Challenges and potential solutions for physician suicide risk factors in the COVID-19 era: psychiatric comorbidities, judicialization of medicine, and burnout

Abstract

Introduction Suicide in physicians outlines a public health problem that deserves more consideration. A recently performed meta-analysis and systematic review evaluated suicide mortality in physicians by gender and investigated several related risk factors. It showed a post-1980 suicide mortality ratio 46% higher in female physicians than women in the general population and a 33% lower risk in male physicians than men in general, despite an overall contraction in physicians' mortality rates in both genders.Methods This narrative review was conducted through a search and analysis of relevant articles/databases to address questions raised by the meta-analysis, and how they may be affected by COVID-19. The process included unstructured searches on physician suicide, burnout, medicine judicialization, healthcare organization and COVID-19 on Pubmed, and Google searches for relevant databases, medical society, expert and media commentaries on these topics.We focus on three factors critical to address physician suicides: epidemiological data limitations, psychiatric comorbidities, and professional overload. ResultsWe found relevant articles on suicide reporting, physician mental health, effects of healthcare judicialization and organization on physician and patient health, and how COVID-19 may impact such factors. This review addresses information sources, underreporting/misreporting of physicians' suicide rates, inadequate diagnosis and management of psychiatric comorbidities and chronic effects on physicians' work capacity, and finally, medicine judicialization and organization failure increasing physician "burnout". We discuss these factors in general and in relation to the COVID-19 pandemic. ConclusionsWe describe an overview of the above factors, discuss possible solutions, and specifically address how COVID-19 may impact such factors.

Continued challenges in pediatric anesthesia during COVID‐19 in 2022: An international survey from the pediatric anesthesia COVID‐19 collaborative

“…Physicians with burnout are more likely to leave their current job 7,10 . Our survey confirmed that 61% of pediatric anesthesiologists were aware of colleagues who had left their current job and 53% of pediatric anesthesiologists were aware of colleagues who had retired early as a result of COVID‐19 pandemic.…”

“…9,13 Physicians with burnout are more likely to leave their current job. 7,10 Our survey confirmed that 61% of pediatric anesthesiologists were aware of colleagues who had left their current job and 53% of pediatric anesthesiologists were aware of colleagues who had retired early as a result of COVID-19 pandemic. A meta-analysis of Panagioti et al completed prior to the pandemic showed that physicians could gain benefits from interventions to reduce burnout.…”

“…Of note, 5 of the 70 respondents (7%) stated that they knew of at least one case of a colleague who had attempted or died by suicide due to the COVID‐19 pandemic. While we did not explore underlying reasons or comorbidities, this alarming finding illustrates that pediatric anesthesiologists are at risk of self‐harm or suicide which might be aggravated by burnout and COVID‐19 induced isolation 7 …”

“…A recent study by Margolis et al surveyed the members of the Society of Pediatric Anesthesia and found that 25% of all respondents felt socially isolated 6 . The COVID‐19 pandemic and lockdown may worsen suicide precipitants among physicians 7 . The COVID‐19 pandemic and burnout have led to a great number of resignations of healthcare workers 8,9 .…”

“…6 The COVID-19 pandemic and lockdown may worsen suicide precipitants among physicians. 7 The COVID-19 pandemic and burnout have led to a great number of resignations of healthcare workers. 8,9 In one report, 31% of the physicians surveyed stated that they intended to reduce their clinical work hours in the next 12 months and 24% intended to leave their current clinical practice in the next 24 months as a result of the direct and indirect consequences of the COVID-19 pandemic.…”