Speaker 1: 0:20

Hey, it's Mark and welcome back to another edition of the Employee Survival Guide. I want to address a very important topic today that's captured my attention and should probably capture yours, because it's a very significant issue. The title of the podcast episode is for lack of better phrasing is Physician, mental Health and Hospital Employers. How do I get topics like this to come into my stratosphere? It's because I have cases that I'm dealing with, or dealing with a current one now, involving a physician in a very reputable hospital in the Northeast, and so I put out a previous episode, most recent one of Dr Cunningham and that started me down that rabbit hole. Very powerful episode. I used the AI device to do it to kind of make it clean. I can't really control the subject matter as well as I can by doing it this way with you and talking with you. That's why I chose to do it this way. Generally, I leave the AI device to do cases, legal cases. Specifically Dr Cunningham if you didn't listen to her speech on YouTube, I would ask you to go do that. It's a very powerful speech. It's about 45 minutes long, but it addresses her travels through mental health a very difficult conversation, or at least a discussion she gave at a conference and I encourage you to look at it. But this episode I wanted to do something that addresses the physician in the hospital setting and attack an issue that really no one really wants to talk about, and that issue is the mental health of physicians working in hospitals. This is kind of your synopsis for this episode. Is, you know, working in the grind of? You know, whatever they do, 24-hour shifts, whatever that is, it's insane. I mean I personally couldn't work those hours. And the level that the doctors are pushing themselves, but also the hospital employers are pushing on the physicians to work to the wee hours and 24-hour shifts, I mean I don't know how people are functioning and whether they're getting care. That's even appropriate given how fatigued they are, but nonetheless, that's the topic I'm hitting on. So it's hospital employers and physicians who are highly competent but are being put under an intense amount of pressure, even though they're paid well or even though the hospital systems are dramatically changing and through mergers and acquisitions, that whole atmosphere is changing, but nonetheless, doctors and mental health it's quite a serious issue. I mean, doctors are employees and so hence why I'm talking about it. It's not the first time I've seen this before in clients. So here we go.

Speaker 1: 3:37

If you ever spent time in an emergency room or a surgical unit which I have in both instances you presume your physicians are providing you with the best medical care they can muster. There is this innate sense that the person in the white lab coat is going to take care of whatever is wrong with you, including the nurses. So shout out to the nurses, because they're really the caregivers. But what if the physician himself or herself is overworked, under extreme pressures, experiencing emotional exhaustion, they're sleep, deprived from a 24-hour shift, and are extremely depressed and diagnosed with depression? You may react that you want a different doctor working on you If you knew that they were suffering from these conditions. But you wouldn't know that because HIPAA prevents that disclosure and the doctor is not going to tell you hey, by the way, I'm having a really bad day. But remember, physicians are human beings too and they also experience the same everyday depression and anxiety and other forms of mental illness that we all do from time to time periodic, episodic or situational or chemical disorders.

Speaker 1: 4:56

In 2024, a survey was conducted by the Physicians Foundation, a not-for-profit involving physicians and residents and medical students focusing on well-being. The survey found some pretty alarming data. I think the sample size is 1,700 people and I'm not citing everything from the survey, but I'll put it in the show notes for you as well so you can read it. But here are the notables For the fourth year in a row, 6 in 10 physicians often have feelings of burnout, compared to 4 in 10 before the pandemic in 2018. More than half of physicians and medical students and nearly half of all residents know a physician or colleague or peer respectively, who has ever considered, attempted or died by suicide. That's pretty alarming. 18% of residents, 22% of students and 12% of physicians know a colleague peer who has considered suicide in the last 12 months. Again, that's a pretty high number.

Speaker 1: 6:06

It is well documented that physicians face high rates of burnout, stress, mental health challenges, which can increase the risk of suicide, and the factors that lead to that include a high workload and time pressure by the hospital. Emotional exhaustion, again caused by the hospital. Emotional exhaustion, again caused by the hospital and also the patient care they're dealing with and think like a pandemic outbreak 2019, 20, whatever and you're on the front lines of something and death is surrounding you. That could be an emotional exhaustion, medical errors and fear of litigation so that's lawyers and malpractice cases. Sleep deprivation because the hospital is causing a 24-hour work shift. Impaired relationships because of you're always working Again. Hospitals putting you on those deadline or those time commitments. Access to lethal means Doctors have access to medication that can be lethal. Now the last one reluctance to seek help due to a stigma or fear of professional repercussions. Licensing issues I'll get into that further now.

Speaker 1: 7:22

There's a real stigma amongst physicians for seeking medical health care. According to the same survey from the Physicians Foundation, for the third year in a row, nearly eight in ten physicians agree that there is a stigma surrounding mental health and seeking mental health care among physicians. I mean eight in ten. That's a lot. Approximately half of physicians said they know a physician who said they would not seek mental health care Half that's a big problem. And four in 10 physicians were afraid or knew another physician who was fearful of seeking mental health care. Given questions asked in medical licensure and credentialing insurance applications, I mean because these applications ask have you ever been diagnosed with a mental health ailment? And you have to report that you did or you didn't.

Speaker 1: 8:18

Stigma is an impediment to reporting or seeking health when you're reaching that point, when, as a physician, you're working around the clock and you are just maybe you're self-medicating. You have a substance use disorder, as Dr Cunningham did in her speech that she admitted she had one for her I think it was alcohol. Others I've read up on they've had people who are like anesthesiologists and have access to medications. All doctors have access to medications and you can create these substance use disorders too so that they're self-medicating just to cope with what they're going through. Again, you know, cope with what they're going through as related to work and working in the hospital setting can be very intense and extreme.

Speaker 1: 9:13

And the stigma of reporting because you know the doctors, you know they are, you know they're experts at covering up their emotions from everyone. They have this self-expectant personification that you should be just stoic in terms of your behavior and, god forbid, you suffer from a mental health issue that you don't want to report it. What if you report it? That license can be revoked. I mean the early stories were people were getting their license revoked by the states because of mental health disorders and I just did some research today on the Westlaw legal database and searching old cases and people were in fact their licensing was revoked because of mental health infirmities, I mean severe ones, but I'm not talking about the severe cases where the person is unable to perform their essential functions of their job.

Speaker 1: 10:16

I'm talking about physicians who are highly competent, well-regarded, pedigreed, worked at fine institutions, fellows, research fellows, et cetera, top of their game, and they themselves are reporting to their employers. They're having problems, need a break, and so what do employers do about it? Hospitals are employers, what do they do? How do they react to it? What do employers do about it? Hospitals or employers, what do they do? How do they react to it? So what captured my attention was well, why do employers ask of physicians, with the wake of all this knowledge They've known, the physician suicide issue has been increasing.

Speaker 1: 11:00

We did hear about it through the press during the pandemic. It's not an old thing, it's not something, it's not new to them. I mean, so shouldn't they be? You know, if they're a hospital setting, you know, address the issue. Ironically, they don't. And I have a current case I'm working on where the employer did the exact worst case scenario, worst decision, you know, bundle, or just made a mistake in terms of their decision making.

Speaker 1: 11:35

I'll get to that in a second, without disclosing the case, but I'll disclose the facts, but it's the insanity of that culture of driving these doctors to work this insane hours, shifts, et cetera, under intense pressures, without sleep whatever. Just why does that exist? Is it a profit motive? You're always having the doctor working the floor and around the clock and they're billing, billing, billing. Is that a money greed issue? Why does the culture exist? I went deeper into the rabbit hole on that one and you should know this.

Speaker 1: 12:10

Historically, this is a true story. There's a doctor, uh, I think the midwest, um, we're talking back in the 1930s, etc. Uh, he would uh basically use cocaine just to keep him alert and awake, to work these round-the-clock shifts and then told his students and other residents to do the same just to keep up with. Of where the insanity, culture of the place, of employment, of the hospital and requiring the physicians to work these insane hours and causing them to burn out. But it's part of the culture. They control it. I think it is profit motive. At this juncture, squeeze every dollar, dime, et cetera out of the time that the doctor spends on the floor.

Speaker 1: 13:06

So we're aware of that, we know it exists in our culture. We know hospitals. You know, obviously, if it's an emergency room, you're there to treat people. I've been there. I mean you want them there, but you want them there to be, you know, on their A game and had a good night's sleep, but you want them there to be on their A game and had a good night's sleep.

Speaker 1: 13:29

So what attracted my attention is this is an employer, hospital setting, and somebody is a physician and they're an employee. And physicians are employees just like everyone else. They have employment rights against discrimination based on perceived and real disabilities, including mental health disabilities such as depression, which can lead to suicide. People have suicide ideation, meaning they're thinking about it. Their employers, typically hospitals, are required to treat them fairly in a ndiscriminatory manner. Hospitals are required to provide reasonable accommodations to physicians when physicians reach out to their managers and administrators that they're experiencing burnout, fatigue and mental nervous conditions, including suicidal ideation. Physicians with mental nervous conditions such as depression should not be disregarded. Conditions such as depression should not be disregarded, discriminated against or identified as having quote-unquote baggage. That's a quote from an actual, real, current case.

Speaker 1: 14:33

The administrator, when confronted by the physician, said to the administrator, to the physician, you know, take your baggage elsewhere. I mean literally told her to get another job somewhere else, when the doctor was saying oh shit, I'm having a lot of problems at work and I've reached my breaking point. These are physicians who are you know, they've been educated in psychology to some degree, I imagine in medical school, and they're running this crazy work environment so they must be aware of these issues. I mean, if a suicide happened on hospital time let's say the physician committed suicide while working that would be a lawsuit, a negligence claim by the hospital. It wouldn't be a working cop claim, it would be a lawsuit against the hospital for their own negligence to allow it to happen. So when you refer to somebody as having baggage, well how does that make you feel? Let's say you're the physician and the administrator and supervisor says take your baggage elsewhere, get another job and then I'll layer it on for you.

Speaker 1: 16:24

The the hospital, a prominent East Coast teaching hospital, well-regarded and a well-regarded faculty member, identified herself as having a mental nervous condition and needed a reasonable accommodation in the form of less work and a different schedule. I did some research today. That was a very common accommodation that was asked for by physicians in the same circumstance in other reported legal cases, which I'll get to in a second. So less work and a different schedule to allow them to what have a better work-life balance, because they're just like us. I mean, everybody wants a better work-life balance. You can't work all the time, it's insane. But yet that's what attracted my attention to the hospital setting, that culture and the demands put upon physicians to do that. So the administrator did not renew the physician's contract in this example I'm speaking of. So told the person you know, take care of your baggage and do it elsewhere and go get another job somewhere else and didn't renew the contract. And this person was on contract and been affiliated for quite some time. So obviously there's a discrimination case there.

Speaker 1: 17:37

The quote baggage comment is what we call direct evidence made by a supervisor. Pretty hard to escape it. It'll get to a jury trial on that basis alone. The failure to accommodate aspect because the doctor was asking for accommodations that too, you know, gets it to a jury. You don't want to. What is a jury? If you're in a jury, you heard this type of dialogue happening when somebody's pleading, when they're at the.

Speaker 1: 18:03

You know the breaking point, the bottom you know. When they refer to people as having their lowest point, they're bottoming out. What happens when you commit suicide. Well, you bottom out. And when you're contemplating or having suicidal ideation which is the DSM-5 psychiatry book on how you label something you're bottoming out. You're bottoming out. You know any rational, sane person is going to say whoa, let's sit down. What do you need? Express compassion, empathy, do all the normal things to take care of, like if you were taking care of a family member. But that didn't happen here and that's a very common experience that physicians are experiencing. So think about when I said stigma.

Speaker 1: 18:54

If they report this worst case scenario I just described it, they get shickhand and their contract doesn't get renewed. Is that the type of help that the physician who is having suicidal ideation is expecting to hear? And that's the last thing they ever wanted to hear. But that happened. So it attracted my attention to address the issue. The elephant in the room these big employer hospitals pushing these physicians into the brink of despair for their greed I don't know, it's corporate money at this juncture, the physicians, the supervisors, the administrators are paid a lot of money, but it's part of a large corporate environment now, but yet they're still pushing these physicians to. They're breaking their backs mentally and this is how they react to it and they say go elsewhere because you've got baggage, for Christ's sake. I mean, everybody has baggage, so that's a real example. I wanted to weave into the episode and attack the issue, because this is not how you handle the issue.

Speaker 1: 20:04

Physician suicide is real and it is increasing, as evidence of the 2024 Physician Foundation survey. It's not going away. There have been numerous stories in the press of physician suicides that are just shocking. These are highly functioning, well-regarded members of the medical profession who suffer in silence Again, think about that stigma and they do not seek assistance and eventually, as you see the data from the survey, they take their own lives. Here's one example. It occurred in the New York Times back in 2020.

Speaker 1: 20:44

Dr Lorna Bream, age 49, the former medical director of the emergency department at New York Presbyterian Allen Hospital, died by suicide in 2020. Dr Breen did not have a history of mental illness but who had worked in the frontline trenches of the COVID-19 outbreak in New York City and witnessed many COVID-related deaths. Her colleagues were shocked about her death. Colleagues were shocked about her death. Dr Cunningham, in the prior episode of the podcast you can hear about. I guess you would call her a success story that she survived it, and even the applause at the end of the speech, the standing ovation she received. She started a speech saying I'm going to interrupt in, tragically, my career by giving this speech, but she was well received in terms of her being transparent and vulnerable in expressing what happened to her and, by the way, she was motivated by a good, dear friend of hers who was younger, also a physician, who did in fact commit suicide, and she does actually call that out in the speech. Again, listen to the speech. It's very heartfelt.

Speaker 1: 22:06

So I went deeper into the rabbit hole in this issue and I began looking for cases against hospitals brought by physicians who had mental illness, and I didn't find much. I had to search very, very hard to locate what I did find. I'll give you examples of them I wanted to bring out. Is there a pattern or theme and then talk about what should be done in each circumstance? Pattern or theme and then talk about what should be done in each circumstance, because there should be something done to take care of physicians before it ever reaches the point where they're brink and they're bottoming out. Hospitals should do something too, and they are. I'm not saying that they're not. But let me get into one of these cases.

Speaker 1: 22:56

John Lindsay sued OSF Healthcare Systems in the Southern District of Illinois, I think. This lawsuit was filed July 3rd 2019 against his employer alleging disability discrimination for his mental health disabilities under the Americans Disabilities Act. Dr Lindsay was diagnosed with depression and anxiety and made his employer aware of his disabilities. He requested accommodations, including adjustments to his patient's schedule Remember I told you that was a pattern. He also asked for a medical assistant to be assigned, but the employer never engaged in any conversation about the accommodations being requested. That's called a failure to engage in the interactive process. That's a big blunder on the employer's part. The failure of the accommodations requested exacerbated Dr Lindsay's symptoms. However, the employer terminated his employment, citing alleged performance issues happening many years earlier. That's again another pattern of nonsense crap that employers do. They go back in time, which is basically worthless, because in this case, dr Lindsay, his performance was always rated satisfactory. That's an admission by an employer, by the way, you've heard me say that before, including the patient treatment. So all things were good, satisfactory in terms of the performance. So the employer really didn't have a defense.

Speaker 1: 24:17

I deep dive even further into the docket, as you know, I do because I was curious and the case was reported settled July 25th 2019. That was less than a month after it was filed. Why do you think that is? I read the complaint. First count was about a breach of contract, about what a breach of contract is, and then the second count was a violation of the ADA, and I read through it. It wasn't my style of writing on complaint. It was more I don't know formulaic lawyers, but kind of boring. There was no pizzazz and drama to it, but the mere fact that the case settled less than a month after it was filed. It was removed, meaning it was in state court first for a period of time. I didn't check the actual date, but it only survived in federal court for less than a month. It means the employer settled the case, did not want that, you know whatever that storyline to get out further about.

Speaker 1: 25:14

Osf healthcare systems was concerned about their reputation, I'm sure. But here there was Dr Lindsay who said I need an accommodation, I have a disability or disabilities plural. And what did the employer do? The employer didn't do anything and fired him. That was like the worst thing you should do, and so maybe there was a decision there for the. They'll just get rid of this bad egg, fire him and then settle it, and then maybe that's what they decided to do. We don't know the amount these cases are and the settlements are confidential, so we don't know.

Speaker 1: 25:44

So, doctor having a disability depression, you know, coming to his brink of his bottom, he's bottoming out and he's asking for accommodations and they didn't give it to him and his symptoms get exacerbated. And you know what happens. You know, there's the doctor in the white lab coat but he's having problems and taking care of patients, but the patients he's taking care of them. So he's still operating, he's still functioning at a very high level and patients are being taken care of, but he himself is suffering and the employee didn't do shit to handle that. That's the point. They work them in this crazy cultural environments of the hospital and they don't take care of the very people who are making them money. Physicians, they're bread and butter. I actually would say the nurses are bread and butter, but we all know. But it's a small little tidbit example.

Speaker 1: 26:38

I had to search for that. It was very hard to find that case. Here's another case I found Dr Mark Ryden versus Essentia Health. This case, out of Minnesota, alleges his employer knew about his worsening depression but did not provide any reasonable accommodation and wrongfully terminated him because of his mental illness. Dr Ryan allegedly proposed a reasonable accommodation plan to catch up on backlog work that he had missed, but his accommodations were denied. Again a similar pattern accommodations being denied. The Minnesota's Department of Human Rights found probable cause for disability, discrimination in that case and a failure to accommodate and also retaliation.

Speaker 1: 27:21

I deep dive further. I was, you know that was at the state agency level. So I said well, let's see if there's a state or a federal court filing here so I can read the facts in the complaint and give you more facts. I researched the federal and state courts and found no further litigation as the case was never publicly filed in a court and most likely it's settled. I had found that case by some I don't know hospital reporting type of newsletter or whatever reporting type of newsletter or whatever, but regardless, hard to find cases like what I was speaking about, much like the physician who was told to take her baggage elsewhere. And what does that mean? It means that you know, if doctors are having a fear of a stigma being attached to them of mental illness, they're not going to report. So it's not surprising that I'm not finding legal cases out there that are being reported in federal and state courts. It doesn't mean the issue doesn't exist. It's just that there's a stigma and there's a fear of reporting. So I did find two cases at least.

Speaker 1: 28:29

Again, it was very specific. I was looking for a hospital setting physicians with mental health conditions, accommodations, termination, that type of thing but no cases I found talked about the rigorous 24-hour schedules. These doctors are working under sleep deprivation. Nothing really addressing that issue. So what I'm doing is trying to bring to light this is a very real concern in the hospital setting, the very place that when I recently went there for an issue I had, you want people to take care of you. You expect the 100% care and doctors and nurses say they're going to give it to you. But if the doctor is having concerns because of being overworked, that's concerning. Are you going to give me that care? Do you have to work those doctors that much?

Speaker 1: 29:19

I mean the physician suicide issue is really, I guess, the end point of the decisions being made by the business, the hospital, to make money to the nth degree by causing people to feel like you know, burnout. There's no escape other than committing suicide. I mean that's the insanity, what I'm trying to poke at with like a big long stick Well short in this instance because I'm inviting the hospitals to react to it, if they can, inviting people to react to it because it's a big issue that no one really talks about. It's the employment setting. It's like the I guess it's probably the worst case scenario setting where you're a physician, you're highly competent I mean, you have like Ivy League degrees behind you and you are well accomplished and you know you're facing this and you have no choice other than reaching out to like an employment lawyer or a psychologist or your psychiatrist to cope and deal with this issue. Because, clearly, in the instance of the baggage comment, the hospital is not addressing your issue. They don't care. I mean, it's as just basic as that. They do not care, they turn the blind eye to your personal situation and that's why I'm trying to call attention to it. What should the employer really do when faced with someone who's expressing a mental nervous condition scenario, burnout, wanting accommodations? Here's what the solution is. It's actually silly, stupid, because you would think that employers would do this. Hospitals would do this.

Speaker 1: 30:58

If a doctor is asking for a reduction in the workload, reduce the workload for a period of time. Have a conversation. First, engage in the interactive process, have a discussion, document things, explore things, brainstorm something. This is your person who's making you money, the physician and you want to make sure that your physician is well taken care of physically, physical health, mental health, physically, physical health, mental health. So if someone, a physician, asks for accommodations, you know if I was the administrator I'd be saying, well, what do you need, how can we accommodate you? And let's take care of this? And you know what do you need and try to do everything you can to avoid the issue of stigma that the person, the physician, already has in inside of them the fear of disclosure.

Speaker 1: 31:49

But once they do disclose, you know already has an insight of the fear of disclosure. But once they do disclose, you know it's probably really bad. If you're from the administrator's standpoint, this person's suffering and you want to take care of this person very carefully because they're very fragile. You know they're a physician, white lab coat. Think about that again. By the way, this is affecting more female physicians than male physicians, because there's another variable point of this is that potentially female physicians are struggling even to keep up with their male counterparts in our today's society, you know, because of gender bias, and so they're going to try even harder. But they're also going to have more fear fear of disclosure.

Speaker 1: 32:33

So when they do disclose, hospital administrator, you got to be a real leader to take care of that moment, to take care of that employee you have, and just map out a game plan to get that person the right care. Put aside the issues of money that you're going to lose while the person takes an absence. They're an employee, they've come to you, they have a problem. So it's very simple you provide reasonable accommodations by having an interactive discussion. You document everything, but you're doing it in a way to make it successful for the employee to survive and continue working, not to fire them. That seems to be the default mechanism that all employers, even hospitals, use, and I gave you two examples. They just default screw it, you're out of here. You got baggage, we don't want you, you're less than human. We burned you out. Next, please, because there's always a next. They believe these are highly paid people. They're paid $300,000, $400,000, $500,000 a year. They're making the hospitals exponential amounts of that.

Speaker 1: 33:43

So it's a weird scenario, culture-wise, that these institutions and there are institutions, by the way and they are making a ton of money off the backs of physicians and no one, no one is out there proclaiming that these people are victims of discrimination. Until now, until I'm doing it, you know you may read about Dr Bream in the New York Times and feel sorry, and I am. I feel sorry for what. I don't know enough about what happened to her. Dr Cunningham, we know what happened to her because she told us. She's telling us in her speech. But something real is happening in these institutions that needs to be corrected. That needs to be corrected.

Speaker 1: 34:28

The culture of physicians working has got to change and maybe this discussion leads and I'm having through this podcast episode leads somewhere. These are real people. They're employees. They're working Under extreme circumstances. Yes, they agreed to go to medical school and they knew all this was coming. But listen, you don't take a profession like to go into it to eventually commit suicide. That's not what they're intending. But the environment they're working in is very stressful. We get that You're taking care of people who are sick, but you would imagine there is even more of a compulsion by the employer to do the right thing and provide the right cultural environment to take care of people when they self-report, and that's what physicians do after they get past the stigma, fear, issue of disclosing that they have a mental illness. So it attracted my attention. I wanted to bring it to your attention and it's not going to be the last one I'm going to do, because it's a very serious issue. It's very systemic, obviously happening in every hospital in the country, I imagine, and few doctors are going to want to call out. But maybe we give them ammunition and the courage to call out and saying you know what damn it.

Speaker 1: 35:49

The state and federal laws do favor me here. There's a requirement, and if I lose my job over this, at least I'll save my life. And you know what comes first life or your job? Well, obviously life. And some doctors, you know they do make the right choice, choice even though they're going to give up faculty progression because they were, their contract wasn't renewed. They turn to lesser stress situations. That maybe and they work in lesser stress situations that takes off the pressure of feeling like they're going to end their life by suicide. So life is first, job is second.

Speaker 1: 36:34

So the law is there to protect physicians who are experiencing depression and the laws are state and federal. The American Disability Act is there. If you're at a teaching institution like Yale. There is the Rehabilitation Act if you're receiving federal monies, which they do in other institutions as well, and the Rehabilitation Act and the ADA function very similarly. I've read a case recently where there's Title III of the Rehab Act or the ADA applied to the physician in that circumstance A very unusual case to read that Usually it's Title I employment, but these hospital systems are now very complex. There's individual practices which have access privileges to these hospitals. It's a very complex world environment that they're all working in, but yet still there's an employer environment that they're all working in, but yet still there's an employer there that has to follow the law. And even though it's complex doesn't mean the law doesn't get applied. And so here the very simplicity of this is that reasonable accommodations affect everybody when they're made and employers have to respond to them, and they have to respond to them in the same manner. It doesn't matter if it's a hospital setting or a private business. So we need to prevent I guess bottom line here is doctors from working in environments that produce that outcome of physicians feeling that there's no way out and they have to just commit suicide as a way out. So it's a game changer and calling attention to it.

Speaker 1: 38:12

And I have to remark on something that really bothered me about this storyline, and it was this fact, this not a fact, but necessarily this momentum thing that happened. There was a call to action for mental health in the sports arena, setting gymnasts, olympians and tennis players, and it came to light and then it just faded away. Well, guess what happens? Dr Cunningham says this. She says in her speech there's no number of Peloton rides that will take care and solve my problem of depression. It's a disease and it's never going away. The point being it's never going away. So this awareness of mental health and kind of social media attention to it and the news, it's never going away.

Speaker 1: 39:04

But what bothered me is that I knew when that thing came out, that momentum of call into action, of taking awareness of people with mental illness, it was short-lived because our society is 15 minutes and that's it. That's all attention we give to something we move on surgical, whatever you know you're wanting to know I'm being taken care of by the best there and that employer hospital is taking care of those physicians in the white lab coats and you want to rely upon that. And if you knew that they weren't, you'd be really pissed and guess what folks? It's really happening and those physicians as we now know by the Physicians Foundation survey, this is a very big issue happening and physicians are under tremendous amount of strain and they are thinking about suicide. I guess that's the point and takeaway of this and we need to stop it. And stopping it is telling employers they need to change the dynamic of that work situation permanently for a new situation that physicians can work in and not feel that they have to bottom out, and employers who should react in a more compassionate manner. I guess that's the final end point.

Speaker 1: 40:27

Again, I'll do another episode at a later point on the same subject matter, but I hope you enjoyed this subject. It's rather intense, rather scary, but it's real and it's happening, and it's happening today to physicians and so they're great people. They take care of us. We want to try to take care of them. Have a great week.