Protecting the Protectors:
Depression, Medical Professionals, and the Conflicts Involved with Under-reporting

Today we’re taking a closer look at how depression can affect doctors and dentists, their practices, and the way they file for disability insurance. We examine how the medical community’s approach toward mental health is perhaps preventing some doctors from reporting illness, and how this changes a doctor’s ability to obtain adequate treatment and secure disability insurance benefits.

Depression and anxiety are undeniably prevalent among physicians and dentists.  For instance, a study in Australia showed that the rates of depression in doctors is four times higher than the general population and in a British study, 60% of dentists surveyed reported being anxious, tense, or depressed.

Simply looking at the daily life of doctors, and comparing that to the risk factors for depression shows some striking connections between the two. Some of the risk factors associated with depression (as outlined by the Mayo Clinic) include being overly self-critical, having serious or chronic illness and dealing with traumatic or stressful events. Interestingly, these are many things that doctors and dentists struggle with; indeed, probably more often than the average person. Doctors and dentists have to be self-critical because if they aren’t, lives could be at stake. In addition, doctors and dentists often suffer from chronic illness and pain due to the physically and emotionally taxing nature of their work. Worrying about patients, running a practice, and working long hours are all part of the job description for the average doctor.

While physicians and dentists commonly have symptoms of depression, they often don’t report their issues due to the stigma of mental health issues within the medical community. Lay people look to doctors and dentists as the paragon of health, and physicians take the same approach: while their patients are characterized by their illness, physicians are supposed to be the ones who cure them. While the general populace’s approach to mental illness has improved greatly over time (we no longer lock people in tiny jail cells simply because they are mentally ill), the negative stigma attached to depression and anxiety in the medical and dental community is still present. In the Australian study noted above, half of the respondents reported thinking that they were less likely to be appointed to a new position if they had a history of mental illness, and 40% admitted thinking less of doctors that have a history of depression or anxiety.

Nevertheless, it is important for doctors to recognize whether they exhibit signs of mental illness. Aside from needing to be mindful of their own health and well-being, doctors are responsible for the health and well-being of their patients, too.  Physicians and dentists both are in the unique position that a mistake that they make at work could endanger a life. Attempting to work through depression and anxiety symptoms that impair the doctor’s ability to provide responsible patient care could lead to a malpractice suit. Perhaps the solution to this issue is a re-evaluation of the medical community’s approach to mental illness. While that seems like a large task to take on, it starts with each individual doctor either seeking treatment for mental health, or supporting those that do.

For physicians, states have programs in place called Physician Health Programs (PHPs) that are supposed to support the health, including mental health, of medical licensees. A PHP is advertised as a way to get the help one needs, while avoiding disciplinary action such as a loss of license. Physicians should be aware, however, that PHPs are often connected to the licensing boards, and non-compliance with the PHP can lead to disciplinary action. For example, in Arizona, while the PHP is operated by an independent agency, it does have a formal contractual relationship with the state licensing board.

Even if a doctor does seek treatment, he or she may be unable to work for at least some period time due to the functional limitations that depression and anxiety can cause. In these instances, it may become difficult for the doctor to make ends meet, especially in an economy like this. That’s where disability insurance comes into play; benefits are meant to provide the economic peace of mind that allows a doctor or dentist to get the treatment he or she needs, without having to put patients at risk or falling behind on financial obligations.

While many doctors and dentists have disability insurance, collecting benefits can be extremely difficult, especially when trying to file for benefits based on mental illness.  Part of the issue is that it is difficult to objectively prove mental illness, and insurers can use this as a way to deny someone’s claim. For example, major depressive disorder is characterized by depressive episodes that include at least two weeks of depressed mood or loss of interest as well as four additional symptoms of depression. These symptoms can include slowing of body movements, slowed speech, poor concentration, and loss of self-esteem. Symptoms like these can’t be proven by objective testing, but are instead typically self-reported. In the absence of objective test results, insurance companies often allege that a doctor isn’t truly suffering from the claimed condition, or that the condition doesn’t actually impair the doctor’s functionality to the extent he or she claims.

Nevertheless, it is important for doctors and dentists to consult with a psychologist, psychiatrist, or other mental health counselor if they start showing signs of depression or anxiety. Having careful documentation and medical records that substantiates a mental health diagnosis and the impairment it causes is essential, not only for effective treatment but for substantiating a disability claim if one becomes necessary.

If you’re a physician or dentist experiencing symptoms of depression or anxiety, we encourage you to contact a treatment provider right away.  If you are wondering what to do about filing a disability claim based on your mental illness, feel free to contact us.

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