Preventing physician suicide

"We must be vigilant for signs of burnout and depression within ourselves and among our colleagues, and we must not hesitate to seek help when we recognize something is amiss. Physicians have resilience and self-reliance in abundance, but when we rely on those traits above all others, we put our own well-being and that of our patients and colleagues at risk."

Susan R. Bailey, MD, president (2020-2021), AMA

Physicians are at a higher risk of suicide and suicidal ideation than the general population.¹ Suicidal ideation has been associated with high workload volume² and medical errors.³ Although previous research linked physician burnout to depression and suicide, a recent investigation suggests that burnout and depression are separate experiences, with distinct consequences for physicians and their patients.⁴ Physicians who experience suicidal ideation have been shown to be less likely to seek the help they need.

Factors associated with suicide among physicians include:

• Depression⁵
• Emotional exhaustion¹
• Substance-use disorder⁵
• Impaired relationships⁵
• Self-destructive tendency⁵

Understanding the incidence of suicide among physicians, residents and medical students will help inform the AMA's continued efforts to promote access to mental health care, improve physician professional satisfaction and well-being and reduce suicide risk for our nation's healthcare workforce.

Taking proactive steps to identify and address physician distress can help to ensure the well-being of colleagues and reduce the risk of suicidal ideation. Additionally, it is imperative that physicians recognize the importance of self-care, model wellness behaviors and encourage others to do the same.

Organizations should also note the importance of creating a supportive atmosphere in the workplace, which can be instrumental in addressing physician distress. Physician advocates can be valuable assets to an organization by providing support services to those in need of help.

Additionally, referral lists for confidential resources inside and outside of the organization should be updated regularly and available to all team members, including physicians.

• One of the keys to the AMA effort to support medical student, resident and physician health and well-being (PDF) has been a close partnership with leading organizations ranging from the Dr. Lorna Breen Heroes’ Foundation, Medical Society of Virginia, Federation of State Medical Boards, Federation of State Physician Health Programs and many others. Collectively, this campaign and these partnerships have benefitted more than 1.1 million physicians and other licensed/credentialed health care professionals.
  • As of September 2024, there now are 34 licensure boards, including 29 medical boards, and more than 370 hospitals and health systems that have verified their licensing or credentialing applications are free from intrusive mental health questions and stigmatizing language. Systems have included local hospitals, state, regional and national health systems. This is an increase from 2022 when there only were 22 medical boards and a few dozen hospitals and health systems that had reviewed their applications.
  • In addition, in the past two years, nine states have enacted “safe haven” type legislation to help enhance confidentiality protections for physicians and others who seek care for wellness.
  • Additional successes have come from revisions to statewide credentialing applications in Iowa, Massachusetts and Oregon, which revised their applications following technical assistance and support from the AMA and its partners.
  • AMA advocacy also has led to support and/or endorsement of AMA-recommended policy changes from key accrediting organizations, including The Joint Commission, National Center for Quality Assurance (NCQA) and the Utilization review accreditation commission (URAC).
  • AMA policy recommendations now are supported by National Institutes of Occupational Safety and Health at the CDC, the National Association of Medical Staff Services, the American Hospital Association and other key stakeholders.
  • At the federal level, the Dr. Lorna Breen Health Care Provider Reauthorization Act, unanimously supported by the House Energy and Commerce Committee, would continue the ongoing work that was established in the original law, enacted in 2022.
  • The AMA continues to work with several dozen additional state medical boards, and hospital and health systems to review and change their applications’ language as necessary.
• AMA STEPS Forward® practice innovation resources help understand how to address physician burnout, engage health system leadership and develop a culture that supports physician well-being.
• Advocacy in action: Large-scale change is needed to address the physician burnout crisis. The AMA is advocating to reduce physician burnout and improve well-being.
• In an episode of AMA Update, Stefanie Simmons, MD, chief medical officer of the Dr. Lorna Breen Heroes' Foundation, discusses the realities of physician burnout and shares advice on seeking mental health services as a health care professional.

• Preventing physician suicide
• After a physician suicide
• Collective trauma: Respond effectively as an organization
• Caring for the health care workforce during crisis
• Identifying and responding to suicide risk
• Assessment of physician burnout
• Medical student well-being
• Resident and fellow burnout
• Scholars of wellness
• Peer support programs for physicians
• Stress first aid for health care professionals
• Wellness-centered leadership

AMA news stories

• Is your physician colleague at risk for suicide? Signs to look for
• Now's the time to have a difficult talk about physician suicide
• Q&A: Clearing up confusion on physician burnout and depression
• To encourage physicians’ healing, make it OK to ask for help
• To ease physician burnout, ditch the stigma against getting help
• When doctors ponder suicide, depression—not burnout—is key driver 

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AMA podcasts

• Creating a Culture that Supports Well-Being
• Creating a Peer Support Program
• Mental health counseling for physicians and APPs
• No one left behind: Expanded peer support and second victim syndrome
• Three simple STEPS for diagnosing your own mental patterns

AMA webinars

• Practical strategies for managing suicidal ideation and reducing risk
• The association of physician burnout with suicidal ideation and medical errors

AMA co-authored research

• Association of physician burnout with suicidal ideation and medical errors
• Suicidal ideation and attitudes regarding help seeking in U.S. physicians relative to the U.S. working population

AMA-sponsored campaign

• All In: WellBeing First for Healthcare

Note: If you or a colleague are thinking about suicide, please contact the Suicide Hotline at 800-273-8255.

¹ Shanafelt TD, Dyrbye L, et al. Suicidal ideation and attitudes regarding help seeking in US physicians relative to the us working population. Mayo Clinic Proceedings. 2021; 96(8): 2067–2080. doi: 10.1016/j.mayocp.2021.01.033.

² Duarte D, El-Hagrassy MM, Couto TCE, Gurgel W, Fregni F, Correa H. Male and female physician suicidality: a systematic review and meta-analysis. JAMA Psychiatry. 2020;77(6):587–597. doi: 10.1001/jamapsychiatry.2020.0011.

³ Shanafelt TD, Balch CM, Dyrbye L, et al. Special report: suicidal ideation among American surgeons. Arch Surg. 2011;146(1):54–62. doi: 10.1001/archsurg.2010.292.

⁴  Nikitha K. Menon BA. Association of physician burnout with suicidal ideation and medical errors. JAMA Network Open. 2020;3(12):e2028780. doi: 10.1001/jamanetworkopen.2020.28780.

⁵ Epstein LC, Thomas CB, Shaffer JW, Perlin S. Clinical prediction of physician suicide based on medical student data. J Nerv Ment Dis. 1973;156(1):19–29. doi: 10.1097/00005053-197301000-00002.

With an increased number of people reporting worsening mental health in recent years, it is imperative that people are aware of the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) telephone program.

People experiencing a suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress can call, chat or text 988, and speak to trained crisis counselors. The national hotline is available 24 hours a day, 7 days a week.

The previous National Suicide Prevention Lifeline phone number (1-800-273-8255) will continue to be operational and route calls to 988 indefinitely.