Physicians gather for documentary showing and thoughtful discussion
by Kate Alfano, CMS Communications Coordinator
Featured in the July-August 2019 Colorado Medicine Colorado Medicine.
The Colorado Permanente Medical Group in collaboration with the Colorado Medical Society hosted a screening in May of “DO NO HARM: Exposing the Hippocratic Hoax,” a documentary about the recent epidemic of suicides affecting the medical profession, at the Sie FilmCenter in Denver. Director Robyn Symon said in promotional materials that the film allowed those touched by suicide to “come out of the shadows to expose this silent epidemic and the truth about a sick health care system that not only drives our brilliant young doctors to take their own lives but puts patients’ lives at risk too.” A guided panel discussion followed the movie.
Doctors have the highest suicide rate among all professions – almost twice the rate of the general population – and more than 50 percent of physicians report feeling burned out. A July 2018 study by researchers at the Stanford University School of Medicine showed that physician burnout influences quality of care, patient safety, turnover rates and patient satisfaction, and that medical errors and burnout can double the risk of suicidal thoughts among physicians.
The film focused mainly on systems issues in medical training and hospital medicine. Two panelists mentioned their aversion to the parallel focus on medical errors for raising questions about safety without providing context.
Panelist Martina Schulte, MD, an internist and chair of the CMS Committee on Physician Wellbeing, said physicians and administrators need to move away from thinking about burnout as an individual issue and approach it as an organizational issue. “Don’t tell us to be more resilient,” she said she has heard from her colleagues.
“When we think about systems issues, part of it is the culture we work in,” Schulte said. “Part of systems change is not the efficiency piece; physicians want to be valued, they want to have control over their schedule, they want to be heard and when bad things happen they want a peer there to listen. Those are big parts of systems change.”
Fellow panelist Abraham Nussbaum, MD, a psychiatrist and chief education officer for Denver Health, agreed. “The real key is to treat people like real human beings,” he said. He sits down with each person on his staff to identify their needs, asking: “I’d like to keep working with you; what will it take to do that?” Some mention higher pay, he said, but most mention other goals such as pursuing a research project, having a flexible schedule to have and raise a child, and others.
An audience member posed a question about the nature of suicide and whether it is predictable and preventable: “The water is getting hotter and some of the molecules are going to pop off. Is it something you can identify in the doctor or is it in the temperature of the water? Is it avoidable?”
Panelists agreed that physician suicide is preventable, but said that organizations need to find better ways to study it, build better data and identify those most at risk. Oscar Sanchez, MD, of CPMG, said the culture must change to make it more acceptable to show weakness, to move away from the façade of perfection.
Another audience member shared her experience of burnout, expressing appreciation for comments by U.S. Surgeon General Vivek Murthy, MD, on the epidemic of loneliness affecting the population as a whole, including clinicians. “Nights like this where we come together are very important,” she said. “The medical school [UC Denver] is dropping some of the science and clinical requirements and creating a new pillar for community and health that includes wellness and resilience. We must support reaching out and connecting.”