What happens when the doctor needs help?

A physician-turned-therapist now gives other doctors the mental health and substance abuse counseling they need.
an illustration showing a male doctor looking out the window and a female doctor in a face mask with her hand up to her face deep in thought
Illustration by Tim Burton / Getty

Vickie Mulkerin was a family practice doctor in Madison for years and can say with certainty that most doctors don’t ask for help. Despite having double or even triple the rates of depression — as well as higher instances of anxiety, substance abuse and death by suicide — physicians are among the least likely to seek mental health counseling or alcohol and drug treatment. Mulkerin knows this now; it’s why she went back to school to get her master’s degree in counseling psychology and became double licensed in mental health and substance abuse treatment. But back in the mid-2000s, when she was living through her lowest, darkest times as a chronic pain sufferer and childhood trauma survivor addicted to alcohol and OxyContin, Mulkerin was still years away from this level of awareness.

“I think I was a really good doctor, but I think I’m actually a better therapist,” says Mulkerin. “And probably a lot of that is just having been through my own journey.”

A smiling woman in glasses sitting in an armchair by the fire with a medium sized white dog with tan ears on her lap

Vickie Mulkerin (Courtesy photo)

Now 15 years clean and sober, Mulkerin started her private practice, White Coat Counseling, in 2021 with a primary mission to provide confidential therapy to physicians. “I’ve kind of been on this one-woman mission to be [open about being] a doctor in recovery,” she says, “partly because I’m trying to destigmatize.” Mulkerin sees patients virtually and in person out of her Gammon Road office, providing flexible scheduling that is uniquely suited to doctors, who often work 60 to 100 hours per week. She is also licensed to provide telehealth throughout Wisconsin, as well as in Florida, California, Colorado and South Carolina. Hers is a cash-only practice, because insurance billings go on the record in ways that physicians fear will cause harm to their reputations, deny them future life and disability insurance, and even cost them their jobs  — major barriers to their seeking help in the first place.

“I can see a person without them having to tell their boss, without having to reveal it to anybody,” says Mulkerin. “No one will know that they’re getting counseling, and I think that’s really reassuring for a lot of doctors.” She will see other types of patients, but she’s uniquely suited to treating doctors because she understands firsthand how prohibitive those barriers can be. She knows some of the personality traits that often make for successful doctors — perfectionism, relentless drive, high tolerance for suffering, an almost superhuman persona and a hyper-independence, not to mention extreme on-the-job stress and busy schedules that don’t allow a moment to check in on yourself — and she also knows what it’s like to think you’re the only one who feels the way you do.

“I’d had some bouts of depression, but for me, anxiety was the big thing and it never occurred to me that it was something that I actually could have gotten counseling for,” says Mulkerin, who also had childhood trauma that she had never formally addressed in therapy. “I was in practice in the ’90s and early 2000s, and no one talked about it. I don’t remember in residency or as an attending physician ever having anybody talk to us about alcohol use or any mental health thing. I don’t remember colleagues talking about it.”

When a debilitating form of arthritis forced Mulkerin to retire early from practicing medicine and landed her on disability, all of her anxiety, trauma and depression symptoms worsened. Like many chronic pain sufferers of that era, Mulkerin was prescribed “safe, nonaddictive” OxyContin and soon became addicted. No longer a practicing physician and on the brink of total collapse, Mulkerin finally sought help without worrying about the consequences.

“By the time I was going to treatment, I was so close to suicide or overdosing to die that I was so desperate for any relief that how it was getting recorded or documented didn’t even occur to me,” she says. Mulkerin not only found recovery, she also experienced a shift that challenged everything she’d believed as a trained doctor.

“I realized that mental health was so much more important to being a happy, joyful, fulfilled person than physical health was,” she says. “Just realizing that was a big shift for me to say, ‘I want to help people find emotional health.’ That’s a more important endeavor for me than helping people become physically healthy.”

As Mulkerin gained awareness about how common her personal experience actually was among other physicians, she began to understand why they didn’t seek help in the first place, and why even doctors who’d found healing were reluctant to reveal they were in recovery. That’s why she’s so open now.

“I want people to hear that you can be an addict and an alcoholic and get in recovery and have a beautiful life,” she says. “I have no anxiety or depression. I have no cravings for opiates or alcohol. All of that melted away when I took care of my mental health.”

Mulkerin’s example seems to be unique in her field. “I think I’m the only physician who retired and then got a master’s in counseling and then did all of the licensing,” she says, adding that she’s written articles that have attracted attention from around the country, including calls from doctors who are either interested in doing what she’s done or are seeking help themselves. But there are a handful of psychiatrists who are specifically targeting doctors — she knows of examples in Seattle, San Francisco and New York. She also knows of a psychiatrist who established a 24/7 crisis phone line for doctors. Closer to home, about a year ago, the Wisconsin Medical Society began offering teletherapy sessions for its members, and the Dane County Medical Society announced the LifeBridge Physician Wellness program. It provides six free sessions with a psychologist per year to address physician burnout, which they say is “as high as 62% in some specialties.” There is also the new Wisconsin Peer Alliance for Nurses, through which nurses in recovery help other nurses with substance use disorders. (Mulkerin will treat nurses, too.)

“People are stepping up trying to help doctors because this is such a crisis,” Mulkerin says. “I spoke to a physician who is thinking of doing what I’m doing . She personally knew two doctors who had died by suicide in the past year. Anytime someone dies by suicide, it’s tragic. We just don’t have the resources to provide counseling for everyone who needs it. But if I can do something with my little corner of the world, I want to do it.”

Maggie Ginsberg is an associate editor of Madison Magazine. This article appeared in the August 2022 issue of Madison Magazine.

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