Medical licensing questions deter physicians from seeking mental health care

By John Murphy, MDLinx
Published October 3, 2017

Key Takeaways

Nearly 40% of physicians reported that they were reluctant to seek formal treatment for a mental health condition because they feared it might affect their medical licensure, according to results of a study by researchers at the Mayo Clinic in Rochester, MN.

Up to two-thirds of state license applications or renewals ask questions about a history of mental illness, with the implication that a mental health condition could affect competency, the study authors noted in an article in Mayo Clinic Proceedings. These questions about a history of mental illness are becoming increasingly common, the authors noted.

Such questions can significantly deter troubled physicians from seeking help, the researchers added. In addition to possible sanctions on their license, physicians who reveal a current or past mental health condition could face restrictions on clinical practice, mandatory psychiatric evaluation for determining their competence, and the very real possibility of public disclosure of their personal health information.

“Clearly, in some states, the questions physicians are required to answer to obtain or renew their license are keeping them from seeking the help they need to recover from burnout and other emotional or mental health issues,” said first author Liselotte N. Dyrbye, MD, MHPE, of the Mayo Clinic Program on Physician Well-Being.

Dr. Dyrbye and colleagues analyzed data from a national survey of more than from 5,800 physicians that asked about professional and employment status, as well as questions about depression and suicide. Previous research has shown that physicians have a high prevalence of psychological distress, yet their mood disorders often go untreated. This contributes to a higher rate of suicide among physicians than other US workers.

The researchers also obtained medical license applications from licensing boards in all 50 states and Washington DC, as well as renewal applications from 48 state licensing boards.

Results showed that physicians were least reluctant to seek care in states where applications and renewals didn’t ask about mental health conditions or asked only about current impairment from a mental health condition. But odds were 21% greater for physicians to be reluctant to seek help in states where both the license application and the renewal asked questions about past mental illness or current mental health conditions that could affect competency.

Also, physicians who were younger, male, and worked in private practice were more reluctant than other physicians to seek help.

“Although there are concerns that the very nature of some illnesses could impede physicians’ abilities to recognize their own limitations, a history of a medical or psychiatric disorder has little predictive value for present impairment of functioning, and there is no evidence that the risk to patients is sufficiently great to require disclosure of private medical records for public scrutiny,” the authors wrote.

Changing medical license application questions, as well as questions asked in the credentialing process, would be a simple but significant step toward reducing barriers faced by physicians seeking help for mental health. Although this would require legislation to amend state medical practice acts, such changes could be implemented at minimal cost, the authors concluded.

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