CME | When colleagues are struggling: a conversation on physician suicide prevention

In this episode of CME On the Go, family physicians Janet West, MD, and Michelle Chestovich, MD, share deeply personal experiences with suicide and explore why physicians can struggle to recognize and address mental health challenges in themselves and their colleagues. Through their stories, they examine the culture of medicine, the stigma surrounding mental health treatment, and the importance of creating environments where asking for help is viewed as a strength rather than a weakness. 

Janet shares her experience surviving a suicide attempt in 2023 and reflects on how perfectionism, independence and the pressure to perform contributed to her difficulty recognizing and responding to her own mental health crisis. She explains how chronic stress and an overwhelmed nervous system can influence emotional regulation, cognitive distortions, and feelings of hopelessness. The conversation also examines how fears surrounding professional reputation, licensing and burdening colleagues can prevent physicians from seeking support, even when they recognize similar warning signs in their patients. 

Michelle shares the loss of her sister, physician Gretchen Butler, to suicide in 2021 and identifies three areas she believes are essential to prevention: reducing mental health stigma, addressing dangerous levels of sleep deprivation and recognizing when someone needs help. She discusses how the expectation to continue working despite exhaustion or personal distress can have serious consequences and encourages physicians and health care organizations to reconsider workplace practices that normalize these conditions. 

Together, Janet and Michelle offer practical guidance for supporting colleagues who may be struggling, including asking direct questions about suicide, recognizing changes in behavior, encouraging professional mental health treatment and considering training programs such as Question, Persuade, Refer (QPR). They emphasize that physicians are not immune to mental health challenges, and that meaningful prevention requires individual awareness, connection, and a shift in medical culture toward prioritizing physician well-being. 

 

Learning objectives 

1. Recognize factors associated with physician suicide risk, including biological, cultural, and professional influences, to support earlier identification of colleagues experiencing psychological distress. 

2. Identify opportunities to recognize and respond to colleagues at risk for suicide, including behavioral warning signs and direct disclosures of distress. 

3. Apply evidence-informed communication strategies to engage colleagues or patients at risk for suicide, connect them with appropriate support resources, and provide ongoing follow-up.  

The AAFP has reviewed CME On the Go, Season 3 and deemed it acceptable for AAFP credit(s). Term of Approval is from 09/30/2026 to 07/06/2028. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

This session, “CME | When Colleagues Are Struggling” Is approved for 0.50 credits Enduring Materials, Self-Study, AAFP Prescribed credit(s). 

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The American Academy of Family Physicians designates this Enduring Materials activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. 

https://www.aafp.org/assessment/take/21262/e  

 

References  

Makhija, H., Davidson, J. E., Lee, K. C., Barnes, A., Choflet, A., & Zisook, S. (2025). National incidence of physician suicide and associated features. JAMA Psychiatry, 82(5), 451-458. https://doi.org/10.1001/jamapsychiatry.2024.4816 

Porges, S. W. (2022). Polyvagal theory: A science of safety. Frontiers in Integrative Neuroscience, 16, Article 871227. https://doi.org/10.3389/fnint.2022.871227 

Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., Rogers, M. L., Podlogar, M. C., Chiurliza, B., Ringer-Moberg, F. B., Michaels, M. S., Patros, C., & Joiner, T. E. (2017). Interpersonal theory of suicide: A systematic review and meta-analysis after a decade of cross-national research. Psychological Bulletin, 143(12), 1313-1345. https://doi.org/10.1037/bul0000123 

Jobes, D. A. (2023). Managing suicidal risk: A collaborative approach. The Guilford Press. 

Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. 

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