Physicians are twice as likely as the general population to attempt suicide, Medscape survey finds

Nearly a quarter of physicians reported clinical depression in a new Medscape survey, while 9% admitted to suicidal thoughts, and 1% shared that they attempted to end their lives.

Medscape surveyed 9,100 physicians across 29 specialties last year. While physicians often address the suicide crisis throughout the U.S., many are struggling with their own mental health. Two-thirds of doctors reported colloquial depression, according to the survey.

Twenty-four percent of doctors reported clinical depression, and the survey also found that doctors are more likely to have suicidal thoughts compared to those in other professions. 

Depression in the medical community has been a serious problem for about as long as it has been measured, Andrea Giedinghagen, M.D., assistant professor of psychiatry at the St. Louis Washington University School of Medicine, said in the report.

“Physicians are also still coping with a pandemic—the trauma from COVID-19 didn’t disappear just because the full ICUs did—and with a fractured healthcare system that virtually guarantees moral distress,” Giedinghagen said. “This is beyond individual solutions for individual problems. Systemic change is necessary.”

In the last year, the percentage of physicians who reported contemplating suicide decreased from 13% to 9%, according to the 2021 report. Of the total U.S. adult population, 4.9% have thought of suicide and 0.5% have attempted the act.

In comparison to the 2019 report, reported depression jumped 8% while suicidal ideation decreased by 5%. Leslie Kane, senior director at Medscape Business of Medicine, told Fierce Healthcare in an email that the shifting reports might be due to lifestyle changes.

"The pandemic created chaos and trauma for physicians, but some physicians left the profession or chose to cut down their workload permanently," Kane said. "Many doctors made important life decisions that they felt ultimately worked to their benefit." 

Female physicians were 2% more likely than males to consider ending their lives. In the general population, females are two to three times more likely to attempt suicide while males are more likely to be successful in ending their own lives. Nationally, men make up 80% of suicides.

As physicians age, feelings of suicidal desire wane with 12% of those ages 27 to 41 reporting thoughts of suicide compared to 8% of those aged 57 to 75. This is counter to the general population where men over 45 years old experience higher suicidal rates.

Younger physicians were more likely to say that a med school or healthcare organization should be responsible for a student or physician’s suicide. Of those aged 42 to 56 years, 57% were unsure whether institutions should bear any responsibility.

“Admitting to having felt suicidal but not attempted suicide does speak to how stressed a certain cohort of today’s doctors are,” Michael Myers, M.D., professor of clinical psychiatry at SUNY Downstate Health Sciences University, said in the report. “The fact that only a small percentage of these individuals went on to attempt suicide is a good sign that they perhaps shared with a trusted colleague, friends or family member or sought professional help.”

Myers also said the statistics might indicate less stigma around disclosing a suicide attempt, “that individuals understand this as a part of a serious mental health issue and not a sign of weakness.”

When it comes to specialty, the top five specialist types most likely to report suicidal thoughts were otolaryngology, psychiatry, family medicine, anesthesiology and OB-GYN. The five specialist types least likely were orthopedics, nephrology, oncology, rheumatology and pulmonary medicine.

Physicians were 4% more likely to share their feelings with a therapist as compared to 2019 when only 34% reported doing so. In 2022, just over half reported sharing with a family member, friend or colleague while a meager 5% reported to a suicidal hotline.

Still, 40% stated they had not shared their feelings with anyone.

These numbers were mostly equal between the genders. Although men were more likely to confide in a family member and women were more likely to confide in a friend or colleague.

Anonymous responses to the report included various reasons for not reaching out for help, including fears that it will put their career on the line. 

According to the survey, 42% of doctors with depression do not want to risk disclosure to the medical board—a 110% increase from Medscape’s 2021 report.

“I was afraid of being put on a 5150 (involuntary detention), losing my job, having an impact on my future job search and credentialing,” an anonymous physician wrote as part of the survey.

Others shared similar reasons for avoiding treatment including the requirement that “meds had to be reported to the state board.”

Another physician wrote that he or she changed their work situation and no longer experiences suicidal thoughts.

“I feel this is passive ideation,” another anonymous physician wrote. “I don’t really plan to do it—I just wish I wasn’t here sometimes.”

When asked why physicians had not sought help, 33% were concerned about the report being on their insurance record and 25% were concerned that a colleague would find out. Just over half said they could “deal with suicidal thoughts without help from a professional.”

Kane pointed to two areas where systematic healthcare alteration could make a difference when it comes to depression: fear of ramifications and burnout. 

"Some physicians noted that after noting that they had received professional mental help, some coworkers or administrators in their organization used that information against them in competitive instances," Kane said. "There should be more oversight or change in attitude as to the use of such information."

When it comes to burnout, Kane highlighted productivity quotas, burdensome call schedules, increasingly greater amounts of paperwork and digital reporting as places where management is asking too much of physicians. 

She said physicians are calling for hospitals to slow down the pace of productivity and provide more time for patient interactions so physicians feel less like "they are on a rushed hamster wheel."

“Though as physicians we recognize suicidal ideal as an area of high concern and would take what a patient says very seriously, we are less likely to do this ourselves,” said Perry Lin, M.D., national co-chair of the American Association of Suicidology’s Physician Suicide Awareness Committee, in the report. “There is a lot of stigma among help-seeking behavior.”

Editor's note: This story has been updated with a statement from Leslie Kane, senior director at Medscape Business of Medicine.