A couple of years ago, only 19 medical boards had licensing applications that were free of stigmatizing language known to discourage physicians from seeking mental health care out of fear of losing their medical license and their ability to practice medicine.
Today, 35 boards have stigma-free language that only asks physicians about current impairments that could harm performance, no longer asking physicians to disclose past mental health treatments or diagnoses.
Similarly, the AMA and the Dr. Lorna Breen Heroes’ Foundation verified that only 75 hospitals had credentialing applications that excluded stigmatizing language. Today, there are nearly 600.
And as state legislatures, hospitals, health systems and medical and other licensing boards become aware of the harm that is done to physician well-being when doctors are asked to list past treatments and diagnoses, they are typically highly motivated to make changes to remove stigma and fear.
This trend toward removing language that would prevent a physician or other health care professional from seeking professional help for themselves was a key point during a recent AMA webinar examining how states are taking up key health care issues such physician well-being.
Keeping physicians, patients safe
The AMA wants to ensure that physicians are practicing safely, and it also wants to ensure physicians are well and don’t fear getting treatment for themselves if they are unwell.
In one study, four in 10 physicians told researchers they were reluctant to seek help. And physicians who lived in a state where the initial or renewal licensing application had overly board questions about mental health history were 20% likelier to be reluctant about seeking help.
Meanwhile, an American Hospital Association report lists stigma associated with talking about and seeking behavioral health care, including fear of losing hospital privileges via the credentialing process, as a key driver of suicide in the health care workforce.
The AMA believes if there is a current impairment, that should be disclosed. The AMA is focused on removing stigmatizing and inappropriate questions on physician licensing and credentialing applications and anywhere else a physician is asked to answer the questions of whether they have ever received treatment for a mental health issue.
And the AMA is focused on ensuring that when changes are made, that they are implemented and that physicians know about the shift.
A team effort
The AMA is working with state medical societies and regulatory boards to change questions and help enact state legislation to prohibit inappropriate questions altogether so that physicians aren’t worried about receiving help.
The AMA is also working with the Dr. Lorna Breen Heroes’ Foundation that was created—in the wake of Dr. Breen’s tragic suicide—to help improve the professional well-being and mental health of physicians and other health professionals. That includes changing credentialing and licensing questions asked by hospitals, health systems and medical boards.
Already this year, more than 500 hospitals have changed their applications to be consistent with the AMA’s and Breen Foundation’s recommendations. 35 medical boards also have made these changes. And the AMA joined a coalition led by the Colorado Academy of Family Physicians in support of amending a state law to ensure that licensing applications going through regulatory boards don’t include stigmatizing questions. Colorado House Bill 25–1176 passed both the House and Senate and at this article’s deadline was awaiting the governor’s signature.
The AMA worked directly with those organizations in Colorado to help produce an amendment, identify physician champions and develop testimony for a legislative hearing. The AMA is able to provide data and examples of how other states have gone about fostering change.
The Federation of State Medical Boards, Federation of State Physician Health Programs, The Joint Commission and many other organizations are also on the same page as the AMA when it comes to physician well-being.
Physician champions can reach out to the AMA to get an opinion on whether credentialing, licensing or other questions put to physicians need to change because they don’t align with the best practices. And AMA experts can work with a physician, chief wellness officer or others to help make improvements if needed. The AMA’s goal is 100% change in inappropriate questions, and the AMA will keep working until that’s achieved.
Learn more with this AMA issue brief on the campaign to support the health and well-being medical students, residents and physicians (PDF).
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