As the camera pans on an aerial shot of the New York City skyline at dusk, we hear the desperate voice message of a doctor inside Mount Sinai Hospital revealing a colleague has just jumped off the building. “This keeps happening and they’re just trying to cover it up.”
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ACEP Now: Vol 37 – No 09 – September 2018It’s the opening scene of the new documentary film Do No Harm by Emmy-winning producer Robyn Symon, who pulls back the curtain of the hidden epidemic of physician suicide and depression among doctors and medical students.
“Someone sent me an article about two residents who jumped off the roof of their hospitals in 2014,” says Ms. Symon, who comes from a family of physicians. “I know what it takes to make it through medical school, so I needed to know why someone who had sacrificed so much would want to end it all.”
Physicians promote a petition asking AAMC and ACGME to take action to prevent medical student and resident suicides.
More recently, in May 2018, a medical student and a resident at New York University took their lives, putting everyone on edge. This is not uncommon; almost every physician knows a physician who has committed suicide. In fact, physicians have one of the highest rates of suicide among all professions and almost twice the rate of the general public. Emergency physicians are at or near the top of the list. According to the American Foundation for Suicide Prevention, an estimated 400 physicians take their lives every year, but the number is believed to be much higher since many suicides are reported as accidental deaths.
Filmmaker Robyn Symon on the set of Do No Harm.
Bullying, sleep deprivation, burnout, the lack of autonomy, and the inability to seek emotional help for fear it could jeopardize a career have created a ticking time bomb. More than 50 percent of attending physicians and over 60 percent of trainees report suffering from burnout. How medical schools and hospitals have responded to this crisis has been disappointing to say the least, turning a blind eye to protect their reputations and reduce the risk of liability.
Overcoming Stigma and Suppression
Due to the stigma associated with mental health, finding physicians to talk about this crisis proved to be a big challenge for the filmmaker. The first person Ms. Symon reached out to was Pamela Wible, MD, a family physician who runs a hotline out of her house in Eugene, Oregon, for suicidal physicians and medical students. Dr. Wible, whose TEDMED talk on physician suicide has been viewed more than 400,000 times, has been on a mission to shine a light on this taboo topic. She connected the filmmaker to many physicians and others whom Ms. Symon and her crew followed for more than a year. Woven into the film are interviews with medical students, senior physicians, authors, sleep experts from Harvard Medical School, and leaders from medical organizations such as the American Medical Association, Association of American Medical Colleges (AAMC), and Accreditation Council for Graduate Medical Education (ACGME).
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10 Responses to “The Making of “Do No Harm,” a Film about Physician Suicide”
September 22, 2018
Amy OndeykaI would like to say thank you to everyone involved in the making of this film, including those brave physicians who allowed themselves to be highlighted , and to Chris Doty for this article. Mental health is such a difficult topic for us to discuss. Not just because society as a whole is uncomfortable with it, or we don’t want to have to report it on our license applications, but because we as physicians are trained to “get over it and move on.” We learn this mentality in medical school, we hone it in residency, and we bring it to a new level as attendings. We have to look past that pediatric code, forget about that cancer diagnosis to the nice young woman, and instead worry about our door to doc times, see those toe pains and rashes immediately, document like you will be reading your chart in court, and get those blankets and waters that were demanded of us. We don’t learn how to correctly process this daily grief and loss, so we try to push through like it didn’t happen, while being hounded by administration and the public, which just compounds the problem. It leads to a breaking point. How can we shine a light on the mental health of our physicians? This article and movie are a good starting point, and will hopefully bring more awareness to this huge problem. Wellness programs are great, but they don’t even begin to fix this problem. We need to work on the culture, start a dialogue, support each other, and take care of ourselves, so that we may continue to care for others.
September 23, 2018
MJ BrownThis is Sooo important to our culture and the health care profession. Six of my colleagues over my career have died by suicide. When i spoke with my husband a few years ago (a science teacher) albeit teaching a stressful profession he did not have any friends, colleagues, acquaintances in education who died by Suicide!
Choosing healthcare as a profession should diminish not increase mental health and suicide risk.
Thank you for this work as a member of ACEP i look forward to this film.
September 23, 2018
MJ brownSo such an important theme and topic for all of us in healthcare.
As a member of ACEP for over 25 years I am thankful for their support and promotion of this project. Vision zero — physician suicide is preventable and films like this will help realize that
goal.
September 24, 2018
Loice Swisher, MDThank you ACEP for having leadership on the issue of physician suicide and as well as suicide in the general population. As experts on all emergencies, suicide awareness and suicide prevention should be in the wheelhouse of emergency medicine. We need to be a voice on this increasing, and potentially preventable, public health crisis.
When will this film be shown in San Diego?
September 25, 2018
Dawn Antoline-WangThe film will be shown Tuesday, Oct. 2, 5:30-7:30 p.m., in room 25B of the San Diego Conference Center.
September 29, 2018
Ann Marie MurphyIf not attending the conference, how can we view this film?
September 30, 2018
Dawn Antoline-WangYou can visit http://www.donoharmfilm.com/ for more information about how to see the film.
October 4, 2018
Andrew PhillipsTotally agree!
October 3, 2018
Jonathan JonesSomething like this is really needed. It is well beyond time that this is just discussed “in theory” or similar. We need action and we need everyone, not just physicians to know about this. Thank you so much to everyone involved!
September 21, 2019
Sue Romanick MDI saw the screening of the entire documentary in Seattle. It took one’s breath away and left an empty but stunning silence in the room at the end. However, it also left me with an anger that so many of the factors that contribute to physician suicide have only received lip service. Important factors in training costs, training programs, attitudes of those who should know better and the increasing psychosocial burdens on physicians have only worsened as technology and scientific breakthroughs have only improved. This is very serious. (This doesn’t even get to the area many of us despise: the health insurances have taken over doctoring in such ways as to hasten doctor burn-out, while denying the individual patient appropriate accessibility to healthcare. Many doctors are so beleaguered with prior-autos that they have come to accept this as standard practice in medicine – but it never used to be so!!!) Those who would expect that patients can only benefit from modernization of medicine, are missing the link between “Healthy doctors, healthy patients.” This is not a cheap advertising point. In fact, when doctors/medical students have the burdens of spouses and kids, let alone from extended family members, and not only have to “doctor” patients but then also worry about documentation in such a way to be able to pass audits, and lose additional sleep and any free time (what free time?) due to unethical (!!!) prior authorizations, plus study for continuing medical education points and write examinations every few years to “maintain certification that puts money in the coffers of those running these ridiculous programs…the list goes on and on…then we realize nobody is really advocating for us and that big business keeps winning. Personally, I feel that doctors might reconsider being able to go on strike. Rotating strikes can prevent patients from experiencing problems in those situations. Really, there is a lot of work that needs to be done. Unless physicians show WITH ACTION that they care and jump on board to discuss how to prevent what IS preventable, the train will never reach its destination. It was my understanding after I viewed the film that it wouldn’t be released until the end of this year to Netflix. I feel it needs to be “out there” and hope that financial reasons are not holding up its accessibility to the public.Doctors should never be in the situation of giving up hope. After empowering patients to the best of our abilities, we should demand humane conditions at work for ourselves.
Sue Romanick MD