Samkoff J S, Hockenberry S, Simon L J, Jones R L
Keystone Peer Review Organization, Inc., Pennsylvania Medical Society, Harrisburg, PA 17105.
Acad Med. 1995 Mar;70(3):242-4. doi: 10.1097/00001888-199503000-00018.
The obituary section of most issues of JAMA announces the death of at least one physician under the age of 40 years. The premature death of a physician is a significant loss to society.
The authors ascertained the mortality of physicians ages 25 to 39 years occurring from January 1, 1980, through December 31, 1988, from obituary listings in JAMA, and calculated mortality rates by gender and age. Death certificates were sought for all decedents listed as residing in California, Illinois, and Pennsylvania. Cause of death was investigated for this subset.
There were 835 young-physician fatalities reported in JAMA during the study period, (an average of 93 deaths per year). The mortality rate among female doctors was 26/100,000; among male doctors it was 40/100,000. The mortality rate of young doctors was less than half that of the general population of white persons of the same age. Of the 122 deaths for which a death certificate was located, 45 (37%) were due to disease, 32 were suicides (26%), 31 were unintentional injuries (25%), and five (4%) were homicides.
Young physicians enjoy a considerable mortality advantage over non-physicians of similar age. If the study findings in the death certificate sample are generalizable, at least half of the deaths of young physicians are theoretically preventable (suicides, homicides, and unintentional injuries). Residency program directors should consider how their training programs may affect the likelihood of a young physician's dying from a preventable cause.
《美国医学会杂志》(JAMA)大多数期次的讣告栏都会公布至少一位40岁以下医生的死亡消息。医生过早离世对社会来说是重大损失。
作者通过查阅1980年1月1日至1988年12月31日期间JAMA上的讣告列表,确定了年龄在25至39岁之间的医生的死亡率,并按性别和年龄计算了死亡率。对于所有登记居住在加利福尼亚州、伊利诺伊州和宾夕法尼亚州的死者,均索取了死亡证明。对这一子集的死因进行了调查。
在研究期间,JAMA共报道了835例年轻医生死亡(平均每年93例死亡)。女医生的死亡率为26/10万;男医生的死亡率为40/10万。年轻医生的死亡率不到同年龄白人普通人群死亡率的一半。在找到死亡证明的122例死亡中,45例(37%)死于疾病,32例(26%)为自杀,31例(25%)为意外伤害,5例(4%)为他杀。
与年龄相仿的非医生人群相比,年轻医生的死亡率有显著优势。如果死亡证明样本中的研究结果具有普遍性,那么理论上至少一半年轻医生的死亡是可以预防的(自杀、他杀和意外伤害)。住院医师培训项目主任应考虑其培训项目可能如何影响年轻医生死于可预防原因的可能性。