Depressed doctor: “I’m angry and frustrated and lost.” →


This is an email subject line from a doctor. Letter published with permission.

Hello Pamela

I have become so disillusioned with medicine. I do not know who to talk to any more or what to do with my life. 

I work one week a month in the ICU. I spend the other three weeks of the month in an outpatient clinic. This is a nightmare. The Electronic Health Record they have in place makes me so slow and inefficient I want to scream when I come to work everyday. They want me to see new complex pulmonary consult patients on the hour every hour. Frequently, just to review their imaging, labs and special studies takes 15 minutes before I even walk in the door to meet the patient. Today I saw 8 new patients in eight hours. I need at least 60 minutes per new patient and a buffer of at least 15 minutes between patients to complete my EHR charting. I am so frustrated and just want to walk away but where does one go. It is the same everywhere now in the USA. EHR’s and conveyer belt, output-driven medicine. I feel trapped and betrayed. I did not go to medical school to sit on my butt for four to six hours a day doing data entry in a computer.

I feel so deflated and trapped. Have to work to pay for the kid’s college and have health insurance for them and yet there is no joy in the work anymore. I find the hospital and the ICU more stimulating but the pace and the hours are brutal. Therefore, I decided to give this more lifestyle friendly version a try. My hours are meant to be 8am to 5pm but I arrive at 7am and leave at 7pm to try and keep up with the EHR communication method and clinical charting. I get every Monday off but it does not make up for the frustration of the four days I do spend in the office.

I know I am being extremely negative and I can not seem to see the forest from the trees. I have lost my joy and my soul is sad. I never used to feel this way about medicine. 

Any suggestions Wise One ??

Wise One to Sad Soul:

1) You are not alone! You’re having a normal reaction to an inhumane health care system—a sad soul.

2) People don’t complain about things they can’t fix (like gravity). You complain about EHRs and assembly-line medicine precisely because you know there’s a better way.

3) The real problem is—us. Yes. Doctors are to blame. We’ve relinquished control of our profession to those with divergent ethics. We’ve allowed ourselves to be abused en masse. You can’t be a victim and a healer. Choose one.

4) YOU can free yourself from the paper chains. 

5) A dysfunctional medical system can only exist on the backs of disempowered physicians—the precursor of which is abused medical students. 

6) Medicine is an apprenticeship profession. Liberate yourself and you liberate the next generation of doctors. 

7) If you do not know who to talk to any more or what to do with your life, start hanging with happy docs. Can’t find happy doctors? Click here to meet some.

~ Pamela

P.S. Anyone else with advice for sad doctor? Please leave your comments below.

Pamela Wible, M.D., is a pioneer in the Ideal Medical Care Movement. She has helped hundreds of physicians reclaim their happiness and their careers at her physician teleseminars & retreats. Dr. Wible has been awarded the 2015 Women Leader in Medicine.

Posted in Business Strategy, Physician Abuse & Bullying, Physician Burnout Tagged with: , , , , ,


Meet the happiest doctor in Idaho! →

I just got to hang out with a graduate of my physician retreat, Ann Cordum, M.D., who now has a successful ideal medical clinic is Boise, Idaho. Here’s what Ann has to say about her new life:

PW: So this is your office!

AC: This is my office in Boise, Idaho! Ya!

PW: So tell me what it is like here working for yourself.

AC: It’s night and day different from before. It’s awesome! I am walking distance from my house or we can ride our bikes. We are open the hours that are convenient for us, by appointment. So life is really good. I have a partner, Kristen Fiorentino, M.D., and we exercise in the morning and then come to work. We’re happy! It’s totally different than routine clinic medicine. We actually get a lunch break. We go to business lunches with colleagues. We are ready for our patients when they walk in.


We often greet them in the parking lot and walk them in, especially the older patients, serve them tea and coffee. We do all that ourselves, Take them back. Do their vital signs, see them, take care of them, check them out ourselves, and I think they’re pretty happy, and then they refer other people if they have a good experience, which most of them have.

So it’s ramping up. We’re only in month 6. So we still have a ways to go, but I am actually pretty confident that it’s going to work. It just feels good. It has good energy. And I’m rested. I feel happy. 

PW: So what was it like before? Had you always been an employee?

AC: I had always been an employee or contract worker. Ya know, up and down before. Lots of fatigue before. Times of cynicism and feeling beat down. I guess one of the biggest things that’s different is I don’t have that rushed feeling anymore. Ya know, ya gotta get them in, ya gotta get them out, you’re running behind, stressed feeling just doesn’t happen anymore and that’s probably the biggest improvement in my life because it makes me feel joyful about what I’m doing and I think the patients pick up on that and they feel more relaxed. You can have all the technology in the world, but if you don’t have a doctor that has time to relax and listen and spend time with you then I don’t think you’re going to get a good quality visit.

PW: What do the patients think? Are you noticing different interactions with patients? The way they are receiving you or responding to you?

AC: Totally. Totally. Lots of comments like, “Wow! This is so different. Feels like I’m in a house. Doesn’t feel like I’m in a clinic.” When they call us with a  question, we either pick up the phone ourselves or we call them back personally and they are kind of blown away because they don’t get that [elsewhere]. So really good feedback from patients.


PW: What about in your personal life? Has this had any side benefits being your own boss? 

AC: Unbelievable side benefits. I actually love working for myself. I love the business aspect of it. Total sense of control, sense of autonomy, sense of peace. Collaboration with my colleague who is phenomenal and some other independent colleagues in town so it just feels like I should have done this 20 years ago, ya know, and that’s a good feeling. 

I hope more doctors do this because I think this is the way it is meant to be. It’s much more natural. It’s why we all went to medical school I think to be able to really listen to patients and honestly if you just listen, you don’t have to have anything fancy. Just listen and you will get them figured out for the most part . . .

PW: So has your husband or kids noticed differences in you? Your family?

AC: Family and friends just notice that I’m happier and healthier and I think that’s a big bonus too because my health, my skin, I don’t feel moody anymore. I don’t cry anymore. I don’t cry anymore. I used to cry all the time just tired and fatigued and irritable. I feel at peace and rested. Sleep is huge. Sleep is huge. I can get the sleep that I need. And get the exercise that I need. And good nutrition. And we can share that with other people. 

PW: Talk about your sleep before and after.

AC: Oh my gosh! Sleep before was fragmented a lot of the time and never consistent, and I was on sleeping pills for 7 years. It just wasn’t healthy and now no problem sleeping and I allow myself 7.5 to 9 hours per night, which is what I finally figured out is what I need to be healthy and productive and with that I feel like I have more energy and can give more to my patient. Another side benefit is I love medicine and I have noticed a complete turnaround in the last 10 years. Ten years ago I thought I’d never practice medicine again and I love it now and I want to do it for the next 15 or 20 years, but I want to do it in a way that is congruent with my values and what I think my patients want.

PW: And just to clarify, are you on sleeping pills now?

AC: No. Got off of them about 6 to 8 months ago. Completely.

PW: Wow!

AC: Yeah.

PW: So other health benefits? You say you feel peaceful. What was it like before and after?

AC: There was just a lot of anxiety and angst and bitterness before and now I feel at peace and calm and I see a lot more joy in day-to-day interactions. I’m just happier and then I think other people sense that and then they’re happy and calmer. before I used to feel more anxious and distraught and I think that energy bounces off and the patients pick up on that and then they get anxious.

PW: So why do you think more doctors aren’t doing this? You’ve had a big turnaround. You’ve gone from not needing medications to being able to be a real doctor and be present for your family and your kids. What do you think is holding doctors back? 

AC: I think fear is holding doctors back. And status quo is holding doctors back. I think new docs and older docs alike have almost accepted that, “Oh my gosh we’ve got to be in an employed model. That’s just the way things are going” and, sadly, that has gotten worse and worse and worse. More meetings about production and bonuses and incentives and how many patients can you get through and then we’re discontent on the side of the doctors.

I would encourage people to step out, take that leap of faith if you’re ready, when you’re ready, and have peace and confidence that it will work out and—it will probably save your life—and save the lives of your patients. I hope more people do it.

PW: What would you say is the one thing that helped you get going or made this feel like it was possible for you?

AC: I think part of it is a timing thing and a personal growth. You have to go through a process of realizing that there’s an issue and it’s not good for your health. Maybe doing some introspection or counseling or writing or whatever it is for you to decide hey, I need to take charge of the direction of my life because this is not good for me or my patients. and then connecting with other people like you who are happy and have a vision and give you the confidence that you can change your life and only you can do it. Nobody else is going to do it for you. 

PW: Did it help to be around a lot of other doctors doing this at the same time?

AC: It did. It definitely did. And the other thing I did is just reached out into other sectors of our society. I watched a ton of TED talks when I was going through this transition and got myself motivated and realized that you need to be creative and when you’re sleep deprived and angry and in a system that doesn’t allow you to breathe or move or think out of the box you’re not going to be creative and if you allow yourself to become healthy again and at peace, then creativity comes out and anything is possible with creativity.


PW: So to wrap up what your vision is from here into the future, like if you could have anything and this office could go the perfect direction, what would your life look like for you maybe 6 months, 2 years from now. What would this be like? 

AC: So my vision is to have this place, this space, be a healing, calm, peaceful space, and I think it already is, but I hope it just grows a little bit more. I don’t want it to be crazy and chaotic, but I want it to be a place where people come and feel safe and come hang out and get their health care. They can get their massage upstairs and get their acupuncture from the gal upstairs or Kristen and get their traditional care with a focus on prevention and wellness. And do more of my walking visits which I’m starting to do which are fantastic! 


PW: Tell us about that.

AC: Yes, so once I’ve established with a patient, if I feel like they are ready to take on a healthier lifestyle then instead of sitting in the clinic for 30 minutes or 40 minutes or 20 minutes, I have then bring their walking shoes or running shoes and I keep mine here, and we go 3 blocks to the trails and hit the trails and do our visit out there. It’s wonderful! They love it. I think it benefits them a lot more than just sitting in an office.

PW: Sounds awesome. So you’ll do more of those. 

AC: I want to do more of those. I just want to have that balance. I want to ride my bike more to the clinic instead of driving and slow down the pace a little bit so that I have time to do that and be able to model health to our patients.

PW: Beautiful! Well congratulations!

Click here to be our next physician success story!


Pamela Wible, M.D., is a pioneer in the Ideal Medical Care Movement. She has helped hundreds of physicians open ideal clinics through her physician teleseminars & retreats and has been voted the 2015 Women Leader in Medicine for her contributions to medicine. Photos and video by GeVe.

Posted in Business Strategy, Ideal Medical Care, Patient Relationships Tagged with: , , , , , ,


Do Physician Health Programs Increase Physician Suicides? →

How do we care for the people who care for us? As doctors, we’re immersed in pain and suffering—as a career. We cry when our patients die. We feel grief anxiety, depression—even suicidal—all occupational hazards of our profession.

A recent Medscape article on Physician Health Programs suggests that the people who are here to help us may actually be doing more harm than good. And they may even be increasing physician suicides.

Both doctors I dated during medical school died by suicide. Eight physicians killed themselves in my town alone. I’ve become a specialist in physician suicide. My cell phone has turned into a physician suicide hotline. And I have a stack of physician suicide notes that I keep at home. Here’s one of them:


Dear Some, My family, I love you. To others who have been good friends, I love you too. This is just the end of the line for my particular train. Earth wasn’t a great place for me. We’ll see what else is out there. Will miss you all. I’m sorry for what it’s worth. Love Greg.”

On June 22, 2012. Dr. Greg Miday killed himself—12 hours after being told not to follow his psychiatrist’s safety plan by the Physician Health Program that controlled his medical license.  Sober for years, he relapsed just before his death. A brilliant clinician, never impaired at work, Greg drank to cope with anxiety.

Afterwards, 2 interns jumped to their deaths from New York hospitals (the same week within 3 days of each other, I believe). Greg’s mother, a psychiatrist, sent this letter to the editor of The New York Times:  

An unacknowledged predicament for physicians who identify their struggle with substance abuse and/or depression is that they are often placed under the supervision of their State Medical Board’s Physicians Health Program. My son, Greg, was being monitored by such a program. He took his own life at age 29, one week before he was to enter an esteemed oncology fellowship. His final phone calls were to the Physicians Health Program notifying them of his use of alcohol while on vacation, a disclosure he had previously described as a ‘career killer.’ These programs, which often offer no psychiatric oversight, serve as both treating and policing agencies, a serious conflict of interest. Threatened loss of licensure deters vulnerable physicians from seeking help and may even trigger a suicidal crisis. Medical Boards have the duty to safeguard the public, but the assumption that mental illness equals medical incompetence is an archaic notion. Medical Boards must stop participating in the stigmatization of mental illness. We cannot afford to lose another physician to shame.

Greg Miday, M.D., and his mother, Karen Miday, M.D.

Greg Miday, M.D., and his mother, Karen Miday, M.D.

Our medical schools, hospitals, and clinics actually cause or exacerbate mental health conditions in physicians, and then they blame us and force us to release our confidential medical records. And in the end, they take our license. . .

Maybe that’s why my friend, an excellent psychiatrist, drives 200 miles out of town, pays cash, and uses a fake name to get mental health care.

And another physician friend who was deemed “too slow” [seeing patients] by her residency director, was sent to a psychiatrist who diagnosed her with mild OCD (don’t we all have mild OCD if we are thorough physicians?). Well she was actually then sent to the medical board who referred her to a Physician Health Program that mandated an AA-style substance abuse program—which makes no sense at all since she does not do substances. She doesn’t drink or smoke.

So who the hell is protecting us from being misdiagnosed, mistreated, and abused?

There are many who prey upon physicians. So who cares for doctors?

And how in the world can we give patients the care we’ve never received?

Pamela Wible, M.D., is a pioneer in the Ideal Medical Care Movement. When not treating patients, she dedicates her time to medical student and physician suicide prevention. Dr. Wible is the recipient of the 2015 Women Leader in Medicine Award. Video by GeVe. Photos courtesy of Miday family.

Posted in Physician Abuse & Bullying, Physician Suicide Tagged with: ,


Is medical school an anti-mentorship program? →

Medical School Mentors

“Medical school is a great anti-mentorship program. You meet a lot of doctors you’d never want to become.” That’s what med students keep telling me.

Mentorless medical students?

I had no idea. Until students started shadowing me. Many also volunteer at hospice and free clinics. I asked one gal, “You must meet a lot of wonderful doctors there. Right?”

“Not really,” she said, “Doctors are on automatic pilot as they try to navigate through a staggeringly high volume of patients. It’s so disheartening. And what’s worse, everyone I speak with says, ‘That’s just the way it is. It is too expensive, difficult, and risky to go into private practice anymore. You can’t be a solo doctor in this day and age.’ After meeting you, I know there is another way.”

“You haven’t worked with solo docs?”

“No. I haven’t met anyone else who has escaped our broken system to practice medicine as it should be practiced—on a personal and human level. I was worried that I was having childish delusions of grandeur by thinking I could actually practice medicine in such a way in today’s climate. I worried I’d go through med school and residency only to find that in the end there was no refuge from our inhumane health care system. I’m here because there are no tools or mentors to help me be the doctor I’d like to be.”

Here’s a tool for docs and med students (because it’s never too early to get a game plan for your ideal future): FREE No B.S. Guide To Launching Your Ideal Clinic

Medicine is an apprenticeship profession. We learn by watching doctors around us. Sadly, many aren’t happy. Most docs I meet have been victimized for years. Many think they’ve got “burnout,” but physician burnout is really physician abuse. Hint: No amount of deep breathing, meditation, yoga, resilience training will make your crappy assembly-line job joyful. Cut your losses, get a real mentor, and move on.

So how do you find a mentor?

Look for doctors who are doing what you want to be doing and hang out with them—now! If you want to be a happy doctor treating real patients, your mentor should be a happy doctor who is treating real patients. If you take business advice from cynical doctors who are depressed—you’ll be getting career advice from depressed cynics, if that’s what you want. Warning: if they’re not happy successful doctors seeing real live patients, how can they help you become a happy REAL doctor?

Need a mentor? Contact me. I can hook you up.

How do you know if you’ve got the right mentor?

The right mentors are practicing medicine the way you want to practice medicine. Beware: there are many physician gurus, authors, speakers and burnout specialists out there who are no longer practicing medicine—because they “burned out.” Would you choose a divorced marriage therapist who has never had a successful marriage? Avoid advice from people who have never done what you plan to do. 

Want a bunch of amazing mentors for life?  Join our teleseminar!

Pamela Wible, M.D., founded the Ideal Medical Care Movement. She has been awarded the 2015 Women Leader in Medicine by the American Medical Student Association for her inspiring contributions to medicine. Contact Dr. Wible. She loves to hear from med students and docs.

Posted in Business Strategy, Ideal Medical Care, Medical School, Physician Burnout, Physician Retreat Tagged with: , , , , , , , , ,


Physician Burnout Is Physician Abuse →

Physician Burnout

Physician burnout is the latest trend among doctors. There are books, workshops, even special breathing exercises for physician burnout. Suddenly every other doctor I meet has burnout. And half of all med students have burnout before they graduate! WTF.

We enter medicine as inspired, intelligent, compassionate humanitarians. Soon we’re cynical and exhausted. How did all these amazing people get so screwed up so fast? ATTENTION medical students and doctors: It’s NOT your fault. 

Burnout is physical and mental collapse caused by overwork.

So why are we blaming the victims? 

The fact is medical students and physicians are collapsing because they are suffering from acute on chronic abuse. At some medical schools, 100% of students report abuse. 

And it doesn’t get better. Physicians are overworked and overwhelmed with bureaucratic B.S. during most of their careers. They are trapped in assembly-line big-box clinics where they are treated like factory workers and berated for not seeing enough patients per day. Some experience human rights abuses in our nation’s hospitals. This doctor worked 7 days in a row with almost no sleep! 

Think this is unusual? It’s not.

Physicians all over the nation are suffering mistreatment.

Folks, this is NOT health care. 

The health care cycle of abuse starts on day one of medical school. Abused medical students become abused doctors who may one day end up abusing patients. Wait! We wanted to help people, not harm them. 

ATTENTION Medical Students and Doctors:

If any of this sounds familiar,  your diagnosis isn’t burnout, it’s abuse. That’s right. If you’ve suffered mistreatment or harm at work or school, YOU are a victim of abuse. 

How do you know if you’re being mistreated? 1) You don’t get lunch or bathroom breaks. 2) You are forced to work multiple-day shifts. 3) You are not allowed to sleep. 4) You are forced to see unsafe numbers of patients. 5) You can never seem to find “work-life balance.” 6) You are threatened verbally, financially—even physically. 7) You are bullied. 8) And if you ask for help, you’re called a slacker or worse. 

If any of this sounds familiar, it’s NOT YOUR FAULT.


So what should you do?  Sign up for a resiliency training? Meditate? Take deep breaths?  Your goal should NOT be to cope with abuse. Your goal should be to STOP it.

Physician burnout is a diagnosis that blames the victim, not the perpetrator. In fact, the term physician burnout IS physician abuse. It implies that you are to blame, not the system and perpetrators of the mistreatment.

To prevent burnout, health care institutions may offer resiliency classes to train doctors to prioritize self-care and manage their emotions. WARNING: You can not meditate your way out of abuse. You can not take enough deep breaths in a year to end your abuse.

WHAT YOU MUST DO: If you are being abused, YOU MUST LEAVE YOUR ABUSER. I know it’s scary. But you are not alone. Need help with your escape route? Call me! I escaped. You can too.

End The Abuse! Stop Being Victimized. Download Instructions: Your FREE No B.S. Guide To Launching Your Ideal Clinic & Telling Your Employer To Take A Hike.

Want an ideal clinic? Join the Physician Teleseminar & Retreat.

YOU were born to be a healer, not a victim.

Pamela Wible, M.D., founded the Ideal Medical Care Movement. When not treating patients, she devotes her life to helping her colleagues find happiness and joy in their own ideal clinics. Ya know, so patients can finally get the care they deserve! Image by Pamela Wible. Videos by GeVe.

Posted in Ideal Medical Care, Medical School, Physician Abuse & Bullying, Physician Burnout, Physician Retreat Tagged with: , , , , , , , , ,


Physician Suicide: NPR Interviews TEDMED speaker, Dr. Wible →


This week TEDMED announced, Pamela Wible, M.D., Physicians’ Guardian Angel, as a speaker at this year’s event in Palm Springs, California. She will speak on physician suicide.

Today, Dr. Pamela Wible was interviewed on NPR station, KPLU in Seattle on physician suicide. Listen in here. Full transcript of her interview below:

GS: You’re listening to Sound Effect from KPLU. I’m Gabriel Spitzer and this is the kind of letter that Pamela Wible gets.

PW: “Dear Pamela, An anatomy professor did in fact inform us that we would commit suicide at a higher than average rate and informed us from the lectern how to accomplish it successfully. Considered following the instructions on 3 occasions—most recently when a 4 year old I had in the hospital died.”

GS: Okay, so this is a letter from a fellow doctor—a doctor who’s grappling with thoughts of suicide. Physicians are in the business of saving lives, but they have one of the highest suicide rates of any profession. An estimated 400 doctors a year take their own lives. Pamela Wible is a physician in Eugene, Oregon, and she’s devoted a big part of her career to helping doctors cope with thoughts of suicide. As you can probably tell this is a tough subject that’s not going to be appropriate for all listeners. And this interview in particular gets pretty heavy. It’s about 10 minutes long. When I talked with Wible, she told me about the moment she realized how big a problem physician suicide is.

PW: I was sitting at the memorial service for the third physician that we lost in our small town in just over a year. And I sat there in the second row of his memorial service, and I just started counting the suspicious deaths of doctors and I realized I had quite a number of them, including both men that I dated in medical school.

GS: What is it about the profession that makes suicide a particular risk?

PW: Well, we have kind of an antiquated medical education model that’s based on the, I would say, tough-it-up, suck-it-up, don’t cry, feelings aren’t welcomed here, do your job, do it efficiently—almost a militaristic model of medical training and that’s very dehumanizing to the students. And a lot of medical students actually graduate with PTSD. So it’s a traumatic educational process and I think that’s the root cause of much of this.

GS: Oh, that’s interesting. So it’s really about the paradigm that’s kind of drummed into them in med school and in training?

PW: Right. Because when you compare the mental health of medical students at the beginning of training, they come in with their mental health on par with or greater than their peers. And something happens during medical training that disables them essentially. 

GS: Can you think of an example from your own training that demonstrates that way in which you feel it dehumanized.

PW: Well, besides the obvious sleep deprivation and the massive amount of material that we’re supposed to learn, in my particular program we had to do dog labs which meant that every 4 students were assigned to one dog that used to be a pet and we were supposed to kill it to learn very simple physiologic techniques that could have been learned in other ways. This is absolutely a dehumanizing process that I protested and was able to get exempted from. In fact, they didn’t even refer to this as an experiment. The physiology professor referred to this as an experience—in which there was no alternative. And they actually made fun of me. The dean told me I had, “Bambi Syndrome.”

GS: Do doctors get care when they need it? I mean mental health care. Considering that doctors are dispensing care and counseling patients all the time, you’d think that they would know exactly what they need and how to get it.

PW: No. Absolutely not. In fact, we are not “allowed” to seek mental health care for fear of losing our license. On our licensing applications there is a question that is actually in the same area as the questions about criminality, and DUIs, and felonies. In there, in that section, there’s a question about if you have ever sought mental health care. And if you check yes, you will have to probably meet with the Board in person to describe why you did that. I’ve known a physician, in my town actually in Oregon, who was delayed in getting her license by 6 months because she checked that box being completely honest and why she checked it is she sought counseling during a divorce. Ya know, everyone is depressed during a divorce. She had to pull her records which that counselor had since retired. They made her go get evaluated by another counselor for her mental health before they would allow her an Oregon medical license. 

GB: So that has a chilling effect, huh? 

PW: It has a chilling effect because, ya know, honestly I have a friend who is a psychiatrist—she’s an excellent psychiatrist—and she actually drives 200 miles out of town, uses a fake name, and pays cash to get mental health care. How would you like that? In order to be off-the-grid and not be tracked by the medical boards. 

GS: Oh, wow. 

PW: The other thing I hear from medical students and physicians all they time is that they actually are jealous of their dying patients in hospice and they wish that they could jump in bed and be the one with cancer so they could get some down time and some rest. 

GS: That is so shocking and it’s so different than they lay public perception of doctors. That doctors are either heroic, mission-driven, ya know, saintly people or, ya know, that doctors are businesspeople or whatever. What you’re describing is really alien to folks who aren’t close to the profession, I think.

PW: Physicians are not allowed to really be vulnerable—and to share what’s really going on. So they put on the white starched coat, and smile, and have their bow tie—and nobody really knows what’s going on under that coat. 

GS: So you have chosen to tackle this in some very particular ways including these retreats that you bring health care professionals on. Can you talk about those? What happens on them?

PW: These whole things began as just business strategy retreats to try to help physicians who want to open independent practices. But interestingly, on that day that I went to this gentleman’s memorial, that evening I had a retreat. And I showed up and I had fallen into this physician suicide topic in such a bizarre way and I just thought I would check in with the people attending the retreat and I opened the retreat by asking, “How many of you have lost a colleague to suicide?” And everyone’s hand was raised. And then I asked, “Well, how many of you have considered suicide? And every single hand remained up, including mine, except for the one female nurse practitioner. 

GS: Did that change the nature of those retreats then?

PW: Well, I started to realize that a lot of people came to the retreats for emotional healing and that was really was in the way of them starting their independent practices. Emotional healing is required before we can really be the doctors that we dreamed of being.

GS: So when you’re together in those settings, how to set out about trying to help people?

PW: Well, I think a lot of it is just having these healers off-the-grid. There’s no cell phone, no Internet service. I’ve got 40 to 50 doctors in a lodge room on 150 acres in the mountains of Oregon. And they literally are just finally willing to share the truth about their experiences in medicine and so there’s a lot of crying, there’s a lot of hugging and a lot of validation. And I think people for the first time feel that they’re not defective. The system is defective and they’ve been abused. The other thing that’s so beautiful is actually because we were wounded collectively, I do feel like the treatment for physicians is collective. Meaning pulling off the “weak ones” on the periphery and throwing them into a psychiatrist’s office isn’t the best way to deal with our collective wounds. So I think when you can get healers together they naturally heal one another. It’s a really beautiful thing to witness. 

GS: So you said that when you asked that question about how many people in the room had considered suicide and everyone’s hand went up including yours. What do you want to say about your own struggles with suicidal thoughts?

PW: I want to say that I came into medicine like most people as an idealistic humanitarian that just wanted to help people and the reason why I developed these suicidal thoughts . . . I mean I did get into some major depression in my first year of medical school completely related to those dog labs and watching the dehumanization process of my classmates which was just brutal. But then once I got into [practicing] medicine, ya know you’re always thinking it’s going to be better on the other side, wait until you graduate. But I was much like everyone else in the country funneled into these assembly-line medical jobs which are not the definition of healing, Seven-minute office visits where you’re just feeling that you smacked Band-Aides all over people is not at all health care and so I got depressed and suicidal because I felt that I could not believe I invested 24 years of education, all this time and energy, into a profession that I love, and when you are stuck in a system that does not allow you to be a healer, it’s a absolute assault on your soul. And so that’s where I was—the dark night of the soul.

GS: What helped you emerge from that?

PW: I had an epiphany that if the patients are miserable and I’m miserable and I’m looking at my colleagues and they look miserable, even though, ya know, they’re faking it sometimes and putting on these smiles. I just decided, you know what, I’m going to turn this over to my community. I’m going to lead a town hall meeting and I’m going to ask the end-user—the patient—to design their ideal practice and to write my job description and I’m going to work for them. And I’ve been so happy doing this now for 10 years in what I call, an Ideal Medical Clinic designed by the patient.

GS: Do you see any signs that this is getting any better? Is the training . . .?

PW: Yes! Definitely. Because we’re talking about it. They fear of speaking about the trauma that we experience as medical students and physicians is dissipating so that we’re more able to have this open and with the Internet kind of conversation. And the fact that we are no longer hiding all these bodies and all the data is the big first step. If you think about it, to use a medical analogy, there’s no way you’re going to solve someone’s medical problem until you have the correct diagnosis. Where would we be if we were afraid to say Ebola out loud or HIV? We would be nowhere. And so we’ve got to be able to say physician suicide out loud. And the next question after people recognize that this is a crisis is “why?” And when people start asking why, then we start solving it.

GS: Well, Dr. Pamela Wible is a family physician in Eugene, Oregon and she joined us from the studios of KLCC. She works with doctors in the Northwest and all over the place on suicide prevention. Thank you so much for being on Sound Effect. 

PW: Yeah, thank you! 

Listen to FULL interview (KPLU 7/18/15) & Dr. Wible’s other radio interviews here.

Pamela Wible, M.D., offers teleseminars and retreats to help her colleagues heal. Hear her speak live this year at TEDMED in Palm Springs, California. View the 2015 stage program and join us!

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