The National Weather Service estimates that about 40 people are struck by lightning every year and die. As a result, most individuals are raised aware of the dangers of being outside in a thunderstorm and so change their behaviors accordingly. When I tell you that the National Institutes of Health estimates that around 300 physicians in the U.S. die by suicide every year, would you be shocked to know that we as professional healers aren’t adequately trying to stop this? In fact, the current Minnesota licensure application explicitly discriminates against physicians who have or have experienced any form of mental duress within the past five years. There are discussions now about changing the language and I adamantly support these efforts for several reasons.
As a medical student at the University of Minnesota and as a future physician, my life is not calm nor necessarily designed with my personal wellness in mind. While medical schools have increasingly put a focus on teaching students coping skills and the ability to recognize burnout, the larger system for physicians and health care overall is not always as supportive. Our field prioritizes and celebrates personal sacrifice – long shifts, the relinquishment of a personal life, and patients’ needs above all. While the personal calling to heal and serve communities is what led us into health care, the systemic devaluing of our health and lives is causing widespread moral injury leading to burnout. Medscape’s 2021 National Physician Burnout & Suicide Report found that 42% of physicians are experiencing burnout – and 79% of them reported it starting before the COVID-19 pandemic. 13% of physicians have had thoughts of suicide. For comparison – in the general population suicidal ideation is estimated to hover around 4%.
In my own life, I have had peers hesitant to reach out for resources that would support their well-being because they are concerned how it may affect their entire career. While some changes supporting trainee and physician well-being have been made in recent years, there are still environmental changes that need to happen in order for us to feel supported to take care of ourselves. A report found that 9.4% of medical students and residents report having suicidal thoughts within the past two weeks. On a personal note, within my own training over the past few years, we have lost several classmates of different years to suicide. Maintaining and feeding a constant culture of perfectionism, stoicism, and silence is quite literally killing us.
Changing the culture of medicine is necessary to save lives and it must happen now. Currently, Minnesota’s physician licensure application stigmatizes mental illness in asking physicians to disclose if they have been “informed or diagnosed of a physical, mental, or emotional condition that impairs their ability to practice medicine in the last five years.” Now as a medical student and in the future, if the organization that processes my application to legally practice labels individuals with a mental illness as “unfit,” there’s no way that I could comfortably talk about my struggles to seek help. I would quite literally endanger my financial safety in doing so when the average student debt for medical students ranges about $200,000. This inability to ask for help publicly creates a culture of silence around mental health that is deadly.
I am taking a stance to publicly support the changing of this language by the Board of Medical Practice. By instead asking more generally if a physician has any condition that impairs their ability to practice medicine competently, ethically, and professionally, we can remove the stigma of mental illness from our profession in Minnesota. Shifting the focus from mental health to generalized health can help raise a future cohort of physicians who aren’t discouraged from talking openly about their struggles – and save the lives of current practicing physicians burdened alone, in silence.
Christopher Seaver is a medical student and executive vice president of the Medical Student Council, University of Minnesota Medical School.
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