EP’s and Depression from EP Monthly

This month’s EP Monthly (terrific and getting better if that’s possible) has published the results of their survey of depression in Emergency Physicians. It surprised them, and me:

Features: Survey Says Many EPs Suffer in Silence

BY: LOUISE B. ANDREW MD, JD

“I have had the pistol in my mouth and would have pulled the trigger, save for leaving my child without a parent.” Thus began one response to EPM’s December article and survey “Silent Treatment.” The respondent continued: “Does anyone honestly think that anyone in our position would report this type of thought to any board? Go under the microscope? Lose our ability to provide for our families? For as much hype as is given to diagnosis and treatment of depression, state boards and everyone else hold their physicians to a different standard. If I were a plumber or musician, I would just go see my psychiatrist, take medication, and go on with my life, better off for having done so. We are held to an impossible double standard.”

This desperation was echoed in countless other anonymous responses, each reinforcing the need to understand physician depression better and do away with stereotypes that might hinder treatment. Here now are our findings, and the many voices that cry for understanding.

Granted, this is a self-report so there’s a selection bias, but the numbers were surprising:

In our EPM survey, 73% of 108 respondents had experienced symptoms that they felt might have been depression.

Suicide, on the other hand, is far more prevalent among physicians than the public, with the most reliable estimates ranging from 1.41% to 2.27% times the rate in the general population. More alarming is that, after accidents, suicide is the most common cause of death among medical students…

Sadly, though physicians have a lower mortality risk from cancer and heart disease relative to the general population, presumably relating to self-care and early diagnosis, we have a significantly higher risk of dying from suicide.

Okay, a sample size of 108 isn’t statistically meaningful, but the numbers presented are surprising to me. And, I would imagine the “%” above was meant to be times.

Best Chief Complaint of the Night

“I was assulted with a telephone, and now my ear is ringing.”

I couldn’t make that up if I tried.