“Doctors take an oath to save lives but are taking their own at an alarming rate, trapped in a toxic healthcare system that puts their lives and their patient’s lives at risk in an epidemic that’s been covered up for decades—until now.” Do No Harm Press Release

“Clinician well-being is essential for safe, high-quality patient care. However, clinicians of all kinds, across all specialties and care settings, are experiencing alarming rates of burnout. Among the most telling of statistics, more than 50 percent of U.S. physicians report significant symptoms… [including] emotional exhaustion and depersonalization (i.e., cynicism), and a low sense of personal accomplishment at work.” National Academy of Medicine Action Collaboration on Clinician Wellbeing and Resilience

Do No Harm, the new film by PBS producer Robyn Snyder, has its finger on the pulse of healthcare in the United States. It portrays the growing concern around physician, medical student, and healthcare worker burnout, depression, and suicide, echoing the very same concerns expressed by the National Academy of Medicine (NAM) in their recent initiatives. The statistics outlined by the NAM are alarming: four hundred physicians die by suicide each year (twice the national average), physicians have a 50% burnout rate and a 39% rate of depression, and nurses have a 23-31% rate of emotional exhaustion and a 24 % rate of PTSD (National Academy of Medicine, 2019).

Do No Harm puts a personal face on these numbers. It follows the stories of Kevin Dietl and Hawkins Mecham, two medical students who both made suicide attempts. Kevin died from the attempt, but Hawkins survived. The film interviews John and Michael Dietl, Kevin’s parents, and eventually puts Hawkins’ and Kevin’s parents together for a discussion of the emotional impact of the epidemic of healthcare suicides. The film also follows Pamela Wibble, M.D., whose suicidal ideation drove her to become an activist for systematic reforms around these issues. Combined with personal stories, the film interviews a range of scholars, clinicians, investigative reporters, and medical school and hospital administrators. The key concerns that the film uncovers include high levels of stress, overwork, sleep deprivation, economic and workload exploitation, bullying, lack of support, and a “no excuses” environment around mistakes. Plus, if this is not enough, the film goes to considerable links to bring out the problem of medical error—now estimated to be the third leading cause of death in the US behind heart disease and cancer—and the likelihood that medical error is increased by this kind of systematic stress and the impact it has on healthcare workers (Makaray and Michael, 2016).

Not interviewed in the film are representatives of the health humanities and cultural studies community, some of whom might have helped put this latest symptom of the larger healthcare crisis into perspective. The most commonly cited symptoms of the healthcare crisis include healthcare cost inflation and lack of quality access. Do No Harm and NAM’s recent initiatives make it clear that a new symptom is healthcare worker burnout, depression and suicide at distressing rates. Health humanities and cultural studies help articulate all these symptoms as part of a larger overemphasis on biological aspects of health at the expense of psychological, social, political (discriminations across race, gender, sexuality, class, age, ability), and spiritual values (Lewis 2011). Although there were meaningful reform movements in the 1970’s towards a more biopsychosocial, humanistic, and gender balance, much of this has been swept away by the aggressive re-biomedicalization of healthcare as an engine of economic profiteering (Clarke 2014, Dumit 2012). We now suffer from the many symptoms of a healthcare system out of equilibrium. These symptoms are bad for our health—not only in terms of patients but also in terms of the healthcare workers themselves.

Do No Harm and the National Academy of Medicine give considerable attention to symptom relief through building medical worker resilience, wellbeing, and by reducing systemic stress—such as on-call time and medical school course loads. All of these moves are urgently called for. At the same time, larger healthcare reforms towards greater psychosocial and humanistic balance are also clearly needed now more than ever. Do No Harm producers have made available one-hour versions of the film to be shown as teaching tools in hospitals and medical schools. The film and the shortened teaching versions are excellent ways to open dialogue and constructive problem-solving around this latest symptom of the healthcare crisis. No one who is involved in healthcare—service users, family members, healthcare workers, administrators, scholars, educators—should miss it. And, ideally, these communities should see it together so that there can be opportunities to work it through and build on its insights.