Improving How State Medical Boards Ask Physicians About Mental Health Diagnoses: A Case Study From New Mexico
Authors: Eileen Barrett, Elizabeth Lawrence, Daniel Waldman, Heather Brislen
Journal: Annals of Internal Medicine (2020)

Ideas and Opinions5 May 2020Improving How State Medical Boards Ask Physicians About Mental Health Diagnoses: A Case Study From New MexicoEileen Barrett, MD, MPH, Elizabeth Lawrence, MD, Daniel Waldman, MD, and Heather Brislen, MDEileen Barrett, MD, MPHUniversity of New Mexico, Albuquerque, New Mexico (E.B., E.L., D.W., H.B.)Search for more papers by this author, Elizabeth Lawrence, MDUniversity of New Mexico, Albuquerque, New Mexico (E.B., E.L., D.W., H.B.)Search for more papers by this author, Daniel Waldman, MDUniversity of New Mexico, Albuquerque, New Mexico (E.B., E.L., D.W., H.B.)Search for more papers by this author, and Heather Brislen, MDUniversity of New Mexico, Albuquerque, New Mexico (E.B., E.L., D.W., H.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3681 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail State-based medical license applications often ask about mental health diagnoses and treatment in terms that stigmatize mental illness, inadvertently discouraging physicians from seeking care (1–3). Physicians cite the potential impact on their ability to obtain a medical license as a reason for not seeking care for mental health conditions (4, 5). Galvanized by a physician colleague's suicide, a multispecialty physician coalition worked with the New Mexico Medical Board in a successful collaboration that resulted in updated and destigmatized language on the state medical license application. We hope that our process might inspire and inform others in similar circumstances.Most state ...References1. Gold KJ, Shih ER, Goldman EB, et al. Do US medical licensing applications treat mental and physical illness equivalently? Fam Med. 2017;49:464-7. [PMID: 28633174] MedlineGoogle Scholar2. Federation of State Medical Boards. Physician Wellness and Burnout. April 2018. Accessed at www.fsmb.org/globalassets/advocacy/policies/policy-on-wellness-and-burnout.pdf on 27 October 2019. Google Scholar3. Gold KJ, Andrew LB, Goldman EB, et al. “I would never want to have a mental health diagnosis on my record”: a survey of female physicians on mental health diagnosis, treatment, and reporting. Gen Hosp Psychiatry. 2016;43:51-7. [PMID: 27796258] doi:10.1016/j.genhosppsych.2016.09.004 CrossrefMedlineGoogle Scholar4. Dyrbye LN, West CP, Sinsky CA, et al. Medical licensure questions and physician reluctance to seek care for mental health conditions. Mayo Clin Proc. 2017;92:1486-93. [PMID: 28982484] doi:10.1016/j.mayocp.2017.06.020 CrossrefMedlineGoogle Scholar5. Candilis PJ, Kim DT, Sulmasy LS; ACP Ethics, Professionalism and Human Rights Committee. Physician impairment and rehabilitation: reintegration into medical practice while ensuring patient safety: a position paper from the American College of Physicians. Ann Intern Med. 2019;170:871-9. [PMID: 31158847]. doi:10.7326/M18-3605 LinkGoogle Scholar6. Dyrbye LN, Eacker A, Durning SJ, et al. The impact of stigma and personal experiences on the help-seeking behaviors of medical students with burnout. Acad Med. 2015;90:961-9. [PMID: 25650824] doi:10.1097/ACM.0000000000000655 CrossrefMedlineGoogle Scholar7. Aaronson AL, Backes K, Agarwal G, et al. Mental health during residency training: assessing the barriers to seeking care. Acad Psychiatry. 2018;42:469-72. [PMID: 29450842] doi:10.1007/s40596-017-0881-3 CrossrefMedlineGoogle Scholar8. American Medical Association. Access to Confidential Health Services for Medical Students and Physicians. 2016. Accessed at www.ama-assn.org/sites/default/files/media-browser/i16-cme-reports.pdf on 27 October 2019. Google Scholar9. Sweeney JM. Physician Suicide Awareness Day: Where are the patients? KevinMD.com. 17 September 2019. Accessed at www.kevinmd.com/blog/2019/09/physician-suicide-awareness-day-where-are-the-patients.html on 27 October 2019. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of New Mexico, Albuquerque, New Mexico (E.B., E.L., D.W., H.B.)Acknowledgment: The authors thank their many colleagues who participated in this effort, including the members of the New Mexico Medical Board; the members and leaders of local professional societies; and their colleagues, students, and residents at the University of New Mexico School of Medicine.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3681.Corresponding Author: Eileen Barrett, MD, MPH, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131; e-mail, barrett.[email protected]com.Current Author Addresses: Drs. Barrett, Lawrence, and Brislen: Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131.Dr. Waldman: Family and Community Medicine, MSC 09 5040, 1 University of New Mexico, Albuquerque, NM 87131.Author Contributions: Conception and design: E. Barrett, E. Lawrence, D. Waldman, H. Brislen.Drafting of the article: E. Barrett, E. Lawrence, H. Brislen.Critical revision of the article for important intellectual content: E. Barrett, E. Lawrence, D. Waldman, H. Brislen.Final approval of the article: E. Barrett, E. Lawrence, D. Waldman, H. Brislen.Administrative, technical, or logistic support: E. Barrett, E. Lawrence, D. Waldman, H. Brislen.This article was published at Annals.org on 24 March 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLiterature Review on Regulatory Frameworks for Addressing Discrimination in Clinical SupervisionMental Health Disclosure Questions on Medical Licensure Applications: Implications for Medical Students, Residents, and PhysiciansGetting Through COVID-19: Keeping Clinicians in the WorkforceEileen Barrett, MD, MPH, Susan Thompson Hingle, MD, Cynthia D. Smith, MD, and Darilyn V. Moyer, MDEliminate Mental Health Questions on Applications for Medical Licensure 5 May 2020Volume 172, Issue 9Page: 617-618KeywordsDisclosureForecastingHearingMedical conditionsPatient advocacyPrevention, policy, and public healthPsychiatry and mental healthResidencySuicide ePublished: 24 March 2020 Issue Published: 5 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...