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Surgery is a uniquely demanding profession. Every day, surgeons literally have the lives of their patients in their hands, having to make hundreds of split-second decisions, and having to make all their decisions right.

Surgeons Hesitant to Get Treatment for Depression

Even the most skilled and dedicated surgeons make mistakes, and those mistakes can be haunting. A survey led by Dr. Tait Shanafelt of the Mayo Clinic in Rochester, Minnesota, found that nearly one in fifteen American surgeons was disturbed to the point of considering suicide in the last year.

Shanafelt told Reuter's "What we are seeing through this work is that there is a high amount of burnout and stress among America's physicians, with potentially serious consequences for both physicians and their patients." The Mayo Clinic researchers found that:

  • Of 7,905 surgeons participating in the survey (about 1/3 of the surgeons in the United States), 501 reported thoughts of killing themselves.
  • Of the 501 surgeons who reported having ideas about suicide, 135 sought professional counseling to deal with profession.
  • Of the the other 366 surgeons who admitted feelings of suicide but did not seek help, 300 said that they kept their problems to themselves (other than in the anonymous survey) for fear of losing their medical licenses.

Surgeons who have mastered their field are the most likely to experience burnout. And they are the most likely to feel suicidal, at rates two to three times greater than the general population. The greatest number of reports of suicidal feelings were in surgeons aged 45 to 61. But why should respected, even revered medical professionals feel burnout?

Why Some Older American Surgeons Feel Burnout

The reason depression and burnout tend to hit American surgeons at the peak of their careers may be precisely that they are so accomplished in their fields. After all, the most difficult cases are given to the most skilled surgeons. Sicker patients are less likely to survive, and the surgeon is more likely to have to deal with a failed operation. But for a variety of reasons, including maintaining morale in their future patients, surgeons cannot talk out their inevitable failures except in very limited circumstances.

The Mayo Clinic researchers asserted that there is very little danger that a suicidal surgeons would "take their patients with them" should they feel so overwhelmed that they committed suicide. In fact, a surgeon who takes failure personally is likely also to develop new surgical skills that enable better treatment for future patients. From the patient's point of view, a surgeon who has already learned from decades of experience, good and bad, is far better than being the surgeon's very first patient.
The surgeons patients should avoid are those who deal with burnout by depersonalization. If a surgeon presents any kind of "I don't care" attitude, or literally says, "I don't care" about patient outcomes, then it is time for a second opinion. Otherwise, your best surgeon may the surgeon who cares enough to feel pain of failure and also enough to get the treatment he or she needs to deal with depression.

  • Shanafelt TD, Balch CM, Dyrbye L, Bechamps G, Russell T, Satele D, Rummans T, Swartz K, Novotny PJ, Sloan J, Oreskovich MR. Special report: suicidal ideation among american surgeons. Arch Surg. 2011 Jan,146(1):54-62.