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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.
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
Licensure Confidentiality H-275.970
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
The Joint Commission. Joint Commission Reiterates Importance of Removing Barriers to Mental Health Care for Staff. Published online March 31, 2021. Accessed November 15, 2022. https://www.jointcommission.org/-/media/tjc/documents/federal-relations-and-public-policy/03312021-removing-barriers-to-mental-health-treatment-statement.pdf
Dr. Lorna Breen Heroes Foundation. Improving Licensure & Credentialing Applications. Dr. Lorna Breen Heroes Foundation. Accessed November 15, 2022. https://drlornabreen.org/removebarriers/
All In: Wellbeing First for Healthcare, Dr. Lorna Breen Heroes Foundation. Remove Intrusive Mental Health Questions From Licensure and Credentialing Applications: A Toolkit to Audit, Change, and Communicate.; 2022. Accessed November 15, 2022. https://drlornabreen.org/wp-content/uploads/2022/09/ALLIN22_Licensure-Credentialing_Toolkit_V3.pdf
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/2780002
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/fulltext
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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.
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