March 12, 2020

Supporting physician wellness

Studies suggest one of about every 400 physicians dies by suicide in the United States each year, translating to more than 1 million patients losing their doctor to suicide annually. Compared with the general population, physicians are nearly twice as likely to succumb to suicide.

Studies have often pointed to burnout due to heavy workloads and long hours as a potential cause, while others suggest fear of judgment for seeking help, limited time to devote to self-care and managing the emotions involved in patient care may also play a role.

“Physicians are a special group in many ways, but they deal with anxiety, depression and addiction just like everyone else,” said Reid Finlayson, MD, medical director of the Vanderbilt University Medical Center Faculty and Physician Wellness Program. “Mental health is stigmatized in general, and especially so for physicians. Physicians are taught to be self-reliant, strong and individualistic, so many are reluctant to ask for help.”

The Faculty and Physician Wellness Program, housed within the Work/Life Connections Employee Assistance Program, is a benefit offered to all VUMC faculty, physicians and house staff that provides confidential counseling, recovery support, clinical assessments and treatment free of charge.

Established in 1999, the program has cared for more than 1,000 faculty and physicians, with 95% being self-referred. In 2019, more than 350 physicians utilized the program for coaching, counseling or workplace consultations.

Physicians can turn to the program for work-related or personal concerns, and appointments can typically be scheduled within 48 hours. Providers who have emergent needs can be seen as a walk-in.

“For the physician who is struggling to find time to devote to their patients as well as their personal life, it might feel like there isn’t enough time in the day to make a wellness appointment. We strive to make our program accessible,” said Terako Amison, MD, assistant professor of Psychiatry, who provides clinical oversight for the program.

To make recommendations for decreasing physician burnout, VUMC also convened the Task Force for Empowerment and Well-being in 2017. The 16-member multidisciplinary group aims to develop a deeper understanding of nationwide burnout and suggest solutions at VUMC.

“The task force adapted what we currently know of burnout and well-being to outline a foundational approach at VUMC, which includes a departmental well-being metric for leadership accountability, recommended resources to support departments in distress and institutional resources that could be made available to clinicians to foster well-being at work and in their personal lives,” said Mary Yarbrough, MD, MPH, executive director of Faculty and Staff Health and Wellness, who co-chaired the task force with Reid Thompson, MD, William F. Meacham Professor of Neurological Surgery and chair of the department. Yarbrough also founded Vanderbilt’s Faculty and Physician Wellness Program.

While physician suicide is still prevalent, Finlayson believes routine education programs are helping, with medical students and trainees often engaging in regular discussions about mental health and ways to identify warning signs of despair in colleagues.

“The thing I always tell my patients is that suicide is a permanent solution to a temporary problem,” said Finlayson.