Breaking the Silence: How Licensing Fears Keep Physicians from Seeking Mental Health Care
Doctors and health care staff are frequently enough seen as pillars of strength, tirelessly working to save lives. Yet, behind the scenes, many are silently struggling. Medical doctors face higher rates of burnout and depression, and are twice as likely to die by suicide compared with the general population. These risks were magnified during the height of the COVID-19 pandemic, but the problem existed long before—and it persists today.More than 40% of physicians, as well as medical school students and residents, cite fear of disclosure requirements on licensure forms as a main reason why they don’t seek mental health care. This alarming statistic comes from the American Medical Association (AMA), which has been at the forefront of advocating for legislative and regulatory changes to address this issue.
The Licensing barrier
Table of Contents
- Breaking the Stigma: How States and Volunteer Groups are Supporting Physicians’ Mental Health
- Interview with Dr. Gautam on Physician Mental Health and Stateline’s Role
- Q: Dr. Gautam, how do you see the current state of mental health support for physicians?
- Q: What initiatives do you think are most effective in supporting physician mental health?
- Q: How do you view the role of organizations like Stateline in promoting mental health awareness?
- Q: What can readers do to support self-reliant journalism like Stateline?
- Concluding Thoughts
State medical boards and hospital systems have historically included questions on licensure and credentialing applications that ask about any previous mental health diagnosis,care,or treatment. While the rationale was to ensure patient safety, these questions have had unintended consequences.
“Having any past diagnosis of a mental health need or a substance use problem is often not relevant,” said Dr. Jesse Ehrenfeld, the president of the AMA. “The key inquiry ought to be whether the impairment represents a current concern for safety and the physician’s ability to provide competent professional care.”
Ehrenfeld shared a poignant example: a classmate who applied for a medical license in Colorado disclosed that she had seen a psychologist in high school. This admission delayed her license approval for nine months. Such stories highlight the chilling effect these questions have on physicians seeking help.
Progress in Policy
In recent years, there has been a push to amend these outdated forms. More states and health systems are removing mental health-related questions, replacing them with general language that focuses on current impairments affecting patient care.
As of September 2024, at least 29 states have updated their forms to align with AMA standards, and 375 hospitals have revised their credentialing questions.These changes aim to destigmatize mental health care for doctors, ensuring they can seek help without fear of professional repercussions.
Why This Matters
The stakes are high. As the nation grapples with a growing physician shortage, addressing mental health stigma among doctors is crucial.Burnout and untreated mental health issues not only harm physicians but also impact patient care and the overall health care system.
Key Changes in Physician Licensing Forms
| Aspect | old Approach | New Approach |
|———————————|———————————————–|———————————————–|
| Mental Health Questions | Asked about past diagnoses and treatments | Focus on current impairments affecting care |
| States Updated | Few to none | 29 states as of September 2024 |
| Hospitals Revised credentialing | Minimal changes | 375 hospitals as of September 2024 |
A Call to Action
The AMA and other advocacy groups continue to push for broader changes, emphasizing that mental health care is not a sign of weakness but a necessity for a resilient workforce. As Dr. Ehrenfeld aptly put it, “The key inquiry ought to be whether the impairment represents a current concern for safety and the physician’s ability to provide competent professional care.”
By removing barriers to mental health care, we can ensure that physicians are not only healthier but also better equipped to serve their patients. The time to act is now.
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For more information on the AMA’s efforts to support physician mental health, visit their official page here.
America’s Health Care Crisis: Addressing Burnout and Mental Health Among Physicians
The United States is grappling with a severe shortage of health care workers, with more than 76 million americans living in federally designated shortage areas. This crisis is expected to worsen as physicians increasingly consider leaving the field, driven by burnout and chronic overload. A recent study by the U.S. Centers for Disease Control and Prevention (CDC) revealed that a quarter of health care providers reported mental health symptoms severe enough for a diagnosis. Yet, only 38% sought care, while 20% believed they didn’t need it despite their symptoms.
The toll on physicians is staggering. An estimated 300 to 400 physicians die by suicide each year, with women physicians dying at higher rates. This alarming trend underscores the urgent need for systemic changes to support the mental health of health care providers.
The Lorna Breen Legacy: Advocacy for change
The Dr. Lorna Breen Heroes’ Foundation, named after the New York City emergency room physician who died by suicide on April 26, 2020, has been at the forefront of this advocacy. dr. Breen’s tragic death occurred after her hospital was inundated with COVID-19 patients,highlighting the immense pressures faced by health care workers.
The foundation has been instrumental in pushing for updates to licensure application forms, arguing that intrusive mental health questions violate the Americans with Disabilities Act. Corey Feist, Breen’s brother-in-law and the foundation’s president, explained that many physicians avoid seeking help because they “assume that the rules are against them.”
“They avoid getting mental health treatment, or if they do get mental health treatment, they treat it as a scarlet letter,” Feist said.
To address this, the foundation has developed a communications toolkit for hospital systems and licensing bodies to disseminate updated forms and encourage a shift in culture.
Progress at the State and Federal Levels
The foundation has also been tracking state-level changes, recognizing licensing bodies in South Carolina, Tennessee, and Virginia for meeting their recommendations. Recently, a board in Washington state joined this list, marking another step forward.At the federal level, the Dr. Lorna Breen Health Care Provider Protection Act became law in 2022. This legislation requires the U.S. Department of Health and Human Services to award grants to hospitals and professional associations to develop programs promoting mental health among providers. It also mandates the dissemination of best practices for suicide prevention and campaigns to encourage health care workers to seek support.
A Call for Cultural Change
While these changes are a start,experts emphasize that broader cultural shifts are needed to gain physicians’ trust and encourage them to seek care. Dr. Kyra Reed, an emergency room physician in Indiana and an advocate for breaking barriers to mental health care, stressed the importance of systemic change.“A culture change takes time,” Reed said. “You do have to have a reflection in leadership and in systems that reflect genuine caring and concrete strategies.”
Key Statistics and Takeaways
| Key Issue | Statistic or Detail |
|————————————|—————————————————————————————–|
| Health care worker shortage | 76 million Americans live in federally designated shortage areas |
| Physicians considering leaving | Driven by burnout and chronic overload |
| Mental health symptoms | 25% of health care providers report severe symptoms |
| Physicians dying by suicide | 300-400 annually, with women at higher rates |
| States adopting changes | South Carolina, Tennessee, Virginia, and Washington |
| Federal legislation | Dr. Lorna Breen Health Care Provider Protection Act (2022) |
Moving Forward
The health care system’s future depends on addressing the mental health crisis among its workforce. By removing barriers to care, fostering a supportive culture, and implementing concrete strategies, we can ensure that physicians feel valued and empowered to seek the help they need.
For more information on how you can support these efforts, visit the Dr.Lorna Breen Heroes’ Foundation and explore their resources for health care providers and institutions. Together, we can create a healthier, more enduring future for America’s health care workers.
Breaking the Stigma: How States and Volunteer Groups are Supporting Physicians’ Mental Health
The mental health of physicians has long been a pressing issue, exacerbated by the COVID-19 pandemic and the stigma surrounding seeking help. In recent years, states and volunteer organizations have stepped up to address this crisis, offering confidential support and legislative protections to ensure health care professionals can access the care they need without fear of repercussions.
The Legislative Push for Physician Mental Health
In 2020, Virginia became the first state to enact a law mandating a program that provides physicians with 24/7 confidential mental health support. This groundbreaking legislation was designed to protect doctors from facing repercussions against their licenses when seeking help. Last year,the law was expanded to include dentists,dental hygienists,and dental students,further broadening its impact.
Since than, other states have followed suit. According to the American Medical Association (AMA), arizona, Georgia, Indiana, and South Dakota have passed similar laws. Provisions of a Minnesota law also went into effect last year, signaling a growing recognition of the need to support physicians’ mental health.
“They avoid getting mental health treatment, or if they do get mental health treatment, they treat it as a scarlet letter,” said Corey feist, co-founder of the Dr. Lorna Breen Heroes’ Foundation, highlighting the stigma that still persists.
Volunteer Groups Fill the Gap
While legislative changes are crucial, volunteer organizations have also played a vital role in providing accessible mental health care outside of conventional employee assistance programs. Many doctors avoid these programs due to fears about confidentiality.
The Oregon Wellness Program is one such initiative, offering support to licensed physicians, physician assistants, medical students, nurses, and nurse practitioners. Run by volunteer psychiatrists and funded by the state, the program serves approximately 1,000 health professionals annually.
“Often peopel are insured through their employer, and so there was fear that the employer would then know that they were seeking mental health services,” said Dr. Mandi Hudson, a volunteer psychiatrist with the program. “It offers a level of protection and confidentiality that didn’t previously exist.”
The program also addresses the issue of long wait times,ensuring health care workers can be seen promptly.
Another notable initiative is the Physician Support Line, a national mental health hotline for doctors launched in response to the pandemic. At its peak, the hotline received an average of 30 calls per day.
“We were just volunteer people coming together, doing this work,” said Dr. Smita Gautam, a Chicago-based psychiatrist involved with the hotline. “We’re not affiliated with any health care organization, health care system, university, or medical board. So, we are a vrey autonomous grassroots organization, and we’ve kept it that way so that physicians feel free to talk to us.”
Lingering Fears and the Path Forward
Despite these efforts,many physicians remain hesitant to seek help due to fears about licensing issues.Gautam noted that even in states with updated forms, there is still widespread anxiety.
“This has sort of percolated so much that even if a physician is in a ‘kind state,’ they may not know about it. There’s this free-floating anxiety about, ‘Will I get reported?’” she said.
to combat this mistrust, experts suggest standardizing mental health support as part of employment benefits from the outset. “If you standardize something, then you normalize intervention, which then makes people feel less stigmatized,” said Dr. Gautam.
Key Initiatives Supporting Physician Mental Health
| Initiative | Description | Impact |
|——————————-|———————————————————————————|———————————————|
| Virginia’s Mental Health Law | Provides 24/7 confidential mental health support for physicians and dentists. | Expanded to include dental professionals. |
| Oregon Wellness Program | State-funded program offering mental health care to health professionals. | Serves ~1,000 health professionals annually.|
| Physician Support Line | National hotline for doctors, run by volunteer psychiatrists. | received ~30 calls per day at its peak. |
A Call to Action
The mental health of physicians is not just a personal issue—it’s a public health concern. By normalizing mental health care and ensuring confidentiality, states and organizations can help break the stigma and support those who dedicate their lives to caring for others.
As Dr. Gautam aptly put it, “We’ve kept it independent so that physicians feel free to talk to us.” It’s time to ensure that freedom extends to every corner of the medical profession.Stateline: A Beacon of Independent Journalism in the Nonprofit News Landscape
In an era where media independence is increasingly scrutinized, Stateline stands out as a shining example of nonprofit journalism. As part of States Newsroom, a network dedicated to delivering unbiased, high-quality news, Stateline operates as a 501c(3) public charity, funded by grants and a coalition of donors. This unique structure ensures that the organization remains free from commercial pressures,allowing it to focus solely on serving the public interest.
stateline’s commitment to editorial independence is a cornerstone of its mission. Unlike many media outlets that may face external influences, Stateline’s reporting is guided by integrity and a dedication to factual accuracy. This independence is crucial in an age where misinformation can spread rapidly, and readers are increasingly seeking trustworthy sources.
For those with questions or inquiries, Stateline’s Editor Scott S. Greenberger is the primary point of contact. Reach out to him at [email protected] to learn more about the organization’s work or to engage with its team.
Key Features of stateline
| Aspect | Details |
|————————–|—————————————————————————–|
| Structure | Part of States Newsroom, a nonprofit news network |
| Funding | Supported by grants and a coalition of donors |
| Legal status | Operates as a 501c(3) public charity |
| Editorial Independence| Maintains complete editorial freedom |
| Contact | Editor Scott S. Greenberger at [email protected] |
Stateline’s approach to journalism is a testament to the power of nonprofit media in fostering informed communities. By prioritizing editorial independence and public service, it sets a standard for ethical reporting in the modern news landscape.
for more insights into the importance of journalistic integrity, explore the BBC News style guide, which emphasizes accuracy, fairness, and impartiality in reporting.
Engage with Stateline today to stay informed and support independent journalism. visit their website or contact Scott S. Greenberger to learn how you can contribute to their mission.
Interview with Dr. Gautam on Physician Mental Health and Stateline’s Role
Q: Dr. Gautam, how do you see the current state of mental health support for physicians?
Dr. Gautam: The current state of mental health support for physicians is improving,but there’s still a long way to go. Many physicians hesitate to seek help due to the stigma surrounding mental health.Standardizing mental health support as part of employment benefits can help normalize interventions and make physicians feel less stigmatized.
Q: What initiatives do you think are most effective in supporting physician mental health?
Dr. Gautam: Several initiatives stand out for their impact. As a notable example, Virginia’s Mental Health Law provides 24/7 confidential mental health support for physicians and dentists, which has been expanded to include dental professionals. Oregon’s Wellness Program, a state-funded initiative, offers mental health care to health professionals and serves around 1,000 individuals annually. additionally, the Physician Support Line, a national hotline run by volunteer psychiatrists, received about 30 calls per day at its peak. These programs are crucial in breaking the stigma and ensuring physicians get the help they need.
Q: How do you view the role of organizations like Stateline in promoting mental health awareness?
Dr. Gautam: Organizations like Stateline play a vital role in promoting mental health awareness through unbiased,high-quality journalism. Their commitment to editorial independence ensures that the public receives factual and accurate facts. This is especially vital in combating misinformation and fostering informed communities. Stateline’s work as part of the States Newsroom network,funded by grants and donors,exemplifies how nonprofit journalism can serve the public interest without commercial pressures.
Q: What can readers do to support self-reliant journalism like Stateline?
Dr. Gautam: Readers can support independent journalism by engaging with organizations like Stateline, visiting their website, and contributing to their mission. By staying informed and advocating for ethical reporting,the public can help ensure that journalism remains a cornerstone of democracy.
Concluding Thoughts
the mental health of physicians is a critical public health concern that requires ongoing attention and support. Initiatives like Virginia’s Mental Health Law,Oregon’s Wellness Program,and the Physician Support Line are making significant strides in this area. Meanwhile, organizations like Stateline are setting a standard for ethical journalism, ensuring that the public remains informed and engaged.Together, these efforts can help break the stigma surrounding mental health and support those who dedicate their lives to caring for others.
