The enduring impact of physician suicide: A call for change and connection

Kim Downey , a physician advocate, and Todd R. Otten, MD, FAAFP , a family physician, recently appeared on The Podcast by KevinMD to discuss their article, "Long-term impacts of physician suicide on patients and doctors."

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The article originated from a conversation on Kim's YouTube channel, where Todd spontaneously shared his struggles with unprocessed grief, including the loss of four physician colleagues to suicide. This deeply personal revelation resonated with Kim, who had experienced the traumatic loss of her own physician to suicide.

Todd's story: The burden of unprocessed grief

Todd describes the profound impact of losing four colleagues to suicide. He acknowledges that he initially failed to grieve these losses adequately, reverting to the ingrained medical training of "stuffing it in a box" and continuing to work. He emphasizes the need for time to process grief and heal, which is often absent in the current productivity-driven health care system.

Todd highlights the secondary negative consequences of unaddressed trauma, which ultimately cost the system more money and can lead to disastrous outcomes. He advocates for readily available mental health support for physicians, citing the example of his current group, which employs a therapist for its staff.

Kim's story: The patient's perspective

Kim shares her experience as a patient, describing the suicide of her physician as the most traumatic event of her life. She recounts the lasting impact, including feelings of guilt for grieving so deeply for someone she had only met a few times, and the resurgence of trauma when revisiting the medical practice. She also describes a heightened anxiety triggered by medical correspondence, fearing news of another doctor's departure.

The power of connection and vulnerability

Both Kim and Todd emphasize the importance of connection and vulnerability in healing from trauma. Todd describes the relief of finally opening up about his struggles and the power of simply asking a colleague, "How are you really doing?" He believes many physicians are desperate for someone to recognize their pain.

Kim's work as a physician advocate focuses on fostering these connections. She creates a safe space for doctors to share their struggles without judgment and facilitates connections between physicians.

Moving forward: Practical steps and systemic change

Kim and Todd offer several practical suggestions for physicians and the broader medical community:

• For those struggling: Reach out to a safe person—a friend, pastor, coach, therapist, or any of the individuals involved in this discussion. Don't be afraid to ask for help.
• For those offering support: Slow down and ask, "How are you really doing?" Look the person in the eye and create space for an honest answer.
• For all physicians: Recognize the importance of relationships and connections. Develop the courage to say "no" to excessive demands. Prioritize self-care.

Todd is also involved in a physician-led documentary project aiming to raise awareness about physician suicide, scheduled for release on National Physician Suicide Awareness Day (September 17).

A call to action: Changing the culture of medicine

Kim powerfully describes the systemic issues contributing to physician burnout and suicide:

• Intense competition throughout medical training.
• An ingrained culture of self-sacrifice and neglecting basic needs.
• Lack of training and support for processing trauma and suffering.
• High responsibility with limited control in a complex health care system.
• Significant financial burdens from student loans.

She calls for a fundamental change in the culture of medicine and urges everyone to thank a doctor, acknowledging the challenges they face and expressing appreciation for their dedication.