Globally, one in four cardiologists have experienced any self-reported mental health condition (MHC), yet most affected cardiologists do not report or seek help, according to results of an ACC survey published Dec. 28 in JACC.

Garima Sharma, MBBS, FACC, member of ACC's Women in Cardiology Section Leadership Council and governor of ACC’s Maryland Chapter, et al., conducted an online, anonymous survey in 2019 to assess the global prevalence and variations in MHCs among cardiologists worldwide, the predictors and protectors of MHCs, and the influence of MHCs on professional satisfaction. Overall, 5,890 cardiologists (77.4% men and 22.6% women) from Africa, Asia, Eastern Europe, European Union, Middle East, Oceania, and South, Central and North America responded to the survey.

Results showed that more than one-fourth of cardiologists experienced self-reported MHC, including psychological distress or other psychiatric disorder. Additionally, significant predictors of MHC included experiencing emotional harassment (OR: 2.81; 95% CI: 2.46-3.20), discrimination (OR: 1.85; 95% CI: 1.61-2.12), being divorced (OR: 1.85; 95% CI: 1.27-2.36), and age <55 years (OR: 1.43; 95% CI: 1.24-1.66).

Of cardiologists reporting MHCs, 42.3% felt dissatisfied in at least one professional metric including feeling valued, treated fairly at work, and adequate compensation. Women were more likely to consider suicide within the past 12 months compared to men (3.8% vs. 2.3%) but were more likely to seek out help (42.3% vs. 31.1%) (all p<0.001). 

The authors note that their study “identifies significant differences in MHCs among cardiologists based on age, gender, career status, and geographic location and its association with working in a hostile work environment and with professional work life.” They conclude that dedicated efforts should be put in place to reduce the fear of reporting and creating a safer, more inclusive environment for those with MCHs at an organizational level.

“These data are important to toughen the conversation around improving the workplace culture and climate, so that those who are suffering from these debilitating chronic conditions are able to provide care to their patients and care for themselves,” adds Sharma.

In an accompanying editorial comment, Andrew J. Sauer, MD, notes that “we have fostered a culture of silent suffering. And although we know we need to better attend to our multiplicity of needs, we find ourselves immersed in dedication to our patients…” Moving forward, he suggests that we need to put focus on promoting leaders who strive to advance diversity, equity and inclusion, eliminate the stigmatization of mental illness by allowing time to attend necessary therapy, and provide mentorship programs to assist with transitions to cultivate a culture that supports doctors and patients.

This is the third study based on data from ACC’s survey led by ACC’s Women in Cardiology Section and Diversity and Inclusion Leadership Council. The first study found discrimination, emotional harassment and sexual harassment contribute to a high global prevalence of a hostile work environment in cardiology, and women and cardiologists early in their career are most likely to experience a hostile work environment. The second study found there are significant regional and gender differences in policies, leave duration and satisfaction levels of paid parental leave policies among cardiologists worldwide. The study authors included several College leaders: Garima Sharma, MBBS, FACC; Laxmi S. Mehta, MD, FACC; Shiavax J. Rao; Pamela S. Douglas, MD, MACC; Dipti Itchhaporia, MD, MACC; Malissa J. Wood, MD, FACC; Khurram Nasir, MBBS, FACC; Roger S. Blumenthal, MD, FACC; Athena Poppas, MD, MACC; Jeffrey T. Kuvin, MD, FACC; Andrew P. Miller, MD, FACC; Roxana Mehran, MD, FACC; C. Michael Valentine, MD, MACC; and Richard F. Summers, MD. Learn more about ACC’s Diversity and Inclusion initiative and access resources on ACC’s Clinician Well-Being Portal.

Clinical Topics: Cardiovascular Care Team

Keywords: Personal Satisfaction, Workplace, Suicide, Cardiology, Fear, Anniversaries and Special Events, Maryland, Leadership, Mentors, Divorce, Stereotyping, Prevalence, Cardiologists, Middle Aged, ACC International, Cultural Diversity

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