Transcript for the Piece Audio version of Physician Depression-Part 3

Murphy
Part 3
Air May 8, 2008

Depression is a growing problem among physicians. It can threaten the doctor-patient relationship and in the worst case can be fatal.

?A grief reaction drifted into depression and it got the point of suicide attempt. I did not expect to recover from it.

Studies show suicide risk among certain physicians is almost 6 times higher than average. In part three of our series on Addicted and Depressed Physicians, KUOW?s Patricia Murphy reports on the prevalence of depression among healthcare workers.

Dr. C, as we?ll call him, has a busy family practice in a rural part of the state. But five years ago he was hit with depression so severe it nearly cost him his life.
?My mom died. My best friend died from leukemia. And I was also his doc, and was there the day he died. I was there with my mom the day she died.
Doctor C admits he didn?t know what to do.
?I had gone through that peculiar circular argument in my head. I think only people who have done a suicide attempt can kind of understand that faulty logic: the world is better without me than with me.

He thought the easiest way to commit suicide would be with a gun.

?And we had a gun in the house. I couldn?t find it. ?

He considered giving himself a lethal injection, but eventually cut his wrists. To his amazement he awoke six hours later, weakened but alive.

? SO I decided well I?ve botched this one, I?ll call 911, get those guys, I know they?re going to throw my sorry butt into a psych ward. I?ll play their game, I?ll come home, get the gun, and do it right.

It?s almost like the margin between excellence and suicide can be very narrow when somebody is that overextended and that under-treated.

Doctor Mick Oreskovich is one of the reasons Doctor C is still alive. He?s Medical Director and CEO of The WPHP, the Washington Physicians Health Program. That?s where Doctor C went to get connected to treatment for his depression.

Studies show that suicide is the most common cause of death for young physicians.

Oreskovich thinks depression has become epidemic among healthcare professionals. Worse, he says most physicians ignore their symptoms.

Physicians believe that if they work harder and try harder they can change the way they feel. So when depression finally makes itself manifest its very profound, it has a rapid downhill course and easily leads to suicidal thoughts and urges.

Some depressed physicians may also turn to drugs to help them cope?compounding depression with addiction.
However, their chances of recovery are much greater than those in the general population.
Richard Ries (ree-s) directs Harborview's Chemical Dependency Program and is a UW psychiatry professor. He says the WPHP is a national model for its multi-layered approach to recovery.
?a lot of intensive treatment a lot of psychosocial treatment you have monitoring, you have available resources for consultation?
Physicians who agree to be monitored for five years gain the program?s endorsement that they ?re safe to practice.
But 25-percent of drug addicted docs do relapse. Ries says for them the stakes are much higher than, say, people who go through drug court.
?What are you going to do with a positive drug screen? For our drug court people it may mean you intensify their treatment. With physicians, the consequences are more drastic if you will. You get your license garnered and you don?t get to go back to work.
Doctor Mick Oreskovich says a relapse can mean termination from the WPHP. But most docs who stumble are able to get back on track and stay clean.

Insofar as we have not had not had any reports of patient harm associated with an initial relapse we look at that as being the last opportunity for completed surrender by them. Our experience has been that after 2 relapses most people do not return to the practice of medicine because we cannot endorse that they are truly safe to practice. ?

Some healthcare workers seem more likely to relapse than others. Dr.Vern Williams is medical director of Hazelton Springbrook, a treatment facility in Newberg, Oregon.
?There are two groups that make me extremely anxious. Oral surgeons who use the same drugs that the anesthesiologists do generally in an outpatient scenario that?s even less controlled than the operating room and anesthesiologists and nurse anesthetists that are opiate addicts.
Williams recommends that anesthesiologists and oral surgeons return to other medical fields after treatment.
The care given to addicted and depressed physicians is expensive. For some, hundreds of thousand of dollars. Much of that patients pay out of pocket.
The money gives them an advantage that most addicted and depressed people don?t have. Dr. Ries and others in the treatment community want to change that by bringing some of the WPHP?s methods to those outside the medical profession. Patricia Murphy KUOW News
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Stay with us for more discussion on this topic this morning on Weekday starting at 9:00.