Various stressors have been correlated to physician suicide, including: personal, financial, and profession.
[i] Anyone who has been under pressure from a legitimate review process will readily tell you that it can be stressful. If the review is a sham, the stressful nature of the review increases dramatically.
This unnecessary stress may increase the risk of depression and suicide in the physicians exposed to sham peer reviews.
Generally, suicide results from depression, which is either untreated or inadequately treated and accompanied by the “knowledge of and access to lethal means.”[ii]
Interestingly, a study of 47 physicians who were followed for a 30-year period “concluded that long hours, demanding patients, and ready access to narcotics were not problems for physicians who did not have preexisting psychological difficulties evident at college entry.”[iii]
Although the two major risk factors for suicide are mental disorders and substance use disorders, because most individuals with these disorders do not commit suicide, other risk factors are involved, such as “stressful events and predisposing factors (eg, impulsivity).”[iv]
Certainly, experiencing any peer review can be a ‘stressful event,’ but a sham peer review poses an inordinate amount of stress because it is difficult for the provider under review to use definable defenses in the review process.
For example, in a typical morbidity and mortality conference an adverse surgical or clinical outcome is openly discussed, and the provider in question may have considerable answering to do regarding the care rendered in that case.
In that situation, at least the provider knows the object of the review, how to respond, and how to improve his or her understanding to better approach similar situations in the future.
However, in the case of an adverse sham peer review action, the provider would not know what was coming, why it was coming, or how to prepare.
He or she is socked with an adverse action with little to no ability to honestly be heard. This results in enormous levels of stress that may be a trigger to developing psychological squeal, and in the most extreme cases, suicide.
Factors that tend to be protective against suicide include: “effective treatment for mental and physical disorders, social and family support, resilience and coping skills, religious faith, and restricted access to lethal means.”[v]
Effective treatment for physicians has similar barriers as to the general populations as evidenced in a study involving medical students, including: “lack of time (48%), lack of confidentiality (37%), stigma (30%), cost (28%), and fear of documentation on academic record (24%).[vi]
Herein lies a major problem, as the protective factors are not as effectively available for physicians.
Practicing physicians with psychiatric disorders often encounter overt or covert discrimination in medical licensing, hospital privileges, health insurance, and/or malpractice insurance. . . [I]t is not known whether medical boards use the information to covertly discriminate against a physician who was treated or previously impaired but does not report current impairment.[vii]
An expert panel noted that in some states, “licensing boards conduct investigations if physicians seek psychiatric treatment, a process that can lead to sanctioning regardless of whether there is any evidence of impaired functioning.”[viii]
As the admission of any psychiatric problem could end their medical careers, many physicians “suffer in silence.”[ix] According to one surgeon who has suffered with depression, “You just would rather take a risk with your health than your career.
It’s not like you get a second chance with it.”[x] Sadly, it has been estimated that approximately 400 physicians die each year from suicide.[xi] Another sad statistic is the suicide completion rate for physicians is significantly higher than the general population.[xii]
If sham reviews could be entirely eliminated and the ability for practitioners to receive effective treatment without the negative ramifications noted above, it is possible that the many physicians who “suffer silently” might be reduced.
However, the present situation is that sham reviews do occur and the stigma of seeking appropriate psychological and psychiatric care is real.
Likewise, defending against sham peer reviews and spurious board actions through the legal system is fraught with many difficulties at great monetary costs to the victim practitioner. It is important to understand that addressing the problem of sham peer review through an organization with vast experience will afford a level of comfort, reassurance, and hope.
One of the protective factors against suicide comes in the form of “support.” While the article cited above mentioned support in the form of “social and family support,” additional support from an organization that offers genuine solutions to a seemingly impossible situation obviously comes within the realm of support that most would need to aid them in coping with the unnecessary burdens of stress due to sham peer review.
The Center for Peer Review Justice specializes in helping those Physicians and Surgeons who are going thru the Sham of a Peer Review or State Board Abuse. It offers excellent Sham Peer Review defense as well as free excellent advice 24-7.
The Doctors of CPRJ genuinely listen and genuinely help as “No Doctor is left behind”. The hotline that is answered by a real caring doctor is 504-621-1670.
[i] American Medical Association Council on Scientific Affairs, Physician Mortality and Suicide: Results and Implications of the AMA-APA Pilot Study. 50 Conn. Med. , 37-43 (1986).
[ii] Louise B. Andrew, et al. Physician Suicide. Medscape Reference. Updated May 26, 2011.
[iii] Claudia Center, et al. Confronting Depression and Suicide in Physicians. JAMA, Vol. 289, No. 23, 3163 (June 18, 2003).
[vi] Id. At 3164.
[viii] Tracy Hampton, PhD. Experts Address Risk of Physician Suicide. JAMA, Vol. 294, No. 10 (Sept. 14, 2005).
[ix] Lindsey Tanner. Medical Know-How Raises Suicide Risk for Doctors. USA Today. May 8, 2008.
[xi] See note 2.
Editor’s Note: Richard Willner is President and CEO of the Innocence Project of the Center for Peer Review Justice http://www.peerreview.org/ or at info@PeerReview.org 504-621-1670