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Comment & Response
June 29, 2020

Seeking and Implementing Evidence-Based Physician Suicide Prevention

Author Affiliations
  • 1Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
  • 2Division of Primary Care and Population Health, Department of Medicine, Stanford University, Palo Alto, California
  • 3Division of Hospital Medicine, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York
JAMA Intern Med. Published online June 29, 2020. doi:10.1001/jamainternmed.2020.1841

To the Editor As suicide loss survivors (ie, persons who knew and cared about someone who died of suicide), we read Isaacs’s Perspective1 with empathy and compassion. Sharing such a deeply personal experience with suicidality is courageous. Among the 3 of us, we have worked alongside at least 10 colleagues during our careers who have died by suicide. We agree emphatically with Isaacs that psychologically safe environments are critical to preserve our precious current and future physicians’ well-being.

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    1 Comment for this article
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    Difficulty obtaining data.
    Steven Reid, MD, FAANS | Doctor Lifeline
    Obtaining accurate figures for physician suicide proves extremely problematic. Just as many doctors successfully hide their depression, burnout, and learned helplessness from their families and colleagues, they may contrive suicidal methods that are ambiguous, or easily classified as another cause of death. In some cases, their colleagues cover up for them after death. Physician suicidality remains a difficult problem to assess, even after the death of the physician. During my career, and before starting Doctor Lifeline, I personally knew 6 physicians who completed suicides. Many of my colleagues who knew these decedents remained unaware of suicide as the cause of their deaths. Discussion of physician suicide remain taboo in much of our "polite society". We need to change the modern practice paradigm to permit physicians to seek and obtain help without stigmatization. Moreover, we need to change the toxic practice environment that leads so many doctors to see suicide as the only solution. 
    CONFLICT OF INTEREST: I am the president of Doctor Lifeline, a nonprofit battling the epidemic of physician suicide.
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