Female physicians are at higher risk of suicide than female nonphysicians, whereas male physicians have a lower risk of suicide relative to the general male population. These discordant findings were part of a study published today in JAMA Psychiatry.
Hirsh Makhija, M.S., of the University of California, San Diego School of Medicine, and colleagues noted that their analysis of data from the National Violent Death Reporting System (NVDRS) could not pinpoint which factors might explain the discrepancy. “Possible contributors include under recognition for similar work and achievements, inequitable pay and opportunities for promotion, greater domestic responsibilities leading to work-life imbalance, and risk of sexual harassment,” they wrote.
The researchers compiled NVDRS data from 2017 to 2021 on suicide decedents ages 25 and older across 30 states and the District of Columbia (the jurisdictions which had consistent suicide data during the five-year period). Their sample included 448 physician and 97,467 nonphysician suicides. Association of American Medical Colleges workforce reports and U.S. Census Bureau data were used to estimate physician and nonphysician populations in the 31 chosen jurisdictions.
After adjusting for demographic variables, the researchers found that female physicians had a 53% greater risk of suicide compared with nonphysicians, while male physicians had a 16% reduced risk of suicide compared with nonphysicians. Both male and female physicians had a higher incidence of suicide from 2017 to 2019 (before COVID-19) compared with 2020 to 2021.
Compared with the general population, physicians who died by suicide (male and female) were:
- About 61% more likely to leave a suicide note.
- More likely to have experienced a job problem, legal problem, or mental health problem prior to suicide, but less likely to have experienced a family problem or substance use problem.
- More likely to use poison or sharp instruments as the method of suicide, and less likely to use firearms.
In an accompanying editorial, Elena Frank, Ph.D., of the University of Michigan, and colleagues wrote that “a shift in culture around work and family within medicine is critical to improving workplace conditions and mental health for female physicians.” Suggestions they noted included improving access to childcare that aligns with physicians’ work schedules and implementing formal coverage systems for last-minute schedule changes.
“As women now represent the majority of medical school graduates and a growing proportion of the physician workforce, the institution of medicine must recognize the unique combination of stressors that female physicians face and endeavor to make real change moving forward,” Frank and colleagues concluded.
For related information, see the Psychiatric News article “Physician Support Line Looks Beyond the Pandemic.”
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