Advocacy Toolkit: Modernizing License and Credentialing Applications to Not Stigmatize Mental Health

Published 9/30/24

ACP policy recognizes that physicians’ commitment to care for those who are ill includes physicians caring for one another. ACP supports recommendations from the Federation of State Medical Boards (FSMB) that state boards approach physician wellness and burnout from a nonpunitive perspective, evaluating whether it is necessary to ask probing questions about mental health, addiction, or substance use, particularly in the applicant's past. A description of the types of questions individual state licensing boards ask can be found here.

Background

This toolkit is intended to serve as a resource for physicians and to help remove any potential stigma about receiving mental health care or having a mental health diagnosis, that may result in physicians not receiving care.

State medical boards set the rules and requirements for obtaining a medical license, assuring that clinicians meet standards for education, training, and professional conduct. Physicians must disclose information that may affect their ability to practice, such as malpractice awards and criminal convictions. This might also include health status information.

ACP states in Physician Impairment and Rehabilitation: Reintegration Into Medical Practice While Ensuring Patient Safety: A Position Paper From the American College of Physicians that physician impairment can be left untreated and that “Physicians may avoid seeking medical help because they fear loss of confidentiality and privacy, loss of livelihood, or the appearance of vulnerability or because they deny or subordinate their personal needs to practice demands and therefore do not recognize the impairment. The stigma of addiction and mental illness added to the concern that diagnosis may lead to professional liability or loss of licensure can compel physicians to suffer in silence and delay seeking help.”

Recently, ACP adopted a resolution advocating for “modernization of state licensure practices that focuses more on the functional impact of mental health diagnoses in physicians and limits additional administrative requirements so that it does not isolate prior or current mental health considerations from other medical considerations in the reporting process.” ACP’s position paper says that “In keeping with the focus on functional impact, ACP recommends that licensure questions address current status rather than past history, not distinguish between mental and physical health, and elicit objective information about functional status.”

Please contact acpwellbeing@acpprograms.org or submit a chapter advocacy assistance request form with questions or for additional resources.

References

Physician Impairment and Rehabilitation: Reintegration Into Medical Practice While Ensuring Patient Safety: A Position Paper From the American College of Physicians

Learn more about state Physician Health Programs (PHPs)

According to a study published as a research letter in May 2021 by JAMA. Thirty-nine states limited questions on initial licensing applications to current conditions with impairment

ACP Internist: Protective equipment for physicians' mental health

Modern Healthcare: The connection between credentialing and physician mental health: a call to action

CDC: Explore NIOSH's Impact Wellbeing Guide. Action 3 - break down barriers for seeking help, such as updating credentialing application questions and identifying confidential ways for healthcare workers to seek mental health support

Bibliography