Top 5 reasons doctors don’t seek mental health care
1. Lack of confidentiality. May have to turn over medical records to others who control your career.
2. State medical boards demand to know. May be excluded from practicing medicine in that state.
3. Hospitals demand to know. May be excluded from hospital staff privileges.
4. Insurance plans demand to know. May be excluded from insurance contracts.
5. Forced into costly, ineffective, and punitive Physician Health Programs. May have to submit to a 12-step program and random urine drug screens—even if never used drugs.
So to prevent being punished and having one’s career derailed, doctors hide their mental health conditions. Most don’t seek the care they would suggest to their own patients. Those who do seek care often pay cash, use fake names, and drive hundreds of miles out of town to hide their treatment—then lie on mental health questions. Witnessing pain, suffering, and death in one’s medical career may lead to mental health issues. So why punish doctors?
Pamela Wible, M.D., is author of Physician Suicide Letters—Answered. Need help? Contact Dr. Wible.
I lie on applications. I seek the care I need and lie. Sucks to have to, but I would not be able to afford treatment under physicians assistance programs. My friend self disclosed and it cost him $40,000 and a limited license and in the end the stress killed him.
Stress caused his early demise or he died by suicide?
I’ve always suspected suicide but the situation made that difficult to tell.
We are masters of disguise—even in our deaths.
After I ended up hospitalized for overdosing (following a major setback which led to losing everything I held dear in my life), the local PHP had me meet a psychiatrist specialized in medico-legal issues to see if I was still fit to practice medicine.
I met him and his assistant, and they agreed I was still fit to practice, at the condition that I provide blood and urine samples to be taken at a forensic laboratory to see if I was an addict of some sort. That lab had cameras in the washrooms, and I definitely was treated and felt like a criminal.
Never in my life, before starting to study medicine, did I envision myself falling this low and having to endure this kind of humiliation.
It’s unfathomable how ailing docs can be treated so harshly.
Not fair – would any other profession – including astronauts, policemen, etc. – get treated this way?
I wish I was brave enough to openly discuss what happened to me but I will share it anonymously. I developed opioids depenedency a few months after a traumatic childbirth followed by many financial, professional and personal challenges while in training. I was treated so poorly by my faculty, the supposed doctors in business of healing, fired from my program for having accessed my records and printed prescriptions then sent by the medical board to PHP for evaluation. He sent me to an expensive rehab for diagnostics which included polygraph testing. They diagnosed me with dependency but I was so traumatized I wanted to go to a different treatment center who also required a polygraph. They said since you left he last place after failing the polygraph you need to take a second one. I didn’t have dual diagnosis nor was my disease advanced. In my practice someone with that level of illness can be managed through intensive outpatient programs. But doctors are treated differently. I had to endure 3 months cohabitation with end stage addicts, sex addicted and pedophiles in a facility that while I was there has to fire several staff for using while on the job or having telations with patients. The financial burden, trauma and shame of this maltreatment has caused tremendous pain. I am healthy now 6 years post my diagnosis despite the atrocious and non evidence based treatment. Yet some of the trauma lingers and I may have developed PTSD. This was cruel and unusual punishment definitly not evidence based. So regardless of disclosing or not, doctored are punished for mental health illnesses. I didn’t disclosclose because I was too sick to know how to get help. I know others who disclosed and were equally punished. Doctors are among victims of this broken system. No one wins. I hope someone smarter than me can come up with a solution.
Dear Anonymous, I am so sorry that you were treated this way, when what you needed was the same care and understanding given to those allowed to be “patients.” This is truly horrific and nonsensical. Thank you for sharing – it helps to realize what is going on so that we can start by pushing for change locally. Sending hugs your way.
Thanks so much for your kind words. Suffering in silence does no good. I plan to do what I can in my capacity to bring light to these issues and am optimistic for a better future for physicians in my situation.
Yes this rings true. I’ve been in practice 20 years, and have been on anti-depressants and anxiolytics for all of that time. I drive 300 miles to seek care and always pay in cash. I am also forced to lie on my state re-licensing every year. There is no way in hell I would ever disclose this to the medical board – they are not our friends.
Such a disgrace that doctors are treated like criminals for needing mental health care. Much of our need (if not all) comes from occupationally-induced emotional distress. Thankfully a documentary is coming out soon to break through this doctor witch hunt. View trailer: http://donoharmfilm.com Do No Harm: Exposing The Hippocratic Hoax
Thank you for your kind words and hard work on our behalf Dr. Wible. I can’t wait to see that film. Doctors suffer in silence.
I’m a little late to reply. Everyone is treated like a criminal if they have mental illnesses especially if suicidal thoughts/actions are a factor. It feels like we aren’t much more advanced than “One Flew Over a Cuckoo’s Nest” (Ken Kesey) when it comes to stigma.
Interestingly, the ethics of counseling (obviously separate from any “ethics” in medicine) directs counselors to seek counseling for themselves and, in fact, insists they do so if there is any indication that their own stress, etc. might interfere with the quality service they provide to their clients.
[It may not always be followed, but at least it is well-established in the ethical guidelines.]
The medical industry, on the other hand, seems to promote an environment in which the coldest, least caring individuals are more likely to succeed and to put patients into situations in which they have to rely on a provider who definitely is not at his/her best.
WE have the wrong incentives in medicine. Self-neglect and abuse is rewarded. It’s insane!
I didn’t disclose a suicide attempt during residency in 2009 on my 2012 application. (There was no such question on application.) The board sent me to a “Patient Boundary” course.
Why did they send you to a “Patient Boundary” course? Based on what? Your application?
My son is in the equivalent of his college’s pre-med track although he is going into a non-physician part of medicine. Second year of college was brutal and he wound up at the university counseling office for depression and anxiety and probably self-medicating a bit too much with alcohol. Everyone asks if he is going to medical school and he never wanted to do that anyway. I would be afraid for his life if he went to medical school. Every year several students kill themselves at his high-prestige college.
I am a nurse and they told us in nursing school that most of us would be on some kind of mood medication by graduation. We were mostly grown adults with families who could not afford or want illegal hard stuff, but many of us were going to the health food store and getting herbal remedies and 5-HTP.
I have worked with suicidal teenagers and hate, hate, hate the fact that school can lead to such despair. Add the loan burden to college and medical students, and it can become unbearable. Medicine and nursing should not be killing its students or turning them into drug-dependent broken shells of themselves.
Just got this email which will remain anonymous to protect the physicians involved:
“I was intrigued by your work and watched your TED talk which was spot-on, you are a wonderful speaker. My [suicidal] friend just asked one of her colleagues to write the prescription for her. She paid cash, avoided the insurance paper trail and swore me to secrecy that she’s even taking an antidepressant. I was dying inside and had tried many self care techniques too. I was the Director of Medical Student Education at a large school of medicine and I saw a lot of depressed and anxious medical students also hiding their pain and swearing me to secrecy. I am considering leaving medicine altogether. I wonder if you have insight or know of doctors who were on the verge of leaving and found the way to happiness either in or outside of the profession by which they have repeatedly felt betrayed. It’s hard to know where to turn when one needs help navigating a potentially permanent decision to leave medicine wondering if ‘leaving’ is a symptom of depression or whether it’s the absolute right thing to be doing.Any insight or resources you could point me to would be wonderful! Thanks for your wonderful work.”
My response: I don’t feel that making decisions based on fear and desperation are often the right decisions long term. It IS important to realize that there is nothing inherently wrong with you. You have experienced Chronic human rights violations and inhumane working environments that injure both doctors & patients. Watch this: https://www.idealmedicalcare.org/blog/doctor-dont-let-your-job-suck-the-life-out-of-you/ You really do deserve to be happy. Be true to the original vision that brought you into med school. What did you write on your personal statement?
They are all related.
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