SHM Sends Letter to the Federation of State Medical Boards Regarding Mental Health Disclosures and State Licensure

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Humayun Chaudhry, DO, FACP 
President and CEO
Federation of State Medical Boards
400 Fuller Wiser Road, Suite 300
Euless, TX 76039

 
Cheryl Walker-McGill, MD, MBA
Chair of Board of Directors
Federation of State Medical Boards
400 Fuller Wiser Road, Suite 300
Euless, TX 76039

 
Dear Dr. Chaudhry and Dr. Walker-McGill,

The Society of Hospital Medicine (SHM), representing the nation’s hospitalists, is writing to support the FSMB’s policy on Physician Wellness and Burnout (Adopted April 2018) and its recommendations regarding mental health disclosures on state medical licensing applications. We also ask the FSMB to encourage its member boards to revisit their policies around mental health disclosures for physician licensure to ensure they are not discouraging seeking out care for mental illness and burnout. 

Hospitalists are front-line clinicians in America’s acute care hospitals and focus on the general medical care of hospitalized patients. Provider burnout and mental health and well-being have been of the utmost importance for several years, particularly after the World Health Organization declared burnout to be an “occupational syndrome.”  However, concerns regarding physician mental health has taken on heightened urgency in light of the COVID-19 pandemic.  

As hospitalists, our members have been on the frontlines of the COVID-19 pandemic caring for patients. In addition to the physical health risks, hospitalists face significant mental and emotional stress when caring for COVID patients. In addition to working exceedingly long hours due to provider shortages, many hospitalists have faced the loss of several patients in a single shift. While the loss of a single patient under ordinary circumstances is difficult, this significant scale of loss takes an unprecedented mental and emotional toll on those whose primary professional and personal goals are to help and heal people.  

It is important to ensure providers are healthy, both physically and emotionally, and are able to care for their patients. However, receiving a mental health diagnosis and accompanying treatment must be distinguished from being impaired as a result of a diagnosis. Current mental health disclosures on state licensures often serve to penalize, stigmatize, or otherwise discourage providers from seeking necessary treatment and care.  
In particular, we support the emphasis of your recommendations on differentiating between having a diagnosis for mental illness and impairment that jeopardizes patient safety. We concur that questions around mental illness, if deemed necessary by a state board, need to focus on current impairment and ability to practice medicine safely.

Destigmatizing mental health diagnoses and necessary care is particularly important within the context of the COVID-19 pandemic. As providers continue to care for patients in this unprecedented era, we must ensure they are comfortable seeking and receiving the mental and emotional support and care they need. As a result of caring for COVID patients, many providers are facing and will increasingly face a variety of mental health and well-being conditions, including burnout, anxiety, and PTSD. Licensure disclosure requirements should not function as barriers to seeking and receiving necessary care. Eliminating mental health disclosure requirements or contextualizing these disclosures as they pertain to actual impairments will help foster a healthier and more supportive profession.

While some states have enacted changes to their medical licensing applications, not all have; so, there is still work to be done. We urge the FSMB to encourage its member boards to revisit their policies for mental health disclosures and, where necessary, prioritize advocacy efforts with state legislatures to address this issue. Doctors across the country should be able to seek mental health care, particularly in these extraordinary times, without fear of future consequences on their medical license applications or renewals.

We appreciate your leadership in addressing this complex, yet critical issue and look forward to assisting with its advancement. 

Sincerely,

Danielle Scheurer, MD, MSCR, SFHM
President
Society of Hospital Medicine