Several Factors Influence Doctors' Suicide Risk

Doctors who were deemed unfit to practice, operated a solo practice, or were using anti-anxiety medications had an outstandingly high suicide prevalence, Vanderbilt University (VU) researchers found.

For a retrospective study published in General Hospital Psychiatry, investigators compared suicide outcomes of 141 physicians enrolled in the Vanderbilt Comprehensive Assessment Program.

Among the 141 physicians, 7 attempted suicide, 5 of which died. Comparatively, the participating doctors’ suicide rate was 175 times greater than the Tennessee state suicide rate of .02%, the VU statement pointed out.

Moreover, the researchers reported strong associations between suicide and being determined unfit to practice (86% vs. 31%, P<.05), employment at a solo practice (71% vs. 33%), and chronic use of benzodiazepines, and anti-anxiety medication (57% vs. 11%, Fisher’s Exact Test, P<.05).

According to the study’s contributor Reid Finlayson, MD, an associate professor of Clinical Psychiatry and medical director of the Vanderbilt Comprehensive Assessment Program, doctors in solo practices often lack colleagues to commiserate with or know how they are doing, which results in feelings of isolation.

“Being found unfit for practice means a loss of income, loss of social contact and loss of social status. It’s very distressing,” Finlayson said in a statement.

Alarmingly, all study enrollees taking Valium or Xanax were offered treatment but declined and continued using their medications prior to suicide. Furthermore, 3 of the 5 physicians who committed suicide were under investigation for their prescribing habits, VU added.

“That suggests that doctors who are taking benzodiazepines may self-prescribe, and may be more likely to be prescribing them too often for their patients, and contributing to the epidemic drug abuse in this country,” Finlayson said.

In light of their findings, the authors deduced these factors play a role in doctor’s increased suicide prevalence. However, the investigators also commented that each of the factors highlighted in their research should be further analyzed individually.

“The intense stress associated with medical practice and the relatively high rates of suicidal behavior among physicians make it important to be able to identify physicians who are at risk, so that appropriate preventive actions can be taken,” the writers concluded.