Let's stop the ‘naming and shaming’ of physicians who need mental healthcare
Key Takeaways
Physicians have higher rates of mental health disorders—including suicide—than the general population.
Doctors are unlikely to discuss their mental health disorders out of fear and shame associated with their reputation and the fear of their licenses being provoked by state medical boards.
Normalizing mental healthcare in the medical community through peer groups such as Physicians Anonymous could potentially have a tremendous impact on the well-being of physicians and, as a result, how they care for patients throughout their careers.
Imagine a world where mental health for physicians was normalized—where physicians (and state medical boards) viewed mental health treatment not only as an option for burnout and substance use disorders, but also as a preventative measure to teach coping strategies for dealing with the stressors physicians encounter daily.
Unfortunately, stigma regarding mental health treatment has been documented repeatedly among the general population and in the medical field.
Hope has emerged in the form of a platform enabling physicians to find support for these issues.
State licensure: A barrier to mental health treatment
A unique barrier to physicians accessing mental health treatment—both preventive and therapeutic—is mandated reporting to state medical licensing boards.
In some states, questions are limited to mental health disorders or treatment that impairs (or may impair) a physician’s work performance. Other states ask ambiguous questions regarding whether the physician has been diagnosed or treated for such disorders within the last 2, 5, or 10 years, or during their lifetime.
A study published by General Hospital Psychiatry assessed barriers to mental health treatment among female physicians.[]
The results showed that of the 2,190 female physicians polled, half acknowledged having a previous diagnosis or treatment of a mental health disorder since starting medical school. The study authors also found that these doctors' mental health diagnoses and treatments were rarely discussed with the state medical boards.
Since the 2018 release of recommendations on physician wellness and burnout from the Federation of State Medical Boards, many state medical boards have changed how they ask about impairments that could affect a physician’s ability to do their job.[]
Questions about a mental health diagnosis now violate the American Disabilities Act, according to the recommendations. However, not all states have changed their application process, and therefore preventing discrimination in terms of licensing against doctors with mental health challenges is still a work in progress.
Related: Peer support groups for mental illness: Do they help?More open discussion
While research discussing the pros and cons of physicians seeking mental health treatment is scarce, physicians are becoming more open about discussing their mental health to shine a light on this epidemic.
In an MDLinx Webinar titled “The psychiatrists' report: A discussion on the state of our own mental health,” three board-certified psychiatrists discussed whether or not mental healthcare should be mandated for physicians.
“I don’t like the concept of ‘mandated’ because it implies forcing people, and in my experience with patients, when therapy is mandated, there’s no growth,” stated Maryna Mammoliti, MD, FRCPC. “Instead, therapy for young physicians during medical school would be very helpful because we bring a lot of baggage into medicine.”
"Providing physicians the time and money for therapy would be very helpful, as mandating it without offering such help would just frustrate them more."
— Melissa Shepard, MD
“There should be more options, and [they] should be readily available as opposed to, ‘Where do I find it? How do I go about doing it? How do I know that my privacy is going to be protected?’” Dr. Shepard added.
A physician community to normalize mental health
There is a blanket of fear within the physician community promoting the belief that openly discussing mental health disorders can harm various career aspects—reputation, licensing and credentials, and malpractice insurance. As a result, physicians may not discuss their ongoing mental battle, and these issues get pushed under the rug.
Physicians Anonymous is a physician-only anonymous peer support platform where doctors can come together to discuss mental health issues in medicine alongside methods to deal with burnout and mental health disorder. The platform also encourages open, honest discussions to break down the stigmas associated with mental health among doctors.
In its online charter, the platform estimated that 27% of medical students and 29% of residents have depression or depressive symptoms, with similar patterns in attending physicians.[]
Related: COVID-19 burnout: Why physicians feel hopelessMaking it safe to ‘come out’
“Physicians have higher rates of other psychiatric illnesses, including anxiety disorder, alcohol, and prescription drug use than the general population,” the authors of the Physicians Anonymous charter wrote.
"Tragically, suicide rates are higher among physicians than the general population, particularly among women doctors."
— Physicians Anonymous
The Physicians Anonymous founders stated that they wished their organization wasn’t needed, and that awareness, discussion, and optimization of mental health were the norm so physicians wouldn’t have to fear being “named and shamed.”
“If we knew that it was safe for any doctor to ‘come out’ as a human being with a vulnerability, then our organization could happily close its virtual doors,” the organizers wrote in the charter. “Until the systemic causes and barriers to getting help for the resultant stress responses are addressed, we intend to be there for our sisters and brothers in medicine.”
Platforms such as Physicians Anonymous may offer hope to doctors who are reluctant to reveal their mental health challenges out of fear of damaging their careers. The opportunity to exchange feelings and coping strategies may offer relief, enabling physicians to express themselves in a safe environment.
What this means for you
It can be difficult for physicians to care for patients when we’re struggling to care for ourselves. The physician community must come together to openly discuss mental health treatment, normalize preventative mental healthcare, and take action to hold medical licensing boards accountable for stigmatizing mental health disorders and treatment. In the meantime, platforms such as Physicians Anonymous may offer relief and methods for coping through the exchange of ideas with fellow doctors.