Cases and Commentaries
Dr. Laura Roberts talks with Peter Yellowlees, MBBS, M.D., author of Physician Suicide, Cases and Commentaries.
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Physician Suicide examines the multiple risk factors that account for the higher rates of burnout, depressive symptoms, and suicide risk physicians experience compared with the general population. Suicide is typically caused by a convergence of factors, chief among these are untreated or inadequately managed mental health conditions. Physicians are less likely to seek professional help for these conditions—in part, because of fear of professional repercussions—and many seek to address their symptoms by self-medicating with alcohol or drugs. Burnout is especially common and is frequently due to workload, work inefficiency, lack of autonomy and meaning, and work-home conflict. The author explores these issues through the lens of a series of beautifully written and fascinating case studies that allow the reader to get inside the minds of his subjects and understand their lives and the stressors they face.
The only volume of its kind, it provides an in-depth and nuanced approach to the topic of physician suicide in the context of the broader topic of physician health and wellbeing:
- The book covers the full range of physician mental health issues, from lifestyle and professional expectations and burnout, through depression, anxiety, addictions, personality disorders, and aging, carefully noting the many interactions with suicide and suicidal behavior.
- Prevention of these diverse problems—at the individual and organizational level—is addressed, with emphasis on the response of health care organizations and institutions to the issue of physician health and wellbeing, and the impact that well-organized physician well-being committees, taking on the function of a physician health program, can have on individual physicians.
- The chapter-long case studies resemble short stories that realistically capture the mental health challenges doctors confront in the cultural context of medical training and professional practice. These represent the core of the book, and they succeed in making the issues discussed personal and engaging for the reader.
- Accompanying each case study is a concise literature review that offers commentary and emphasizes the most important points. A detailed reference list is also offered for readers who want more extensive background material.
- The author calls clearly upon the medical profession to take serious actions to improve physician health and thereby reduce the number of physicians who kill themselves each year.
- Physician Suicide is a case-based textbook of physician health and wellbeing that can be used in courses teaching physicians and medical students about self-care.
There is little mention in the health literature of the daily pressures inherent in the physician lifestyle, which may lead to unintended consequences, of which suicide is the most extreme. Physician Suicide is an attempt to document the pain and suffering that physicians are trained to deny, especially in front of their patients, in the hope that such discussion may improve the lives of current generations of physicians and prevent further suffering in future generations.
- About the Author
- Chapter 1. Personal Stress Therapy
- Chapter 2. Trapped at Work
- Chapter 3. The Second Victim
- Chapter 4. Recovery One Day at a Time
- Chapter 5. The Conundrum of Treating the Physician Addict
- Chapter 6. Disruptive Behavior and Life as a Ponzi Scheme
- Chapter 7. A Sudden Disastrous Day
- Chapter 8. The Physician's Physician
- Chapter 9. Caring for the Carers
- Chapter 10. Physician Heal Thyself
About the Authors
Peter Yellowlees, MBBS, M.D., is Professor of Psychiatry and Vice Chair for Faculty Development in the Department of Psychiatry at the University of California, Davis School of Medicine in Sacramento, California; and President of the American Telemedicine Association, headquartered in Washington, D.C.
Physician burnout and risk for suicide is an issue of our time, and Dr. Yellowlees' work will go a long way toward increasing awareness and reducing the mystique and stigma associated with physicians at risk for suicide. Suicidal ideation is often a treatable condition, and we cannot afford to lose one more physician. Read this book and become part of our conversation!—Anita Everett, M.D., DFAPA, President, American Psychiatric Association 2017–2018
Dr. Yellowlees, employing the lens of a seasoned clinician and teacher, has created a unique book on a difficult subject, physician suicide. With ten bountiful – and riveting – fictional cases of ailing physicians and cutting-edge commentary, he covers the vast landscape of the individual and cultural forces that bring physicians to their knees and too often lead to acts of self-destruction. Full of sage advice, this is a must-read book by a gifted writer for physicians, their families, those who treat them, and a curious public. Dr. Yellowlees' muse, the late Dr. Oliver Sacks, would be proud!—Michael F. Myers, M.D., Professor of Clinical Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York
Finally! A timely book that sheds light on the vital topic of physician health and well-being. Dr. Yellowlees uses a powerful combination of physician accounts with evidence-based recommendations to suggest how to address physician burnout. The book discusses the underlying causes of physician suicides, depression, burnout, and addiction and describes means of addressing them. What sets the book apart is that it describes methods for working through the many challenges to implementing solutions to physician burnout. An interesting read for anyone interested in knowing about physician well-being and a must-read for medical leadership.—Rashi Aggarwal, M.D., Director, Residency Training Program, Associate Professor, Department of Psychiatry, Rutgers New Jersey Medical School, Newark, New Jersey
Dr. Yellowlees draws on his experience at UC Davis to illustrate and spotlight the all too common crisis of suicide and burnout affecting the physician population. A well-written and energetic book in the style of Dr. Sacks, each chapter begins with a compelling story that seems all too real, drawing the reader in, while the subsequent commentary puts everything in perspective. He draws on the vast body of medical literature to emphasize his points. A must-read for anyone who wishes to understand the complex world of physician Wellness.—Rajiv Misquitta, M.D., FACP, President, Sierra Sacramento Valley Medical Society (SSVMS); Medical Director, Department of Lifestyle Medicine, South Sacramento Medical Center; Co-author of Healthy Heart Healthy Planet and of the sentinel article on Lifestyle Medicine in the Permanente Journal
An illuminating must read for anyone interested in physician suicide, stress and well-being. Organized around beautifully illustrative case examples and salient commentary that are thought provoking while offering pragmatic suggestion for clinical treatment and clinical approaches.—Jay H. Shore, M.D., M.P.H., Professor Department of Psychiatry University of Colorado Anschutz Medical Campus, Associate Medical Director, Colorado Physicians Health Program
Doctor, care for yourself if you are going to be able to care for others. Physician health and mental health is not selfish, it is responsive and responsible to all involved.
Yet doctors are notoriously negligent about their wellbeing. It is almost bred into us when in training, when tolerating the demands of on-call and sleeplessness, large patient loads, and the stress of being the doctor when no one else is around. We take pride in our endurance and determination, but at a considerable price, as Dr. Peter Yellowlees teaches us in his new book about why physicians take their lives. Suicide among doctors in not at all uncommon, starting with medical students.
This wise and comprehensive text covers burnout and depression, addiction to alcohol and drugs (ubiquitous in the medical community), aging as well as resilience, physician health programs, and the complexity of doctors treating other doctors. We are all fortunate to have Dr. Yellowlees be the doctor/writer who is trying to improve and save the lives of his colleagues.—Lloyd I Sederer, M.D., Adjunct Professor, Columbia/Mailman School of Public Health; Chief Medical Officer, NYS Office of Mental Health
This book is the first to address the multiple aspects of physician mental health in an accessible and case-based manner. As a medical professional, is hard to read this book and not feel compelled to look at one's own workplace for ways to improve physician well-being.—Brian P. Gomoll, M.D., Doody's Book Reviews
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