For as long as I've written about medical practices, a recurring theme is the plight of solo physicians to preserve their autonomy. But one of this week's top stories touches on a darker side of independence.
Seventy-one percent of the physicians who attempted suicide were in solo practice, compared to 33 percent of the remainder of the sample, according to the retrospective study of 141 physicians evaluated at the Vanderbilt Comprehensive Assessment Program.
"It stands to reason," said Reid Finlayson, M.D., associate professor of Clinical Psychiatry and medical director of the Vanderbilt Comprehensive Assessment Program, in an announcement. "Doctors who are in large practices or who work at a hospital have colleagues who can see what's going on with them. They're observed and they can be pointed toward getting help."
With a clear disclaimer that I'm not a doctor nor have I ever been suicidal, I do have a measure of experience with some rather secluded occupations: At-home parent and freelance writer. Combine working 90 percent from home with a personal tendency to shy away from human contact in general, and you have a recipe to become a dangerous recluse.
The truth is that I like to fly solo, as many strong-minded physicians probably do as well. But I have, at times, felt almost helplessly isolated, particularly during the early months home alone with my firstborn son. I also prided myself in keeping up a façade of having it all together. But in reality, I can't remember a more desolate emotional place than my 11,000 square-foot home, where it was just my seven-pound howling infant, a world of responsibility and me. It's been seven years, and I still get emotional recalling how overwhelmed and alone I felt, in spite of having a fairly strong support network just a call away. (Naturally, most of the time I was too stubborn or embarrassed to call.)
In that situation, I was in charge of just one cranky yet healthy person, not the thousands most physicians care for. There was no business to run and no government regulations with which to comply. No paperwork burden or threat of lawsuits or other people's family members to sometimes have to tell bad news. Compared to most of you, I had it easy--and it was still terrifying.
Throughout the years since, I made an effort to stay connected to social support, almost as though it's part of my job description. Currently, there are three main ways I do this:
Volunteer work. I provide childcare at my local gym two hours per week, but the free membership is not the primary reason (I could just as easily work out at home). This job gives me facetime with other parents and allows me to opportunity to feel good about interacting with kids other than my own. Some experts believe that volunteer work can help physicians stave off burnout, but an overlapping benefit may be the opportunity to build an extra layer of professional relationships.
Extracurricular activities. Running is by nature a solo activity, but it also offers membership in a community full of like-minded, supportive and motivating friends and acquaintances. Again, research shows that physicians benefit from the chance to blow off steam through physical activity, but the don't overlook the camaraderie effect.
Social media. Unlike when I worked in an office, I don't have the possibility of bumping into coworkers in the hallway or chatting over lunch (I do have a standing weekly coffee date with a friend, which I prioritize as though it were a critical business meeting). My rough equivalent to this is to take a few minutes between tasks, throughout the day, to check in on Facebook, or even LinkedIn or Twitter, to experience some social time, and even ask the masses for advice with a particular problem, or celebrate a special occasion or achievement. Remember, social networking isn't just a way for physicians to connect with patients, it's also a means to network with other doctors and medical professionals--to share ideas, commiserate and even laugh.
What do you think? Is social isolation a problem for physicians, particularly in solo practice? What are your strategies to overcome it? - Deb (@PracticeMgt)