Physician intraprofessional disrespect endangers patients →

An interview with two physicians I admire for their courage to speak and share the truth uncensored. Thank you, Drs. Corina Fratila and Kevin Pho. May we all learn from your dedication to the physician community.

Kevin Pho: Hi, and welcome to the show where we share the stories of the many who intersect with our healthcare system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Corina Fratila. She is an endocrinologist and she wrote the KevinMD article: Are physicians the stewards of healing that they are meant to be? Corina, welcome to the show.

Corina Fratila: Thank you so much, Kevin. It’s good to be here.

Kevin Pho: We’ll get into your article in a little bit. But first off, can you share your story and your journey to where you are today?

Corina Fratila: I went to medical school in Romania, which is a communist country with a lot of oppression and corruption. I studied hard for six years in medical school. To prepare for the end of the medical school exam, the exam who determines who gets into what residency. It essentially determines the rest of your life as a doctor in Romania. But the system was so corrupt to the point that, the day after the exam, I found out that a lot of my medical school colleagues had access to the exam questions and answers in the day prior to the exam. It ended up being a national scandal and the exam was canceled and all the graduates took the residency exam all over again. But by then, I have lost trust in the system, so I had decided to go learn English and leave my home country. It took me two years to prepare.

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How to get your loans forgiven in your own ideal clinic →

My med school was 5k/year. At graduation, I left with 22K of loans. That was 1993. University of Texas Medical Branch at Galveston—still one of the best deals in medical education (current tuition is 24K). During my first two years of family medicine residency on a salary of 30K/year, I paid off my loans. By age 36, I owned my house and was living debt free.

Now med students have 300K loans—or more. One mid-career physician friend has a debtload of 1 million—and growing. With compound interest it takes a lifetime to pay down med school debt. Some never do. I know trainees who have died by suicide next to unpaid med school bills, in essence their suicide note.

How can our doctors care for the most vulnerable and underserved patients when they themselves are so stressed by unmanageable debt? How can doctors live their dreams in medicine when many choose specialties based solely on perceived earning potential? Read more ›

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What NOT to do after a medical error →

If you are a doctor (or med student/health professional) and you are human, you’ve probably made a medical mistake. You’ve probably not received emotional support for the mistake. Maybe you’ve never told anyone about a mistake that still haunts you today. 

The truth is most all physicians have admitted to medical mistakes sometime in their careers. Depending on the patient outcome, many doctors carry the distress of medical errors for months, years, even a lifetime. Some may even develop PTSD.

If you’ve experienced anxiety, depression, guilt, loss of confidence, or were haunted by intrusive thoughts in the aftermath of a medical error, you are normal. In fact, you’ve had second victim syndrome—a real condition that describes the psychological trauma a physician (or health professional) experiences as a result of an error.

I just got off the phone after speaking with a highly-skilled specialist suffering in isolation with grief, shame, and guilt after a recent medical mistake. During our hour long conversation she recalled another mistake from several years prior. I then shared de-identified case studies of other physicians I know (including my own) as examples of what not to do. 

Top 3 ways NOT to respond to a medical error:

1) Do not die by suicide. I know of several physicians who have taken their own lives in the aftermath of making even a minor medical mistake. Do not kill yourself. Please. Call someone. Call me.

2) Do not respond with self-abuse. Do not take the patient’s chart home to punish yourself by obsessing on your mistake over and over again for years to remind yourself that you are not as smart as you think you are (like one doctor I know who did this). Do not allow a mistake to overshadow your years of excellent care.

3) Do not wait decades to share your trauma. One physician broke down in tears in front of me about a medical error she experienced 30 years ago. She then apologized for crying. Then she told me she had not been able to cry in 10 years! 

After a decade helping doctors heal from suicidal thoughts, self-abuse, and isolation from recent and remote medical mistakes, I’ve discovered what actually works. Read more ›

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Suicidal Surgeon: 55 Orthopaedic Surgeon Suicides & How To Prevent #56 →

Since my original keynote 2 years ago: 33 orthopaedic surgeon suicides: How to prevent #34, we’ve lost 22 more orthopaedic surgeon to suicide. On September 10, 2020, at the American Orthopaedic Foot & Ankle Society, I share why each of these 55 doctors died died and how we can prevent future suicides among doctors. Afterwards we had 3.5 hours of Q&A and continued conversation (confidential, not recorded). Need to talk? Contact Dr. Wible here.

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Coronavirus pandemic increasing already high risk of doctor suicide →

Listen to the interview on Oregon Public Broadcasting here.

Rates of suicide for physicians are among the highest for any profession. And the strain of the coronavirus pandemic is making already strenuous working conditions nearly impossible to bear for some and impossible for others. We talk with two Oregon doctors involved in responding to the mental health crisis in medicine and ask what is being done to prevent it. Pamela Wible practices medicine in Eugene and is the author of “Human Rights Violations in Medicine: A-to-Z Action Guide.” Don Girard is professor emeritus at Oregon Health & Science University and chairs the executive committee of the Oregon Wellness Program.

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