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In September 2014, two doctors in the second month of two different medical residency programs flung themselves to their deaths from high rise buildings in New York. These two tragic cases were 1 in 200 of the 400 cases of doctor suicide in the United States last year.
One can never know what drove these promising young physicians to suicide, but just a few months earlier they probably had celebrated their graduations from medical school with their families and friends. They probably had entered their post-graduate training programs with enthusiasm for full-time work in healing patients. And they probably had tremendous debt after financing their educations, many doctors borrowing hundreds of thousands of dollars to get through medical school, worked at least 80 hours a week, and possibly more, and suffered tremendous emotional trauma at learning the limitations of their profession's ability to help people in medical need.
Young Doctors Especially Vulnerable To Depression
A 2009 study found that 9.4% of fourth-year medical students, nearly one in ten, had experienced thoughts about or desire to commit suicide in the two weeks preceding the survey. Male doctors commit suicide at twice the rate of the general population, and female doctors commit suicide three times more often than male doctors. Over the course of their careers, about one doctor out of every 50 ends his or her own life.
Medical school and residency (formerly known as internship), especially in the United States, are traditionally times of tremendous stress. Medical students take the equivalent of 24 to 36 semester hours per semester, twice the academic load they endured as undergraduates. Medical school courses require labs and work in clinic, not just preparation from notes and lectures.
Before 2003, American medical residents typically worked 24 hours on, 24 hours off, grabbing sleep when they could in break rooms occupied by the entire staff. Doctors in training were expected to stay with a patient from admission into the emergency room until resolution in the hospital, no matter what toll the experience took on their health or their personal lives.
Economics of The Practice Of Medicine Not What They Used To Be
In the 1960's and 1970's, in the US, doctors were the highest paid of all professions. Many doctors became truly rich. In the twenty-first century, however, more and more patients are insured by health maintenance organizations (HMO's), which strictly limit what doctors are paid for their services. A specialist who has 25 years of experience after 8 years of residency and 8 years of college and medical school who has to maintain a staff of 20 with their offices and equipment might receive as little as $100 for an hour-long consultation. Medicare and Medicaid can take months, or even years, to pay service providers.
In many states, doctors are exposed to malpractice liability, and have to pay onerous fees for malpractice insurance coverage. Patients read about their conditions on the Internet, and expect doctors to know more, while often failing to appreciate the doctor's hard-earned clinical judgment. And doctors go into debt not just hundreds of thousands but sometimes millions of dollars setting up their practices in parts of the US.