Are punitive rules forcing doctors to hide their mental health problems

Dr Mary Dinh, 31, described her medical training during the pandemic as a soul-crushing experience. She constantly feared that she would bring home the virus from lack of PPE, used one N95 mask until it disintegrated and saw 13 patients die in one day at her Pennsylvania hospital. Dinh felt hopeless seeing unprecedented death, her colleagues struggle with depression and a fellow resident attempt suicide.“Residency is already one of the most difficult and challenging times in a physician’s life,” Dinh said, referring to the three to four years of training after medical school. “Throw a pandemic on top of that, a shortage of doctors, and residents are essentially slave labor for the hospital.”Dinh says her program fostered a culture in which residents couldn’t ask for mental health care while sustaining the demands of 80-hour-plus work weeks. She turned to older doctors who advised her to drive out of town, pay cash and use a pseudonym if she needed to talk to someone. “It’s almost like a really shady deal just to get mental health care and some support,” Dinh said. “I’m not doing anything illegal.”She found a therapist nearly two hours away. “It was incredibly helpful and rejuvenating,” Dinh said. But her work environment was so excruciating that one month ago, Dinh quit the program. A year into the pandemic, doctors are struggling with the occupational hazards of working in medicine, including trauma, death and lack of sleep. The Covid-19 virus has only added to the burnout that physicians already faced before the pandemic. A 2018 literature review of 10 years of research published in peer-reviewed journals showed that physician suicide was twice the rate of the general population. At 28 to 40 per 100,000, the loss was higher than the military. Most of the general public can seek mental health care without being worried that their careers will be at risk. This is not the case for doctors. In most states, once a physician seeks help for mental health issues, including anxiety, post-traumatic stress disorder (PTSD) or addiction, they are obligated to report their condition on their application for a state medical license. Answering mental health-related screening questions honestly can raise a red flag, putting the physician’s license at risk. After a decade of education and medical school debt averaging $215,900, doctors are scared to jeopardize their livelihood. Interviews with doctors reveal the extraordinary measures some will take to avoid being linked to a mental health diagnosis. They will travel to an out-of-state pharmacy for medications, pay cash to see a therapist or psychiatrist so that health insurance billing isn’t linked to a mental illness, and strategically discuss their struggles with only those they trust. State medical boards are responsible for licensing, investigating and disciplining a physician. But Dr Pamela Wible, a family doctor, researcher and Founder of Ideal Medical Care who began a hotline in 2012 for physicians

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