I was invited on to this TV show to share why burnout and moral injury fail to address the underlying cause of physician distress—human rights violations in medicine. View full TV show here.
Doctors have the highest suicide rate of any profession. I run a doctor suicide hotline and I’ve investigated more than 1,300 doctor suicides. Root cause analysis reveals human rights violations as the culprit. Doctors who don’t succumb to suicide are victims too. Coping with abuse is not a solution. Ending abuse is. Injured morals offers no solution. Burnout is a smokescreen that distracts from human rights violations that are killing doctors—and patients. Let’s focus on facts and real solutions through institutional triage, definitive diagnoses, and targeted treatment.
1) Institutional Triage
As physicians, we address life-threatening emergencies first to save our patients’ lives. Stop the arterial bleed, the treat the acne. Institutional triage means prioritizing doctor suicide prevention by eradicating human rights violations in medicine that lead to suicides. When doctors are groomed to accept a culture of abuse, we perpetuate it on ourselves, our peers, and our patients. Eliminating hazardous working conditions will create a culture of wellness for us all.
2) Definitive Diagnoses
Students enter the medicine with their mental health on par with or better than their peers. We are then wounded by hazardous working conditions Illegal in all other industries that value safety. As a result, doctors may develop lifelong health sequelae such as new onset constipation, insomnia, anxiety, depression, PTSD, and suicidal ideation. Precise language is paramount. Burnout and moral injury distract and confuse victims while deflecting attention from abuse perpetrated by the medical system that labels victims as defective. By holding the system accountable for violating the specific rights of doctors (and patients), we can proceed with a targeted treatment plan.
3) Targeted Treatment
Unlike moral injury and burnout, human rights violations have proven medicolegal solutions that protect victims. Sleep deprivation is a known torture technique, yet new doctors are forced to work 28-hour shifts. The solution—a bed and a pillow. Food and water deprivation are common among sleep-deprived doctors who have no set breaks on marathon shifts. The solution—regular meals. Hazing and harassment is rampant in our hospitals. The solution—legal prosecution as is standard at other institutions that value human life. Doctors are collapsing from overwork, found dead in hospitals. The solution—comply with the same labor laws that protect pilots who fly 8-hour shifts (not 28-hours). All human rights violations in medicine are categorized here with simple, effective treatments.
Read fascinating history of burnout, moral injury, and human rights violations in medicine here.
As I see it hospitals need doctors more than doctors need hospital. Hospitals cannot function without doctors and doctors can function without hospitals. Need I repeat this? How many times? Doctors should trade short (apparent only) gains for long term of independence and prosperity. Why not unionize and fight together the stressful forces meddling with physicians’ normal functioning. No life needs to be sacrificed. Thing worth fighting for must not include suicide.
UNITING the victims is key. Divide, conquer, and secrecy keeps us all in chains. Time for the truth. Not watered down BS.
Thank you for all you do Pamela! You’ve given us all a voice!
I lost my father the late Ronald Chance Brown, MD to Suicide in 2002
Was this overwork related? Or fear of seeking mental health help? Or both? Are you still in DC Yasamin? The Do No Harm film will be screened there April 29 and would love to see you again. Thanks for being so courageous in sharing your dad’s life with us.
I’m back in New Jersey
Fear of seeking mental health help.
Hi Pam. What time on the 29th?
Washington DC Premiere. APRIL 29th! ONE NIGHT ONLY! DO NO HARM at the Miracle Theater. 7 pm.
I lost my father the late Ronald Chance Brown, MD to Suicide in 2002.
Human rights violations is what almost got me. As a matter of fact suicide was suggested to me by the big boss at my University! I joined Human Rights Watch and have raised concerns but felt no one gave a damn about doctors, until I recently read about a suicide in Seattle in the ASH magazine, and I looked for the address of the physician wife left behind to share her grief. Instead I came upon Dr Wible’s work and spent many hours reading. Nothing of this sort existed, leave alone no internet when I was going though my horror chamber, with no help from the majority of faculty “friends” as they all tried to protect their own ass, even when they clearly knew what was being done was wrong. This is the “evil power” of an autocrat, as Departmental Chairmen, Deans and Presidents of Universities have become. This is a mini version of the broader life story, where evil prevails in a whole country. Fear rules even the mighty>
Glad you survived the trauma. Please reach out if you need help. Happy to speak to you or anyone who is struggling.
This is so true and I’ve experienced this first hand as a doctor. Doctors need to remember the Hippocratic Oath that they took in Medical School to “Do No Harm.” There needs to be laws in all 50 states to prevent abuse and bullying in workplaces for not just doctors, but every workplace. Burnouts, mental health issues and nervous breakdowns are real and a lot of it is situational caused by the toxic and abusive environments physicians are in. Physicians need to work together cohesively and realize that patient care is number one, not to compete with other doctors.