The UK media are reporting that a body found at the seaside in Dorset has been formally identified as that of missing junior doctor Rose Polge. The press had stated that when she first went missing she may have written a note that mentioned Health Secretary Jeremy Hunt.
Jeremy Hunt, the UK Minister for Health is currently locked in a battle with the British Medical Association – the ‘doctors’ union’ – over proposed changes to the doctors’ contract with the National Health Service.
Among many reasons the medical profession is resisting these proposals is doctors argue these changes will make their lives even more stressful just as working conditions for physicians in the UK become ever more impossible.
The family Of Dr. Rose Polge has requested their privacy at this very difficult time.
Speculation as to what happened would be inappropriate. But it is inevitable that this kind of tragedy draws attention to the stress junior doctors are under and their campaign over working conditions.
A study published in the Journal of Epidemiology and Community Health entitled, “Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979–1995,” found that the suicide rate in female doctors was higher than in the general population, whereas the rate in male doctors was less than that of the general population.
This investigation, by a team led by Professor Keith Hawton, from the University of Oxford found the difference between the mortality ratios of the female and male doctors was statistically significant. There were also significant differences between specialty with community health doctors, general practitioners and psychiatrists having significantly increased rates compared with doctors in general hospital medicine.
Keith Hawton, Aslog Malmberg and Sue Simkin from the Centre for Suicide Research, Department of Psychiatry, University of Oxford, published a study in 2004 that remains one of the largest psychological investigations into suicide in doctors.
The authors describe their research as a “psychological autopsy study,” of 38 working doctors who died by suicide in England and Wales between January 1991 and December 1993. Most of the deaths appeared to have been planned and two thirds of doctors had left a suicide note, while a third were known to have spoken of suicide before their deaths, most within the week beforehand.
Twenty-five of the doctors had significant problems related to work, 14 had relationship predicaments and 10 had financial difficulties.
Given the current working atmosphere in the NHS, it is particularly interesting that the study found most doctors had significant problems at work. Seven were facing complaints, which in five cases appeared to have been a key factor leading to suicide. Most of these doctors were also facing other difficulties at work or home.
Other common professional problems included feeling overloaded by the volume of work, long hours and struggling with the responsibility of the job.
The study, “Suicide in doctors: a psychological autopsy study,” was published in the Journal of Psychosomatic Research’. It investigated 28 men and 10 women. 44% were under 35. 47% were married, 29% single and 10% divorced or separated. Of 25 who worked for the NHS, 15 were consultants or principals in general practice and 10 were junior staff. Twelve worked in general practice.
The pattern of diagnoses was similar to other studies, but with lower rates of psychotic illness and personality disorder, as would be expected, the authors of the study contend, in such a professional group.
The authors argue that physicians, in general, tend to minimize their own health problems, often fail to seek suitable help, do not take time off work and distrust occupational health services.
The doctors in this sample, the authors explain, reflected this pattern. They were less likely to have consulted their GPs shortly before death than people in other population-based studies of suicide.
A surprisingly high proportion, the authors say, had received treatment for depression compared with subjects in other studies. However, their probable ability to conceal the profundity of their hopelessness and suicidal drive from others might explain why so few had been admitted to hospital or seen by their GPs before death.
The authors of the study conclude that the impact of complaints, overwork and burden of administration on some of the doctors studied is of great concern. Given the study was done in 2004, David Casey and Kartina Choong from the University of Central Lancashire, in their more recent investigation of doctor’s suicides, quote a report issued by the Royal College of Physicians in 2012.
This demonstrated that there were one-third fewer acute trust beds than 25 years ago yet a 37% increase in hospital admissions over the last 10 years.
Under More Pressure?
David Casey and Kartina Choong’s study cites evidence that 75% of medical consultants reported being under more pressure than three years ago and 25% of medical registrars reported their workload as unmanageable.