a report in the Archives of Surgery.

Among the 7,905 surgeons surveyed via e-mail by researchers from the Mayo Clinic and elsewhere, 502 (6.3%) said they had had thoughts of suicide at some point in the previous 12 months, as compared with 3.3% of the general population of the U.S., according to the report.

Of those who thought about suicide, only 130 (26%) sought professional help, while 301 (60.1%) said specifically that they didn't seek help because of license concerns. The report noted that 80% of state medical boards ask about mental illness on license applications, and 47% do so on renewal applications.

Working more than 40 hours a week and having a greater frequency of being on overnight call led to more-frequent thoughts of suicide, but one of the highest factors contributing to suicidal thoughts was having experienced a major medical error. Among surgeons who said they had a major medical error in the three months before the survey, 16.2% reported having suicidal thoughts in the previous year, compared with 5.4% among those not reporting an error.

The researchers also noted several ways in which surgeons do not fit common suicidal profiles. Among physicians, the report said surgeons appear to have the lowest rates of substance abuse and dependency. Surgeons also are highly educated and "nearly universally employed," and 88% are married—all factors that reduce suicide risk in the general population, according to the report.

The report concluded that more study is needed to be able to identify why surgeons have higher rates of suicidal thoughts and how to lower barriers to using mental health services.

"We are human; to err is inevitable; and suicide is not the right answer for those tormented by the expectation of perfection," University of Pittsburgh School of Medicine physicians Dr. Kelly McCoy and Dr. Sally Carty said in a commentary accompanying the report.