Everyone is vulnerable to mental health challenges, but physicians and other health professionals face some unique considerations in this area.
There’s fear of litigation. There’s fear of licensing board action. There’s fear of what colleagues may think, to name a few of the extra pressures.
“All of these fears compile to create this ball, and around that is a wall that becomes a hard shell of protection because if I get exposed, then all of these things could penetrate that wall. And then all of a sudden, I lose my financial well-being, I lose my emotional well-being, I lose my job,” said Mila Felder, MD, an emergency physician in suburban Chicago and vice president of well-being for Advocate Health.
Knowing the challenges that physicians and other health professionals face, Advocate Health has worked to remove a big barrier to doctors seeking the care that they need: Changing how credentialing questions are asked so they are only focused on any current impairments.
Working alongside Dr. Felder, Advocate Health’s enterprise medical staff services led by Jennifer Mangan-Moore played an essential role in helping bring this change to life.
The more than 20,000 Advocate Health physicians and other clinicians in North Carolina and Wisconsin who are filling out credentialing paperwork no longer face invasive questions about whether they have ever sought mental health support or care for a substance-use disorder. The change aligns the paperwork with recommendations from the AMA (PDF) and the Dr. Lorna Breen Heroes’ Foundation to remove stigmatizing language that can be a barrier for physicians to seek care.
Advocate Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Dr. Felder expects similar credentialing changes will take place at Advocate Health’s locations in Georgia before the start of 2026. In all, more than 35,000 physicians are on the medical staff or aligned with Advocate Health, which serves nearly 6 million patients at 69 hospitals and more than 1,000 sites of care in seven states.
In September, Advocate Health spearheaded a letter to the Illinois Department of Public Health asking it to update rules to allow the health system to make changes to the credentialing questions in that state. The AMA joined Advocate Health, alongside the Illinois State Medical Society, Illinois Hospital Association and other major Illinois health systems in asking for the change.
On top of that, Advocate Health has supports in place to encourage physicians to reach out for help and has actively worked to change the culture around mental health care. These and other changes contributed to Advocate Health’s recently earning gold-level recognition as part of the AMA Joy in Medicine® Health System Recognition Program.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine.
How others can initiate change
To begin the discussion about making changes, Advocate Health brought together stakeholders from across the organization to figure out what needed to be done and how to go about it. With a footprint in multiple states, leaders determined that they would need a different approach in each state based on what laws or regulations govern credentialing questions that health systems ask.
Advocate Health then worked with the AMA and the Dr. Lorna Breen Heroes’ Foundation throughout the process to evaluate what changes needed to be made.
The AMA and the Dr. Lorna Breen Heroes’ Foundation are focused on removing stigmatizing and inappropriate questions on physician licensing and credentialing applications and anywhere else a physician is asked to answer the question of whether they have ever received treatment for a mental health issue or substance-use disorder. The AMA and the foundation then provide their analysis, further technical support and work with the hospital or health system to make the necessary changes.
Here is one example of a modification of a disclosure question.
Current: Do you have a medical condition, physical defect or emotional impairment which in any way might impair and/or limit your ability to practice medicine with reasonable skill and safety?
Modified: Are you currently suffering from any condition that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical and professional manner? (Yes/No).
Advocate Health in Wisconsin and North Carolina have been recognized as a Wellbeing First Champion, a designation from the Dr. Lorna Breen Heroes’ Foundation that recognizes the health system’s forms are free of intrusive questions and stigmatizing language.
Advocate Health joins other health systems in making these changes. At this article’s deadline, there were 1,850 health care organizations in the U.S. that had made changes consistent with recommendations from the AMA and Dr. Lorna Breen Heroes’ Foundation.
For other health system leaders who may be interested in changing credentialing language, Dr. Felder suggested starting small. For example, Advocate Health started by changing a peer-reference form. It was a statement to the medical staff, as well as executive and operational leaders that helped them understand what was being done and why.
From there, she suggested that health system leaders continue to educate and elevate mental health services and make bigger language changes in credentialing forms.
“And then make a big splash once the goals are accomplished,” Dr. Felder said.
Learn more with this AMA issue brief on the campaign to support the health and well-being medical students, residents and physicians (PDF).
Changing the culture too
Beyond making changes to credentialing questions, Advocate Health has committed to creating a workplace culture where physicians can feel more comfortable finding mental health care and have resources at their fingertips to find it.
Charlotte, North Carolina, ob-gyn Sarah A. Pollock, MD, helps direct physician well-being efforts for Advocate Health’s locations in the Southeast. A key part of that is its “Best Place to Care” program.
The systemwide initiative aims to strengthen well-being, reduce administrative burdens and make the health system a top destination for physicians, nurses and the entire care team by:
- Streamlining workflows so physicians and others can focus on seeing patients.
- Providing well-being programs to support mental health, manage stress and reinforce work-life balance.
- Offering professional support and growth through mentorships and training and development opportunities for professionals in all stages of their careers.
“Our survey data over the years has asked questions about why someone doesn’t seek mental health resources, and we’ve addressed that in many ways. Sometimes it was: ‘I didn’t know where to go,’ or ‘I didn’t know who to talk to.’ We’ve addressed those,” Dr. Pollock said, explaining that there is a phone number physicians and other health professionals can call and access 24 hours a day to connect with an on-call psychiatrist and mental health team.
And Advocate Health survey data shows that there has been some improvement destigmatizing mental health care.
“There is still always more work to do, but we really are moving the needle,” Dr. Pollock said.
