APMA News - March/April 2023 - 11

When the Physician Becomes the Patient:
Addressing Physician Suicide Amongst
Podiatric Physicians
By Jaclyn D. Wessinger, DPM, and Sindhu Srinivas, DPM, MS
Each year, hopeful students descend into medical schools across the nation to study the core tenets of physiological wellness.
The path is paved in years of meticulous study and acquisition of necessary skills while often forgoing sleep, proper
nutrition, exercise, and doctors' appointments as well as time with family and friends. Social isolation may ensue as priority
goes to schoolwork; fear of failure becomes palpable as thousands of dollars are placed toward becoming physicians. As
students transition to residency, long hours of study may become weeks of managing patients in the hospital setting without
reprieve. Normalcy on the job may become days of continuous call thus leading to burn-out and increased propensity
for medical errors. Many physicians become masters of imparting precepts of wellness to patients without pausing to
consider impacts upon their own individual physical and psychological wellness. As national physician suicide rates appear
to be on the rise, what protocols may be put in place to reduce the stigma of discussing mental wellness? What resources
are available when the physician becomes the patient?
To change the narrative, we must fashion a structured program to address mental health crises amongst physicians
while identifying causative factors. Firstly, we must create a culture of humanity amongst podiatric physicians. Physicians
as a conglomerate often harbor perfectionistic tendencies while heavily berating themselves for perceived failures in the
home, the offi ce, and the operating room. We are taught to refrain from admitting fl aws that may be considered weakness
by our employers or credentialing boards for fear of being perceived as incompetent. It is imperative that we identify
potential colleagues who may be displaying symptoms of depression or burn-out and welcome them to discuss their
experiences. Colleagues who may begin to chronically appear lethargic or apathetic, show lack of interest in their careers
or patients, speak of hopelessness or having no reason to live, increase their abuse of substances, give away possessions
or begin to self-isolate may be at increased risk. We must invite these colleagues to share burdens and urge them to seek
assistance, reminding them that there is no shame in utilizing therapy or counseling services.
Reduction of the social stigma begins locally within our own hospitals and clinics across the nation. Public posting of
crisis lines in physician spaces such as workrooms or lounges by employers may allow providers to feel validated by their
institutions. Physicians may be more apt to express their concerns without fear of being ostracized. Investing in physician-to-physician
mentorship programs may be benefi cial in providing doctors with a trusted listening ear in times of hardship.
Funding for readily available counseling sessions around normal work hours may prove advantageous to physicians
who fi nd themselves unable to break away from patient care. Mobile crisis teams, walk-in crisis clinics as well as hospital-based
psychiatric services may assist the most at-risk physicians with easily accessible resources. These interventions
must be promoted by employers to ensure that providers feel safe in accessing these services without fear of ridicule or
losing their careers. Quarterly in-training sessions taught by mental health professionals may assist providers in identifying
symptoms of depression and teach healthy coping strategies concomitantly with ways to access resources within their
institutions if desired. Anti-bullying campaigns promoted by hospitals and national credentialing boards may also prove
valuable in ending ridicule, abuse, or hazing of struggling physicians, residents, and trainees.
At the resident level, we may employ each of the aforementioned interventions while also considering the high workload
of today's podiatric resident. Many programs do not grant post-call days following lengthy periods of continuous call.
This is a simple intervention to scheduling that may allow the resident a day to leave the hospital and rest within their own
homes. Wellness half-days are small gestures that may be incorporated quarterly into schedules to allow for doctor visits
or necessary procedures. To foster community between residents outside of the hospital, programs may fund increased
numbers of resident wellness activities. At the student level, we may advocate for requiring pre-medical undergraduate
students to take courses including social or intrapersonal psychology, group dynamics, or appraisal of the individual.
At every level, we must work to mitigate the stigma of discussing mental health amongst physicians and to prevent the
loss of our best and brightest across the nation. Cognizance of this urgent matter is key to implementing a strong program
to care for our physicians when they need it the most.
APMA.ORG
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APMA News - March/April 2023

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