Healing the healer: The Physician Support Line

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Physicians need support more than ever, and there may be no one better positioned to provide that support than our psychiatrist colleagues. That was the thought process of Mona Masood, DO, when she envisioned the Physician Support Line, “a national peer to peer service provided by volunteer psychiatrists who are unapologetically supporting their physician and medical student colleagues on the many intersections of their personal and professional lives.”

The Physician Support Line was spurred by the start of the COVID-19 pandemic, when Masood realized that her colleagues were struggling with emotional trauma caused by the public health emergency. “I found myself discussing with colleagues more than just the virus, but perhaps for the first time, how we were coping as physicians and as human beings,” said Masood. “Physicians were really overwhelmed, and I think we finally gave ourselves permission to speak about our struggle.”

Masood said she noticed that while physicians were beginning to share their concerns on social media, much of the early discussion was framed in an intellectualized way. “I would see posts like, ‘Does anybody have a good lawyer to write a will?’,” she said. “You can read between the lines—they are saying that they’re worried about their mortality, about not surviving this, and what that would look like.” Masood and her colleagues grew alarmed at the tone of these posts. “The Physician Support Line started from a mindset of, if not me, then who? We knew that we had to address this before it took us over or ended us.” Masood called on her psychiatrist colleagues, who responded enthusiastically. “Their response was incredible, and it just speaks to the generosity of spirit and sincerity of our of our colleagues.”

Physician Support Line

Launching in 2020, the Physician Support Line is available to medical students, resident/ fellows, attending physicians, and retired physicians. The current hours are weekdays from 8 AM to midnight, and the service is free and completely confidential. “We don't report to anyone, which is a big fear that all of us have regarding licensing,” said Masood.

The purpose of the Physician Support Line is not a doctor-patient relationship, but rather, peer-to-peer support. “These volunteers have shared the same experience of physician training and navigating the healthcare system,” said Masood, who notes that physicians can call to talk about any issue, not just those related to practicing medicine. “We have talked with callers about anything from being burned out to our frustrations with the health care system, including moral injury of what we thought we were going to be as physicians and who we turned out to be, and how that feels like some moral reckoning,” she said. “We talk about family, and we talk about marriages. We talk about loneliness, sleep, isolation, and anything under the sun. It doesn't have to be a crisis to call, it really is more important that you're giving yourself permission to center your own story and center your own wellness. And I think that that is something that is so needed.”

The line is staffed exclusively by board-certified, licensed psychiatrists, who are trained to respond to the needs of physician callers. “The purpose of line is really up to the person who calls in,” said Masood. “The person may be saying, ‘I just need to vent this out, because there's really nobody in my life that understands what I'm going through.’” While some calls start as venting, Masood notes that physicians may begin to realize the benefits of therapy after talking with psychiatrist volunteers. “By the end of the call, they may be saying, ‘Wow, this was so eye opening to me on the benefits of working through something, and I didn't even know or wasn't even aware of what I was actually going through.” If the physician is interested in exploring further therapy, volunteers provide resources for continuity of care. “We ourselves cannot offer continuity on the line because it is anonymous both ways,” said Masood, “But we can suggest referrals for either therapy or for psychiatric care.” Alternately, psychiatrists may provide articles or self-help resources.

‘Pink’ flags of when to seek help

Who should call the Physician Support Line? According to Masood, doctors should watch for the ‘pink’ flags, rather than waiting for a red flag or crisis. “I think we put this big banner like, ‘Oh, it’s a call for help’—we call it something that feels so drastic, but it’s actually not,” said Masood. “Often it’s almost just unburdening yourself and sharing with someone else. Like, ‘Are you seeing what I’m seeing? Or am I overthinking?’” Masood advises physicians to consider ourselves the way we could consider any patient. “We can’t treat ourselves. We need someone to be more objective, to take it off your shoulders. Let someone else look at it and say, ‘Yeah, you know, this doesn’t sound so good.’”

Masood says that physicians should consider reaching out if they find themselves experiencing anhedonia or social withdrawal. “When you’re starting to see that things that you enjoy are not as enjoyable,” she said. “If you're not wanting to be around the people you usually enjoy as much anymore, and you see yourself withdrawing.” But Masood also says that doctors should call even if they just want to talk or check-in. In fact, many of the calls Masood and her colleagues receive are exactly that. “We do get a few calls from doctors who are at very overwhelmed and feeling at the end of their rope, but the majority of the calls are, ‘I just want to talk about something with somebody who I think gets it.’” Masood thinks of it as a ‘curbside consult.’ “There's nothing at stake—there’s honestly no risk. It’s either helpful, or you are back where you started before you called us.”

But for many physicians, Masood says that the Support Line has made a difference. “One of the things I’ve noticed about these calls that is just so telling is that when physicians call, the initial thing that they say is, ‘I'm so sorry for taking your time.’ And this goes to show how unused to and how uncomfortable we are with even desiring support.” Masood wants physicians to know that they are worthy of help, and they are not a burden. “When doctors say this to me, I explain, ‘This is literally called the Physician Support Line. The person picking up has volunteered to do this. So, there is no need for apology.’”

Masood said that this common physician response is an example of one of the many internalized ideas that doctors have of what it means to be a ‘good’ physician. “At the very least, what we can do is to be there as peers, as fellow physicians, reminding you that yes, you have worth. Yes, what you are doing is incredible, and you as a human being deserve to be well.” Masood says that calling the support line “doesn’t have to be one of those giant commitments that we talk ourselves out of. It really just has to start with seeing ourselves as worthy of support.”

The Physician Support Line is available at PhysicianSupportLine.com or 1 (888) 409-0141.Free, Confidential & Anonymous. No appointment necessary. Call for any issue, not just a crisis. We report to no one. Open Monday to Friday (except federal holidays) 8:00 AM - 12:00 AM ET.

Rebekah Bernard MD is a Family Physician in Fort Myers, FL and the co-author of Physician Wellness: The Rock Star Doctor’s Guide. You can find her interview with Physician Support Line founder Mona Masood DO here.