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Should Licensing/Credentialing Organizations Inquire About Clinicians' Past Mental Health?

Learning Objectives
1. Describe the myth or issue that impacts physicians and their care teams
2. Explain how state licensure, physician credentialing services, and professional liability insurance carriers should frame questions about clinicians' mental health, addiction or substance use history on licensure and credentialing applications
0.25 Credit CME

To earn full credit for this activity, you must review all accompanying resources, which have been curated to support your learning of the subject matter.

The Myth

The Joint Commission and the Federation of State Medical Boards (FSMB) require that medical licensing boards, credentialing bodies, and professional liability insurance carriers ask applicants about any past history of mental illness or substance use disorder on licensure, credentialing and other applications.

Debunking the Myth

Neither The Joint Commission, nor the FSMB, require that licensing and credentialing organizations such as state licensure, physician credentialing services, and professional liability insurance carriers ask probing questions about clinicians' past mental health, addiction, or substance use history on licensure and credentialing applications. Rather, they strongly encourage them to refrain from including these types of questions when collecting professional information from clinicians for credentialing, privileging or other purposes.1

Despite a growing body of evidence demonstrating that asking questions about mental health, addiction, or substance use history on licensing and other applications deters physicians from seeking care, several state medical license applications and credentialing applications continue to ask these questions.2,3

For state medical boards that prefer to include questions that address physicians' mental health to elicit information intended to protect patients, the FSMB advises that they do so in ways that (1) limit inquiries to current impairments and (2) don't discourage physicians from seeking out treatment.1,4 Further, the FSMB recommends that these organizations avoid public disclosure of a physician's diagnosis and offer non-reporting options to physicians who are receiving treatment and in good standing with a recognized physician health program (PHP) or other appropriate health care professional.4

AMA Policy

Resources

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The AMA Debunking Medical Practice Regulatory Myths series provides physicians and their care teams with regulatory clarification to streamline clinical workflow processes and improve patient outcomes. Learn more

Article Information

AMA CME Accreditation Information

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships.

If applicable, all relevant financial relationships have been mitigated.

References
1.
The Joint Commission.  The Joint Commission Statement on Health Care Worker Mental Health.  The Joint Commission. Published 2021. Accessed November 15, 2022. https://www.jointcommission.org/resources/patient-safety-topics/healthcare-workforce-safety-and-well-being/resources-from-the-joint-commission/
2.
Saddawi-Konefka  D, Brown  A, Eisenhart  I, Hicks  K.  Consistency Between State Medical License Applications and Recommendations Regarding Physician Mental Health.  JAMA Network. 2021;325(19). Accessed November 15, 2022. https://jamanetwork.com/journals/jama/fullarticle/2780002Google Scholar
3.
Dyrbye  LN, West  CP, Sinsky  CA, Goeders  LE, Satele  DV, Shanafelt  TD.  Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions - Mayo Clinic Proceedings.  Mayo Clinic Proceedings. 2017;92(10):1486–1493. Accessed November 15, 2022. https://www.mayoclinicproceedings.org/article/S0025-6196(17)30522-0/fulltextGoogle Scholar
4.
Federation of State Medical Boards (FSMB).  Physician Wellness and Burnout: Report and Recommendations of the Workgroup on Physician Wellness and Burnout.; 2018. Accessed December 8, 2022. https://www.fsmb.org/siteassets/advocacy/policies/policy-on-wellness-and-burnout.pdf
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Enduring Material activity for a maximum of 0.25  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 0.25 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 0.25 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 0.25 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 0.25 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 0.25 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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