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The occupation with the highest suicide rate

Doctors committing suicide at high rates

For many years now, physicians have had the highest suicide rate compared to people in any other line of work. Is this surprising? Does this happen because doctors are continually exposed to other people's problems? Because of something about a physician's lifestyle? Looking at these suicides more closely provides some answers.

To begin with, their methods of suicide follow a different pattern than those of the average person: physicians are far more likely to commit suicide by overdosing on medication (as opposed to, say, using a gun). So part of the reason for doctors' high suicide rate is their easy access to powerful, very lethal drugs. Furthermore, doctors know better than anyone which types of medication to take and what dosages to take them in to get the job done. Hence, physicians are more successful in their suicide attempts than other people.

A more unexpected finding concerning physician suicides is that there's no difference in the rates between male and female doctors. This is surprising because in the general population, men commit suicide at much higher rates than women. For example, in the United States, men commit suicide at nearly 4 times the rate of women, but women constitute about half of all physician suicides.

Several explanations have been proposed for the high rate among female doctors. First, while being a physician can be stressful for anyone, it may conflict with the life goals of women more than men. Given that women, on average, tend to place more value on spending time with family, friends, and engaging in other social activities, the amount of hours physicians work takes away from all these things. For example, the long hours make it more difficult to maintain stable relationships, to have children, and to be a parent. Women may be more negatively affected by the social isolation than men.

Another stressor for women is that, like in many male-dominated fields, female physicians are probably exposed to greater levels of sexual harassment than male physicians. This may not be a problem for doctors who have their own practice, but could be for those who work at large hospitals.

Unfortunately, male and female doctors who are suicidal encounter several obstacles to getting effective treatment for these problems. One issue is the stigma associated with these symptoms. Suicide and depression are already stigmatized within the general population, but this stigma is even stronger if you're a doctor, a person who is expected to be physically and mentally healthy. Thus, doctors are probably reluctant to seek treatment for suicidal tendencies, because doing so would be bad for their reputation and bad for business, should word get around. (Ask yourself, would you continue to get treated by a doctor who you knew to be suicidal?)

For doctors who do seek help, the quality of treatment they get is often not as good as it should be. Therapists who treat physicians may assume that their patients know how to take care of themselves, being that they're doctors, so the therapy tends to be more hands-off and less helpful. Suicidal physicians, in response to these difficulties in getting help, may thus turn to self-medicating with alcohol or prescription drugs, increasing their risks of drug addiction and a further downward spiral.

In sum, there are several reasons for the higher suicide rates of physicians: greater stress, social isolation, access to powerful drugs, barriers to getting treatment -- and especially for women -- greater role conflict and sexual harassment.

Having said all this, here's one more fact: physicians live longer and are generally healthier than people in most other professions. Even if you include physicians who commit suicide or suffer from depression, life expectancy and well-being are still very high amongst doctors. But how can this be if they also have such high suicide rates?

Keep in mind that only about 1-2% of the population dies by suicide, and perhaps (this is just an estimate) 2-4% of doctors. But doctors who don't fall into this minority tend to have very healthy habits: they exercise more, eat better, smoke less, earn more money, and receive better medical care than the average person. Thus, although there is definitely an elevated suicide risk for physicians, the vast majority of physicians are not suicidal and actually do things that lead to healthier and longer lives.

Their higher suicide levels make sense when you consider that, as in other professions that demand long hours and involve a great deal of responsibility, there are more potential rewards but a greater risk of burnout.

(This post was co-authored by Josh Foster.)

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