The definition of a high-risk physician is one who’s struggled with depression, problems with alcohol and drugs, has access to means, is driven, competitive, compulsive with excessive risk taking, individualistic, ambitious, age greater than 45 in women and greater than 50 in men, graduated of a high prestigious school.
Nonthreatening, but annoying physical illnesses, self-destructive tendencies, a guilty self-concept, change in status, a threat to autonomy, financial stability, et cetera. The High-Risk Physician.
In 1980, a study was done retrospectively, through interviews with family and friends, by the American Medical Association, and found that more than one-third of physicians who committed suicide, were believed to have had a drug problem at some point in their lives, as opposed to, 14% of controls in general population. 42% had been seeing a mental health professional at the time of their death, as opposed to 7% of controls in general population. One-third had a history of at least one psychiatric hospitalization. There was a slightly higher incidence of suicide amongst their own parents, and they reported more emotional problems before age 18, than controls.
It’s estimated that 40% of physician suicides are associated with alcoholism and 20% with drug abuse. Prevalence rates vary, but recent data suggests that abuse of alcoholism and illicit drug by physicians, is similar to the general population. Female physicians have a higher frequency of alcoholism versus general population, according to the study by Banck, at the University of Cologne Medical School of Germany. Physicians are at increased risk for prescription drug abuse. Anesthesiologists are over represented among sorted physicians with substance abuse problems. 5.6% of total licensed physicians, 25% of physicians with substance abuse disorders. One of the reasons is access and unintended second-hand environmental exposure.
There are special substance abuse programs for physicians, such as the Talbott-Marsh clinic in Atlanta, and Caduceus Clubs exist, all over the United States and Canada.
Relationships play an important role. Compulsive personality traits, which are widely heralded as the key for professional success, may lead to more distant relationships. Divorce rates among physicians are 10% to 20% higher than the general population. Couples that are including a physician who remain married, report more unhappy marriages, associated to the Medical Marriage 1996, by Sotile.
Physicians become masters of delayed gratification. Medical students spend years coping with the level of demand medicine requires, with the expectation, that later they will be rewarded with a happy, more balanced life. That doesn’t always happen.
