Factors Influencing US Physician and Surgeon Suicide Rates 2003 to 2017

Abstract

Background and Objectives: With the rate of physician suicide increasing, more research is needed to implement adequate prevention interventions. This study aims to identify trends and patterns in physician/surgeon suicide and the key factors influencing physician suicide. We hope such information can highlight areas for targeted interventions to decrease physician suicide. Methods: Review of Centers for Disease Control and Preventions National Violent Death Reporting System (NVDRS) for 2003 to 2017 of physician and dentists dying by suicide. Twenty-eight medical, surgical, and dental specialties were included. Results: Nine hundred five reported suicides were reviewed. Physician suicides increased from 2003 to 2017. Majority surgeons' suicides were middle-aged, White males. Orthopedic surgeons had the highest prevalence of suicide among surgical fields (28.2%). Black/African American surgeons were 56% less likely [odds ratio (OR) = 0.44, 95% confidence interval (CI): 0.06-3.16] and Asian/Pacific Islander were 438% more likely (OR = 5.38, 95% CI: 2.13-13.56) to die by suicide. Surgeons were 362% more likely to have a history of a mental disorder (OR = 4.62, 95% CI: 2.71-7.85), were 139% more likely to use alcohol (OR = 2.39, 95% CI: 1.36-4.21), and were 289% more likely to have experienced civil/legal issues (OR = 3.89, 95% CI: 1.36-11.11). Conclusions: The prevalence of physician suicide increased over the 2003 to 2017 time-frame with over a third of deaths occurring from 2015 to 2017. Among surgeons, orthopedics has the highest prevalence of reported suicide. Risk factors for surgeon suicide include Asian/Pacific Islander race/ethnicity, older age, history of mental disorder, alcohol use, and civil/legal issues.

Orthopaedic Surgeons Have a High Prevalence of Burnout, Depression, and Suicide: Review of Factors Which Contribute or Reduce Further Harm

“…13 For suicides among all surgical specialties, men comprised 95.8%, and men were much more likely to die at an older age compared with female surgeons (64 vs. 39 years, respectively). 13 Among surgeons, Black/African Americans were 56% less likely (OR = 0.44 95% CI, 0.06 to 3.16), and Asian/Pacific Islanders were 438% more likely (OR = 5.38, 95% CI, 2.13 to 13.56) compared with the general population to die by suicide. These demographic differences are alarming and likely reflect specific cultural, gender, and generational gaps to further explore.…”

Identifying and Addressing Burnout in the Orthopaedic Surgeon

“…4 Orthopedic surgeons compose the largest percentage of physician suicides at 28.2%, with a third of the suicides between 2003 and 2017 occurring in the last 2 years alone. 3,5 The signs can present early in one's career, with over half of orthopedic residents reporting being burnt out, 13% screening positive for depression, and 61% meeting the criteria for hazardous alcohol use. 6 Overall, surgeons were shown to be 362% more likely to have a mental health disorder, 139% more likely to use alcohol before suicide, and 289% more likely to have experienced civil and/or legal issues.…”

“…6 Overall, surgeons were shown to be 362% more likely to have a mental health disorder, 139% more likely to use alcohol before suicide, and 289% more likely to have experienced civil and/or legal issues. 5…”

Resilience in Residency and Beyond

“…Surprisingly, up to 52% of orthopaedic surgeons claim to be burned out, and in response, Pearl et al recently published a thorough review with recommendations to identify early signs and slow progression 22 . More alarming, Elkbuli et al recently published an article that highlights orthopaedic surgery as the surgical field with the highest prevalence of suicide based on a review of Centers for Disease Control and Preventions National Violent Death Reporting System from 2003 to 2017 26 . This statistic demands the attention of our specialty.…”