As the COVID-19 pandemic rages on, the mental health of healthcare workers has been widely reported as deteriorating. Despite the growing attention, barriers to seeking mental health care remain high. For example, doctors are often required to disclose details about their mental health history in applications for medical licenses ostensibly to serve patient safety.While there is no published evidence that these issues improve patient safety, there is ample evidence to address these issues in medical licensing applications can stop doctors Seeking care for privacy, reputational and employment risks.

Therefore, the national organization that advises state medical boards, the Federation of State Medical Boards, developed a detailed advice About how medical boards should and should not ask questions about mental health in a medical clearance application. While there is general agreement on the recommendations, few states and territories have adopted them meaningfully. Also, unlike state medical boards, which receive guidance from the FSMB and are usually accountable to state governors or legislatures, employers of health systems and clinics have no oversight of mental health concerns they raise in their certification documents.

In the spring and summer of 2021, the Healthcare Improvement Institute Leadership Coalition convened representatives of the nation’s health systems to identify opportunities for collective action to remove barriers associated with seeking accreditation for mental health services. While it is critical to focus on the mental health of the health care workforce as a whole, and many of these same issues affect all licensed health care professionals, the focus of this foundational work is specific to physicians. After reviewing the literature, presentations by published authors, legal advice, and back-and-forth discussions, the group developed a number of design principles for de-stigmatizing certification application issues.

To reduce unnecessary harm to physicians seeking or receiving mental health care, applications for certification should:

? Be unbiased and only use language that does not stigmatize mental health care or a mental health diagnosis.

? Avoid distinguishing between physical and mental health conditions.

? Focus on current competencies, eg since last application or within the past two years.

? Include only questions asking about harm or impact on practice, not just the presence of disease or diagnosis.

? Make a clear distinction between content related to an individual’s physical and mental health and content related to criminal or unethical activity.

If a decision must include questions about a physician’s health, our team recommends the following language in the certification application: “Do you have any current conditions that adversely affect your ability to practice medicine in a safe, competent, ethical and professional manner?” We also recommend amending the certification application to include supportive language for physicians seeking and receiving mental health care, such as:”Clinicians often feel overwhelmed and seek help when appropriate. We stress the importance of well-being and appropriate treatment and support for all health conditions. “

While healthcare leaders continue to praise the way physicians and the entire healthcare workforce are compassionately caring for patients during the COVID-19 pandemic, here are five concrete actions leaders can take today to support physicians in continuing this important work.

? Determine how your organization asks questions related to physician mental health in your credentialing application.

? Determine how your state’s medical board currently asks physician mental health-related issues on licensure applications.

? Promote the use of recommended de-stigmatizing questions and supportive language among medical institutions, state medical boards, and insurance companies.

? Identify and mitigate barriers for physicians to seek mental health care.

? Encourage investment in evidence-based research and interventions that promote and protect physicians’ mental health.

More than ever, people are concerned about the pandemic and its attendant losses mental damage Already assumed the healthcare workforce. As we overcome this collective grief, what are we willing to do for those who have made great sacrifices to care for us all?

Also contributing to this article: Dr. David Marcus, Chair of the GME Physician Welfare Committee and Resident Director of Northwell Health’s Joint Program in Emergency Medicine, Internal Medicine and Critical Care; and Dr. Robin Motter-Mast, Chief of Staff and Medical Director of Care Transformation, GBMC Healthcare.