Preventing physician suicide. The role of family, colleagues, and organized medicine.

Psychological barriers in the minds of the failing physician, his family, and colleagues may thwart prevention of physician-suicide. The failing physician may be shunned by colleagues for his disturbed behavior. He denies illness, resorts to self-medication, and avoids treatment. Recognition and rational handling of this presuicidal state may be hindered by the need of the doctor, family, and colleagues to preserve a fantasy of the doctor's omnipotence. Treatment also may be impeded by the failing physician's reluctance to form a therapeutic relationship with the treating psychiatrist. The psychiatrist must help his doctor-patient to determine if he should continue practicing. The key to successful intervention may depend solely on our awareness and handling of these problems.