In the medical community, it is no secret that U.S. physicians are more than twice as likely as the general population to commit suicide, a rate higher than any other profession. Preventing physician suicide starts with recognizing symptoms of burnout before they snowball into depression.
To help address increased rates of physician burnout, depression and suicide, the AOA formed the Physician Wellness Taskforce at its 2016 House of Delegates meeting. The task force’s plans include developing a curriculum to train teachers on recognizing burnout in students and creating resources for the spouses and families of DOs and medical students.
Systemic changes to the health care landscape must occur to better support physician well-being. Recognizing that enacting change can be slow, Robert Piccinini, DO, chair of the AOA’s Physician Wellness Task Force, says that the best thing physicians can do immediately to help a struggling colleague is to talk to them about it.
When in conversation with a physician struggling with burnout or symptoms of mental illness, it may be useful to have some tangible advice on hand. The DO talked with members of the osteopathic community who offered advice to share with physicians who are struggling, whether they are in crisis or just beginning to experience burnout and depression.
Therapy is an option, despite confidentiality and privacy concerns
Physicians should be encouraged to seek professional help at all junctures of mental illness, especially those suffering from suicidal ideation and debilitating symptoms of depression. Some physicians avoid seeking help for mental health issues to circumvent running into patients or acquaintances, notes Vania Manipod, DO, a psychiatrist. But Dr. Manipod says attending therapy helped her work through feelings of failure over not maintaining her expected levels of productivity.
In a perspective piece from the National Academy of Medicine, AOA leadership recognized the need to talk with state licensing boards about physician concerns that they must report visits to a psychiatrist to boards, which could negatively impact their licensure and ability to practice.
“People connect with me because most of us don’t talk about mental illness, and I decided to even publicize that I was in treatment and made some tangible changes as a result,” says Dr. Manipod, who drove an hour from home to see a therapist who wasn’t in her medical organization. “There are things we can do instead of waiting for larger bureaucratic changes, and I’m an example of that.”
Track your emotions daily
Dr. Manipod blogs about her experience recovering from burnout and depression in order to destigmatize mental illness and help other physicians and medical students recognize signs of burnout and depression.
Tracking her emotions in a tangible way helped her to better identify the progression of her healing, Dr. Manipod says.
“I started noticing I was writing more about self-care than my super busy life as a physician,” says Dr. Manipod. “I noticed that putting myself and my priorities first ultimately made me a better physician to my patients.”
Asking a loved one to pay special attention to your mood and outlook is also a great idea, Dr. Manipod says. This way, someone else is actively looking out for you and will raise their concerns if they notice symptoms of burnout or depression.
Practice self-observation through mindfulness meditation
Meditation can help students and physicians create a more thoughtful and less automatic response to stress, notes Ulrick Vieux, DO, MS, the psychiatry residency program director at Orange Regional Medical Center in Middletown, New York. However, mindfulness meditation takes practice, and it may take some time before physicians notice results, so this mental exercise may be more helpful to combat mild symptoms of burnout and depression.
“Insight is a key aspect in maintaining mental wellness and can be learned with effective practice,” says Dr. Vieux. “Insight can challenge hopelessness and negative automatic thoughts that are at the crux of physician burnout and dissatisfaction.”
A study from the Journal of the American Medical Association supports Dr. Vieux’s claim that individual and group mindfulness meditation can be beneficial. It found that physicians participating in a group mindfulness curriculum had improved engagement and morale at work.
Visit your local art museum
Physicians and medical students suffering from mild cases of burnout and depression could benefit from a trip to the art museum. At Kansas City (Missouri) University of Medicine and Biosciences College of Osteopathic Medicine (KCU-COM), educators find trips to the Nelson-Atkins Museum of Art improve reflection and empathy skills that can help alleviate burnout and encourage renewal.
Jim Dugan, PhD, KCU-COM’s director of counseling and support services, says with depression rates among medical students at 27%, KCU-COM’s Art, Observation, and Medicine program is a beacon of well-being for medical students.
“Critiquing and discussing art can foster emotional intelligence and critical thinking, and serve as a buffer against the all too common maladies of medical students—depression and anxiety,” says Dr. Dugan.