Licensing and Physician Mental Health: Recommendations

A number of factors appear to discourage physicians from seeking help for emotional distress. Their reluctance may be exacerbated by fears - well-founded or imagined - that by seeking help, a physician will jeopardize his medical license. To address this situation key representatives from organizations including the Federation of State Medical Boards (FSMB), Federation of State Physician Health Programs (FSPHP), AMA, APA, and Joint Commission, undertook an examination of the licensing applications, policies, and procedures of state medical boards with regard to physician mental health. Based on their findings they made the following eight recommendations.


Recommendations

  • State Medical Boards as well as hospitals and physician groups should have non-punitive and non-threatening mechanisms for identifying physicians with depression and other mood disorders.
  • State Medical Board applications should ask if physicians have any physical or mental condition (including alcohol or drug abuse) that is limiting, impairing, or may be likely to limit or impair the ability of the physicians to practice their profession. If physicians answer yes, then questions as to whether the limitations or impairments are being addressed by treatment are, and will be perceived, as appropriate.
  • State Medical Boards and those who appoint their members should have a psychiatrist on the Board to assist in resolving licensing issues involving psychiatric conditions.
  • If psychiatric evaluations are indicated for physicians who are possibly impaired, independent psychiatric evaluators could be appointed who can review any treating psychiatrist’s information rather than having the members of the Board do so. Although the evaluator should have access to all information needed, personal details unrelated to the physician’s ability to function as a physician need not be communicated to the board.
  • State Physician Health Programs that are not already addressing the unique needs of physicians with mental health problems, such as depression are encouraged to do so.
  • FSPHP should encourage County and State Medical Societies to introduce anonymous, self-evaluation screening on the internet for depression for physicians, recommending that they seek treatment if it is indicated. Hospitals and medical groups should be encouraged to do the same. The Joint Commission should be encouraged to determine how such screening could be made part of the accreditation process.
  • FSMB and FSPHP should work together to develop and recommend to their members policies and procedures that would encourage physicians with depressive disorders to seek help to prevent impairment from developing.
  • State and CountyMedical Societies should have liaison committees with State Medical Boards that would produce information about what actually happens at Board meetings. This would help reduce misunderstanding that exists among physicians about how Boards operate and permit them to address jointly procedures that arouse concern.