Running Out of Gas: What Physician Suicide Is Telling Us
Rebecca Margolis DO FAOCA, Norah Janosy MD, Myron Yaster MD, and Patrick Ross MD
September is Suicide Prevention Awareness Month—a time to raise awareness, promote hope, and normalize help-seeking. Suicide affects millions of people every year, yet too many struggle in silence. In today’s PAAD we are reposting and updating a PAAD that was first posted on October 15, 2024. Myron Yaster MD
Will West, MD, was a 33-year-old ophthalmology resident at George Washington University. His death by suicide shook his colleagues and family, not only for the loss itself, but for the stark warning he left behind. In his final letter, Dr. West urged those in authority “to understand, support, and mentor residents rather than simply to assess and drive them.” His words echo a broader truth: physicians at every stage of training and practice are quietly fighting life-and-death battles with mental health.
Despite decades of awareness campaigns, physician suicide remains a devastating reality. Studies estimate that the profession loses the equivalent of an entire medical school class each year to suicide. Female physicians die by suicide at rates more than double those of women in the general population, while male physicians’ rates are also significantly elevated. For anesthesiologists the risk is even higher.
Barriers That Keep Physicians From Seeking Care
The JAMA Special Communication Reducing Barriers to Mental Health Care for Physicians highlights why, despite effective treatments for depression, anxiety, and suicidal ideation, less than one-third of physicians with mental health conditions seek care. Several interlocking barriers persist:
Cultural expectations of stoicism: Medical culture prizes endurance and self-sacrifice, reinforcing the belief that distress is a personal weakness rather than a human response to extraordinary demands. Many physicians, like Dr. West, feel compelled to mask symptoms that may otherwise be misinterpreted as laziness or incompetence.
Stigma and fear of professional consequences: More than half of medical students and residents cite fear of stigma and confidentiality concerns as reasons for avoiding care. Many worry that seeking therapy will appear on licensing or credentialing applications, damaging careers before they begin.
Logistical challenges: Rigid schedules, lack of time, and the need for confidentiality often drive physicians to seek care outside their networks — if they seek it at all. Some even choose to pay out of pocket to avoid leaving an insurance record.
Misdiagnosis as “just burnout”: Burnout and depression overlap but are distinct. Burnout predicts medical errors, while depression predicts suicidal ideation. When physicians misattribute major depression to burnout, they may forgo treatment that could save their lives.
Evidence-Informed Paths Forward
There are solutions, and they are both urgent and actionable:
Normalize help-seeking: Senior physicians sharing their own mental health journeys can reduce stigma. Programs like the Emotional PPE Project and peer support networks break isolation by showing that seeking care and being an excellent physician are not mutually exclusive.
Policy reform: Removing intrusive mental health questions from licensure and credentialing applications has already begun to change the landscape, thanks to advocacy by groups like the Dr. Lorna Breen Heroes’ Foundation.
Confidential, accessible care: Anonymous screening programs, confidential counseling, and opt-out check-ins with mental health professionals during training can proactively connect physicians with support.
System-level accountability: Accrediting bodies like the ACGME and the Joint Commission can enforce protected time and resources for mental health, ensuring institutions move beyond performative wellness initiatives.
The Call to Action
Dr. West’s letter was not just a goodbye; it was a plea for change. He reminded us that among us are residents and physicians “fighting a true life and death battle” invisible to those around them. His story, like too many others, underscores that physician suicide is not about individual weakness — it is about systemic failures to provide accessible, stigma-free care.
Each of us has a role. As colleagues, we can ask, “Are you okay?” — and mean it. As leaders, we can ensure policies protect rather than punish. And as a profession, we can reject the culture of silence and replace it with one of compassion.
We owe it to Will West, and to every physician silently struggling, to build a system where seeking help is not an act of bravery but an expectation of care.
Wondering what you can do today? As an individual you can start by asking someone who seems a little off if they are okay — and truly listen to the answer. Learn about the resources available at your institution. The ASA has an excellent resource guide, and the SPA offers a practical one-pager to help you start the conversation. We must also acknowledge that physician suicide, particularly among anesthesiologists, is massively underreported. Only by supporting initiatives like the Anesthesiologist Suicide Reporting Database can we better understand these tragedies and learn how to prevent them. And remember immediate help is always available through the 988 Suicide & Crisis Lifeline. As a group, you can consider using the month of September as an opportunity to host a talk about suicide risk and the factors associated with it. Creating a space where physicians feel safe to discuss this topic may normalize seeking help. Together, we can reduce stigma, support one another, and help prevent suicide.
References:
1. Portnov J. A young doctor’s final words offer a mental health warning for others. The Washington Post. 2024 10/05/2024.
2. Saddawi-Konefka D, Moutier CY, Ehrenfeld JM. Reducing barriers to mental health care for physicians: an overview and strategic recommendations. JAMA. Published online August 14, 2025. doi:10.1001/jama.2025.12587
3. Mata DA, Ramos MA, Bansal N, et al. Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis. Jama 2015; 314(22): 2373-83.
4. Gold KJ, Schwenk TL, Sen A. Physician Suicide in the United States: Updated Estimates from the National Violent Death Reporting System. Psychol Health Med 2022; 27(7): 1563-75.
5. Dutheil F, Aubert C, Pereira B, et al. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PloS one 2019; 14(12): e0226361.
A comment from Patrick Ross
As a person who has had suicidal ideation, I want to point out that for many who consider taking their lives, they don’t want to die but they just want the pain to stop. As physicians who are charged with alleviating pain and suffering, one would hope that stigma shouldn’t prevent these people from seeking help if they need it; but it does. Stigma also prevents people from speaking up about their own experiences. I have found tremendous benefits from therapy and have not worried about the impact that statement has on my career. I am fortunate that is the case. As policies and opinions change I hope we reach a point where sharing this information is more common or normalized. I think it is important for our trainees to understand that people who suffer from anxiety and suicidal ideation can look like them or like myself and seeking help is encouraged.