When Lorna Breen, MD, recovered from COVID-19 and returned to work in the busy emergency department of a Manhattan hospital, she was struggling mentally and physically. But her top concern wasn’t her failing health—it was the fear of losing her medical license.
Dr. Breen was also worried that, if she sought help, she would land a reputation among her colleagues that she somehow couldn’t handle the strain that the pandemic was creating.
“Everyone can tell. I can’t keep up,” she told her sister Jennifer on April 1, 2020—her first day back at work. Still, Dr. Breen continued to work more than 12 hours a day with limited personal protective equipment and very little rest between those long shifts.
Soon thereafter, Jennifer organized a group of friends to drive Lorna various stretches from New York to their hometown of Charlottesville, Virginia where Jennifer lived, to help Lorna get the treatment she needed.
License worries top health concerns
“It was her first mental health treatment ever, and her first thought was that she was going to lose her license and that her career was over,” Dr. Breen’s brother-in-law Corey Feist recalled during a keynote address to the AMA. “We thought it helped, but it was too little too late.”
Dr. Breen, 49, died by suicide on April 26, 2020. In response, the Feists formed the Dr. Lorna Breen Heroes’ Foundation to honor her memory, share her story, and work to prevent her tragic end from being repeated.
“We started our foundation in Lorna's honor,” said Feist, the former CEO of the University of Virginia Physicians Group. “But it was also to support all of the clinicians who are hurting, and … to reduce the burnout of our health care professionals, safeguard their well-being and job satisfaction, and envision this world where seeking mental health services is universally viewed as a sign of strength for health care professionals.”
Read more about preventing physician suicide and find out why now is the time to have a difficult talk about physician suicide.
Stigma discourages seeking help
The foundation advocates for reducing the stigma of seeking mental health help by removing questions about prior mental health treatment from state licensing, hospital credentialing, and commercial insurance contracting applications, and not allowing past mental health treatment to be used against a health care professional in a medical liability lawsuit.
Feist cited a statement from the Joint Commission that agrees with this approach, which echoes AMA policy.
“We strongly encourage organizations to not ask about past history of mental health conditions or treatment,” reads the May 2020 statement by Ana Pujols McKee, MD, the Joint Commission’s executive vice president and chief medical officer. “As an alternative, we support the recommendations of the American Medical Association to limit inquiries to conditions that currently impair the clinicians’ ability to perform their job.”
The foundation has also worked with Congress to advance the Dr. Lorna Breen Health Care Provider Protection Act (PDF), legislation that the AMA strongly supports (PDF).
To advance solutions, the foundation has teamed up with a group called #FirstRespondersFirst to develop the All IN: Wellbeing First for Healthcare campaign. The AMA supports this campaign as part of its comprehensive efforts to work with all stakeholders to address physicians’ mental health and wellness.
The campaign aims to advance solutions to improve the well-being of the health care workforce and to create systemic change, “By accelerating a cultural shift that prioritizes health care workforce well-being and creates systems of accountability,” Feist said.
“We know from our experience—and the survey data backs this up—that physicians need greater supports, and we are committed to advocating for policy and practical changes to accomplish that,” Feist concluded.
Read more about how physicians and health systems can cut the stigma on seeking help and how states can help doctors get the confidential care they deserve.