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Letter to the Editor

The Roots of Suicide and the Culture of Medicine

doi: 10.1097/01.EEM.0000552806.27725.41
Letter to the Editor

Editor:

I found the recent article by Janae Sharp examining suicide in EPs to be insightful and informative. (“Preventing Physician Suicide Starts with Radical Honesty,” EMN 2018;40[9]:18; http://bit.ly/2CsMcuD.) I know physicians who have considered suicide and one who succeeded.

A recent article examined the frequency of burnout symptoms among second-year residents. (Fam Pract Res J 1994;14[3]:213.) Burnout, even this early in their career, was common among 53.6 percent in emergency medicine. More than 11 percent experienced career choice regret. Few of my colleagues cited the practice as the source of their dissatisfaction; rather, it was the administration of the practice. Other issues that make the practice of medicine increasingly frustrating are administrative domination, malpractice threats, and the total lack of control that physicians have over their professional lives. It has been well documented that burnout is associated with poor medical practice (JAMA Intern Med 2018;178[10]:1317), so not only are the practitioners at risk, their patients are as well.

Suicide is just a more tragic exit, but the truth is the realities of the practice of medicine, particularly emergency medicine, are driving good practitioners to take desperate steps to exit the specialty. Those who stay do so with near heroic personal sacrifice of their own well-being and happiness. It is the culture in which we are forced to practice that drives us away. The roots of suicide do not originate in the practice but in what we must tolerate to practice what is truly a most noble art and science.

Paul Janson,MD

Lawrence, MA

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