Myth or fact? Medical boards must probe mental health history

Tanya Albert Henry , Contributing News Writer

Physicians and other health professionals filling out applications often encounter questions from medical licensing boards, credentialing bodies and professional liability insurance carriers about any past history of mental illness or substance-use disorder. 

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But do The Joint Commission—which accredits hospitals and other health care organizations—and the Federation of State Medical Boards (FSMB) require that states, hospitals, insurers or others ask about this history?

The answer is no.

“Rather, they strongly encourage them to refrain from including these types of questions when collecting professional information from clinicians for credentialing, privileging or other purposes,” according to the latest research that the AMA has done through its “Debunking Regulatory Myths” series.

If a state medical board does prefer to include questions that ask about a physicians’ mental health to gather information intended to protect patients, the FSMB advises them to do it in a way that:

  • Limits inquiries to current impairments.
  • Doesn’t discourage physicians from seeking treatment.
  • Avoids publicly disclosing a physician’s diagnosis and offers nonreporting options to physicians who are getting treatment and are in good standing with a recognized physician health program (PHP) or other appropriate health care professional.

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Changing what questions are asked on licensing and other applications is important, studies show.

Despite having higher rates of depression, burnout and suicide than the general population, research has shown that about 40% of physicians would be reluctant to seek mental health care because they would be concerned about the repercussions to their medical licensure. Those in states that didn’t follow best practices regarding questions about past mental health issues were significantly more likely to report that they would not seek mental health care.

“Since that survey in 2016 many states have changed their licensing questions to align with recommendations. State medical societies, with support from our state advocacy team at the AMA, have been instrumental in achieving these changes,” said Christine Sinsky, MD, the AMA’s vice president of professional satisfaction and a co-author of the study.

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AMA policy, among other things, encourages state licensing boards to require that physicians only disclose current physical or mental health conditions that impacts them from being able to practice medicine.

State medical boards and other entities with problematic language are beginning to make changes, with positive steps being taken in Minnesota, Georgia and Virginia. Henry Ford Health—a member of the AMA Health System program—also recently updated its credentialing application to focus on current impairment.

There is still much work to do on licensing, credentialing and other areas, according to the AMA. The AMA works with the Dr. Lorna Breen Heroes’ Foundation. For information, consult the foundation’s toolkit, “Remove Intrusive Mental Health Questions from Licensure and Credentialing Applications A Toolkit to Audit, Change and Communicate,” which is available for download at the organization’s website.

Find out more with the “AMA Debunking Medical Practice Regulatory Myths Learning Series,” which is available on AMA Ed Hub™ and provides regulatory clarification to physicians and their care teams. Physicians can submit questions or ideas they have about regulatory myths by emailing the research and policy team.