Creating a Safer Workplace for Physicians

Physicians see some horrific things in their line of work. A list beginning with gunshot wounds to toddlers doesn’t need to go any further. Add racism and bullying in the workplace, and the result can be traumatic.

Pamela Wible, M.D., has written about the psychologically hazardous working conditions endured by many physicians. Part of the problem is a culture of quietly enduring the pain, and that needs to change, said Dr. Wible, the guest speaker on June 26 at the Medicine Assisted Treatment (MAT) Ohio Opiate Project ECHO session held by Northeast Ohio Medical University.

The medical profession is cloaked in a culture having to hide your humanity, said Dr. Wible. Every once in a while, a physician suicide is reported. Lorna Breen, M.D., the physician who treated COVID-19 patients and finally died by suicide, made national news. But there is much more everyday hurt under the surface of physicians’ lives, says Dr. Wible, the author of Physician Suicide Letters—Answered.

“Don’t pathologize the terrible things you have seen. You are having a normal response to trauma,” said Dr. Wible to the online audience. Physicians need more psychological support and safe places to process their emotions, she said. She offered suggestions, such as dedicated spaces in medical facilities where providers can go to cry and recover after a traumatic incident.

Dr. Wible also explained one support system, called a Balint group, started by a psychoanalyst named Michael Balint and his wife, Enid, who facilitated psychological training for physicians. Meeting regularly with facilitators to discuss cases in such groups, physicians can process their raw emotions.

Workplace Hazards

When working conditions include racism (including on the part of patients) and bullying of younger physicians, it creates a hazardous workplace, said Dr. Wible. The culture of medicine has encouraged those coming into the system to accept these hazards as part of the job. Medicine has the highest suicide rate of any profession, noted Dr. Wible. And the culture needs to be changed so that practitioners have access to a safer workplace and the freedom to seek mental health care for themselves.

She points to medical licensure applications, which in some states ask about the applicant’s mental health history. Those applications should be asking questions to determine whether the applicant is currently competent, not whether they have ever been treated for a mental health condition, said Dr. Wible. Knowing about such questions and the general stigma surrounding mental health can deter physicians from seeking help for themselves, placing them at greater risk.