Specialties with highest suicide rates

[anbuitachi]

Recently saw this from Pamela Wible, whos been tracking suicide rates for the past some years. She had 10 names in 2012, now 1363. Anesthesiology as expected is #1 by far. Thought this would be interesting to see for some of you

---

Members don't see this ad.

 

[mehc012]

Why is Anesthesia expected to be #1 by far?

 

[anbuitachi]

Why is Anesthesia expected to be #1 by far?

Oh i mean based on prior data and just general knowledge i guess. Its well known anesthesiologists have highest suicide rates even before she collected these

 

[VA Hopeful Dr]

I have to wonder if some of those anesthesia ones are accidental ODs since if memory serves y'all do have the highest drug abuse rate (for the obvious reason).

 

[mehc012]

Oh i mean based on prior data and just general knowledge i guess. Its well known anesthesiologists have highest suicide rates even before she collected these

I find that...really surprising, actually. Seems like a sweet gig on the surface.

 

[anbuitachi]

I find that...really surprising, actually. Seems like a sweet gig on the surface.

perhaps a lot of med students who entered thought so as well... then reality hits .. leading to depression

 

[IMGASMD]

Why is Anesthesia expected to be #1 by far?

We are number 1 at something?! Congrats!

Joking aside, it is a very stressful job. It looks easy, but we do bring people to the brink of death every time we administer anesthesia. That line is very thin, if you f up, patient pays dearly, quickly.

We also have all the drugs at our disposal. Uppers, sure we have them. Downers? Plenty. Easy access along with the know-how to kill oneself, and stress.

I can see why we are number 1.

Nothing to be proud of. I am in a very collegial group, and had a few very bad outcome cases. There is virtually no one to really talk to about those cases. The best support I got was, sometimes s*!t happens. If I cannot talk with my partners/colleagues, certainly not lawyers, some parts of the cases do get played back in my head. Not healthy, but that’s the reality of the profession.

I will let some other more senior members comment more.

 

[TypeADissection]

Why is Anesthesia expected to be #1 by far?

I remember a mandatory lecture in med school where an anesthesiologist talked about his problem with addiction and how it almost killed him. The job is stressful since you're essentially being paid to never make a mistake. The patients can be very sick depending on where you work. He talked about how you have such ready access to potent medications and you're smart enough to find ways to abuse it systematically without getting caught right away. It's sad. I still think it's a great gig for the right type of person though and will often recommend it to med students who like physiology, biochem, procedures and have the ability to multi-task well. Cheers.

Side bar: I think about our cardiac anesthesiologists that only work in our HVI and there are just no chip shots with these patients. STEMIs, transplants, ruptures, dissections, etc. Even our outpatient cases roll in with AICDs and EFs of 10-15%. These aren't the 20 year olds that I was banging out hernias on in residency. I recently created a fistula on a 35 year old who already had an MI and CABG x 3 four years prior. I just imagine our anesthesiologists rolling up to each patient in Pre-Op and just saying, "So let me guess, you're really sick eh?"

 

[sloop]

Why is Anesthesia expected to be #1 by far?

Assuming that these are completed suicides, it is probably driven primarily by knowledge of and access to highly lethal means.

In fact, this whole list generally shows a trend of increasing rates with increasing access to highly lethal means. Surgeons and anesthesiologists are in an operating room environment, so obviously they could access fentanyl, barbiturates, etc. EM has similar access to lethal drugs. Psychiatrists could get their hands on a bunch of nortriptyline or something and know roughly how much would probably be lethal.

 

[Osteosaur]

Anesthesiologists also have ready access to a means that is not painful or distressing. I think that might confound the results a bit if you're looking to use it as a measurement of 'specialty most harmful to mental health'.

 

[curbsideconsult]

The job is stressful since you're essentially being paid to never make a mistake.

Isn't this every specialty?

 

[nimbus]

I find that...really surprising, actually. Seems like a sweet gig on the surface.

It is sweet for the right people. Others are miserable doing it. You have to relish and enjoy control in some aspects of your job but also accept that you have no control over other aspects. For example all your patients are compliant while they are under your care and you can minutely titrate their SVR/MAP/CO/FIO2/Vt/PEEP/etc, but you also have to accept that your 3pm case will actually start at 6pm because the surgeon is busy in the office or at another hospital or they can’t reach a family member for consent.

 

[nimbus]

I have to wonder if some of those anesthesia ones are accidental ODs since if memory serves y'all do have the highest drug abuse rate (for the obvious reason).

This for sure. I know of many overdoses. No idea how many were intentional.

 

[Mad Jack]

I have to wonder if some of those anesthesia ones are accidental ODs since if memory serves y'all do have the highest drug abuse rate (for the obvious reason).

My first thought as well. In the case if a doctor it is often more benign for the family to paint a death as a suicide rather than a death from addiction, as the latter leaves people questioning their clinical judgment in every case leading up to their passing. Though addiction and suicide often go fairly hand-in-hand, so it is always difficult to tell whether things were accidental or intentional when both are present.

 

[VA Hopeful Dr]

This for sure. I know of many overdoses. No idea how many were intentional.

and that's kind of what I was getting at, it wouldn't surprise me if a lot of unintentional overdoses are classified as suicides

 

[DO_or_Die]

Recently saw this from Pamela Wible, whos been tracking suicide rates for the past some years. She had 10 names in 2012, now 1363. Anesthesiology as expected is #1 by far. Thought this would be interesting to see for some of you

View attachment 286583

I'm glad I'm going into peds now lol (just kidding), but medicine is a stressful profession. I believe I read that every day there is one physician suicide in the united states.

 

[anbuitachi]

and that's kind of what I was getting at, it wouldn't surprise me if a lot of unintentional overdoses are classified as suicides

yea its unclear. could be other way around too. suicides classified as unintentional overdoses. who knows

 

[~Soñadora~]

Why is Anesthesia expected to be #1 by far?

Easy access to drugs. This isn't a graph of who is more likely to have suicidal ideation or attempt suicide, this is a graph of completed suicides so it makes sense that anesthesia has the best access to the most lethal means.

 

[TypeADissection]

Isn't this every specialty?

Not really. I'm not here to cast aspersions but there are many specialties that by their very nature are orders of magnitude removed from the direct responsibility of the patient's life since they can consult many other services to manage a variety of issues.

 

[UnoMas]

Isn't this every specialty?

I think what he/she meant is:

In Anesthesia, you make decisions on the fly with whatever clinical data you have. This is unique to Anesthesia. You 'order' a medication, you mix it, you give it. There is no pharmacy verification, nursing verification like on the floors.

On the floors or even in the ICU, things go through multiple levels of safety checks. If you order something suspiciously dangerous, you will get a page from pharmacy immediately, or the nurse asking why?? This is not the case in Anesthesia. Also, the medications routinely given by Anesthesia in the OR are some of the most lethal that are only given by code team or in the ICU.

Also like TypeADissection alluded to above, Anesthesia in the OR is usually just the resident + attending. If something were to go down, it's up the those 2 to manage the crisis, not the case for other specialties on the floors.

 

[anbuitachi]

I think what he/she meant is:

In Anesthesia, you make decisions on the fly with whatever clinical data you have. This is unique to Anesthesia. You 'order' a medication, you mix it, you give it. There is no pharmacy verification, nursing verification like on the floors.

On the floors or even in the ICU, things go through multiple levels of safety checks. If you order something suspiciously dangerous, you will get a page from pharmacy immediately, or the nurse asking why?? This is not the case in Anesthesia. Also, the medications routinely given by Anesthesia in the OR are some of the most lethal that are only given by code team or in the ICU.

Also like TypeADissection alluded to above, Anesthesia in the OR is usually just the resident + attending. If something were to go down, it's up the those 2 to manage the crisis, not the case for other specialties on the floors.

the worst is when you are the only anesthesiology member in the OR and something goes bad. i heard once in my department, late at night the patient was crashing and anesthesiologist needed extra hand and one of the attending surgeon unscrubbed and helped however he could (mostly drawing stuff up/fetching equipments)

 

[nimbus]

I lost a few surgeon colleagues to suicide within just my first few years in practice. A prominent ortho surgeon I knew stabbed himself in the heart (with his kid in the house). Depression is a monster.

Yes surgeons too.

Long time burn director where I trained drove out to the desert and shot himself. Part of me wondered how long he could do what he did for a living for so long.

I also knew an excellent, thoughtful, well-trained cardiac surgeon who ended up a homeless alcoholic and drank himself to death.