In a 1999 article on physician suicide, a Finnish author stated:

Current adequate treatment for depression seems to be as rare among physician victims as among suicides with major depressive disorders in the population.¹

The citation refers to a study of seven cases of physician suicide; the authors found that none of the physician victims had received adequate treatment with medications or therapy. And indeed, this reflects NCPHP experience with depressed physicians. While most of the physicians and PAs referred to NCPHP are not suicidal, a high percentage of depressed individuals have not sought or obtained adequate treatment prior to their NCPHP evaluation.

The barriers to treatment for physicians and PAs are many. A fair number of those who realize they are clinically depressed (with symptoms of disturbed mood/appetite/sleep, loss of interest, etc.) are afraid of the consequences of seeking help. They fear that an admission of clinical depression will be seen as “weakness”, or that there will be repercussions to their medical license or hospital privileges. Amazingly enough, these are often the very same physicians who are telling their patients how important it is to get help, and how effective the current treatments for depression can be.

The NC Medical Board annual license renewal application for physicians asks:

Have you been told, since you last registered, that you were professionally or personally impaired as a result of your medical, surgical, or psychiatric condition and have not been involved with the NC Physicians Health Program?

The question is worded so that a licensee may honestly answer “no”, if they have been evaluated by NCPHP and have followed the recommendations. And even for those physicians who choose not to avail themselves of NCPHP services, the Medical Board encourages treatment for depression and does not penalize physicians for getting help.

An October 2002 workshop sponsored by the American Foundation for Suicide Prevention (AFSP) resulted in a number of recommendations for institutional change.² These recommendations included development of model regulations for state licensing boards, hospitals, etc. that would encourage physicians to seek help. The model regulations would also promote the privacy of physicians’ psychiatric records and endorse licensing questions that focus on function vs. impairment rather than diagnosis or treatment.

1.      Lindeman S, Henriksson M, Isometsa E, Lonnqvist Treatment of mental disorders in seven physicians committing suicide. J. Crisis. 1999;20(2):86-9.

2.      Confronting Depression and Suicide in Physicians: A Consensus Statement. JAMA.  2003;289:3161-3166