March 10, 2023: State Advocacy Update


Removing intrusive questions within credentialing is one of many necessary steps forward to emphasize that often overlooked fourth leg of the quadruple aim, said Joel Bundy, MD, chief quality and safety officer of Sentara Healthcare. Sentara is a not-for-profit integrated health system with 12 hospitals in Virginia and North Carolina.

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After discussions with the Dr. Lorna Breen Heroes’ Foundation and the AMA, Dr. Bundy worked with his team at Sentara to remove questions that asked about past hospitalizations and past treatment for mental illness or substance use disorders because they do not accurately identify whether an applicant has a “current” impairment or other medical issue that accurately represents a physician’s ability to safely and competently practice medicine. 

“Burnout is a major concern within health care right now. It is multifactorial and primarily driven by our health care ‘machine’ with its workflow inefficiencies, administrative burdens, and the loss of joy and purpose in work,” said Dr. Bundy. “We must quickly make these changes within our fragile health care workforce ecosystem. This includes ensuring that we change credentialing questions or anything else that fosters burnout, whether large or small. The output of a resilient workforce is safer, high-quality care for our communities, our families, and for ourselves.” 

Reducing burnout and supporting physician wellness is a key component of the AMA’s Recovery Plan for America’s Physicians.  

The AMA strongly encourages all health systems to review their credentialing and other applications and work with the AMA to remove intrusive questions about past mental health or substance use disorder treatment. Please contact the AMA Advocacy Resource Center for more information. 

The Texas Medical Board (TMB) recently revised one of its rules in a way that makes it easier for physician practices to provide more comprehensive pain management. 

The rule change came about in part because of widespread concerns that patients who cannot access effective treatment for chronic pain from a physician will turn to illicit substances, increasing problems of addiction, overdoses and overdose deaths from counterfeit pills that contain illegally manufactured fentanyl. 

Read more about the TMB rule