No More Lip Service: Let’s All Advocate for Physician Wellness

Author: Trintje Johansson, DO

Keywords: wellness, burnout, support, mental health

Medical school and residency selection has changed to value humanism and compassion more than in years past, changing how we practice medicine and the makeup of the people practicing medicine. Many early career physicians and trainees wish to pursue mental health care as a part of remaining healthy so they can provide compassionate and humanistic care, but then find themselves thrust into a situation where doing so can impact their credentialing and licensure.  

There are lots of reasons why physicians don’t seek mental health care, including but not limited to the fear of having to report receiving mental health care. There is also stigma that to have a mental health diagnosis or to seek counseling is a weakness. We can help to normalize help-seeking by actively and publicly sharing resources that provide mental health care to clinicians (such as Emotional PPE, the Physician Support Line, professional society resources, or their employee assistance program) and having content on physician mental health during existing meetings such as grand rounds. But none of these fully address someone’s fears about having to report mental health on their license or credentialing applications.

Physicians who are concerned about having to report receiving mental health care are not fully wrong about it. Historically most state licensing boards and healthcare institutions have stigmatized physicians who have sought mental healthcare. The good news is that this is changing and many states are changing their application processes so that they are only asking about receiving mental health care or having a mental health diagnosis if it affects how they provide care. Some notable examples of states with recent changes are South Dakota, Arizona, New Mexico, and Minnesota. Even more states are evaluating their processes in response to recommendations from national organizations not to ask these questions. Many other states are doing so because there is now a more widespread recognition that practicing medicine in a pandemic is hard, and the adage that no one can give from an empty cup has never been more true.

Progress in revising organization credentialing applications is generally lagging, though. Most healthcare institutions have been overwhelmed for the last several years, and have not yet reexamined their internal processes despite people in those same organizations advocating for state license application changes. But this, too, can change, and you can be a part of this change. 

Often, hospitals and health systems have not had anyone ask them to change! If you have a moment, you can reach out to your credentialing office (sometimes called a medical staff office) and ask them to evaluate their applications. Feel free to draw upon the information provided through this information provided by the Helping Healthcare Heal Coalition at the IHI.

During a hard time it can be hard to consider doing one more thing. And this is true! It is also true that sometimes a small amount of effort can do a lot of good - and in this case one example of that is asking your organization to revise their credential application not to ask about mental health care and to add language that is supportive of clinicians receiving mental health care.

About the author: Trintje Johansson D.O. works as an academic hospitalist at the Raymond G Murphy VA Medical Center in Albuquerque, NM. She is passionate about resident education and physician wellness.