As the camera pans on an aerial shot of the New York City skyline at dusk, we hear the desperate voice message of a doctor inside Mount Sinai Hospital revealing a colleague has just jumped off the building. “This keeps happening and they’re just trying to cover it up.”
It’s the opening scene of the new documentary film Do No Harm by Emmy-winning producer Robyn Symon, who pulls back the curtain of the hidden epidemic of physician suicide and depression among doctors and medical students.
“Someone sent me an article about two residents who jumped off the roof of their hospitals in 2014,” says Ms. Symon, who comes from a family of physicians. “I know what it takes to make it through medical school, so I needed to know why someone who had sacrificed so much would want to end it all.”
More recently, in May 2018, a medical student and a resident at New York University took their lives, putting everyone on edge. This is not uncommon; almost every physician knows a physician who has committed suicide. In fact, physicians have one of the highest rates of suicide among all professions and almost twice the rate of the general public. Emergency physicians are at or near the top of the list. According to the American Foundation for Suicide Prevention, an estimated 400 physicians take their lives every year, but the number is believed to be much higher since many suicides are reported as accidental deaths.
Bullying, sleep deprivation, burnout, the lack of autonomy, and the inability to seek emotional help for fear it could jeopardize a career have created a ticking time bomb. More than 50 percent of attending physicians and over 60 percent of trainees report suffering from burnout. How medical schools and hospitals have responded to this crisis has been disappointing to say the least, turning a blind eye to protect their reputations and reduce the risk of liability.
Overcoming Stigma and Suppression
Due to the stigma associated with mental health, finding physicians to talk about this crisis proved to be a big challenge for the filmmaker. The first person Ms. Symon reached out to was Pamela Wible, MD, a family physician who runs a hotline out of her house in Eugene, Oregon, for suicidal physicians and medical students. Dr. Wible, whose TEDMED talk on physician suicide has been viewed more than 400,000 times, has been on a mission to shine a light on this taboo topic. She connected the filmmaker to many physicians and others whom Ms. Symon and her crew followed for more than a year. Woven into the film are interviews with medical students, senior physicians, authors, sleep experts from Harvard Medical School, and leaders from medical organizations such as the American Medical Association, Association of American Medical Colleges (AAMC), and Accreditation Council for Graduate Medical Education (ACGME).
“Many practicing physicians have suppressed their experiences from medical school, but it’s laid the foundation for an unhealthy, disconnected, wounded healer syndrome that physicians have learned to cover up very well,” says Ms. Symon. “Especially surgeons and ED physicians who experience life and death every day, yet are offered no coping skills. It’s like suffering from PTSD.”
The impact of our assembly-line health care system is taking a toll on practicing physicians. Many self-medicate, which can lead down the slippery slope to addiction. Others retire early, which has led to very real doctor shortages. “A perfect storm is brewing,” says Ms. Symon. “You have baby boomers relying more and more on a health care system where more and more disillusioned doctors are headed for the exit.”
The film delves into the link between sleep deprivation and medical errors where Harvard sleep expert Charles Czeisler, MD, says residents and physicians working marathon shifts are set up to fail.
Many hospitals are adding wellness programs, but the film contends what’s really needed is an overhaul of the medical training system and state medical licensing boards. In many states, physicians must disclose whether they’ve ever sought emotional help, forcing many physicians to hide treatment and lie or self-medicate to obtain a medical license.
Starting a Dialogue on Suicide
The film, completed in June 2018, took four years to make and will be launching an international film tour in the fall, which will include screenings at hospitals, medical schools, and conferences, including ACEP18.
The goal of the film is to open a dialogue in the medical community about a crisis that’s been covered up for decades and discuss solutions and there are some promising signs that change is afoot. As Darrell Kirch, MD, President and CEO of the AAMC says in the film, “we have to take care of ourselves if want to take the best care of our patients.” The simple truth is we can’t afford to keep losing talented physicians to depression and suicide.
To watch the trailer and for information on the film, visit www.DoNoHarmFilm.com
Dr. Doty is professor and vice chair for education at the University of Kentucky in Lexington.
Ms. Symon is the director and producer of Do No Harm.