As an emergency medicine resident, Stefanie Simmons, MD, didn’t plan on experiencing postpartum depression following the birth of her second child. But she also didn’t seek care—a decision that, to this day, she attributes to the harmful belief that physicians should power through any and all obstacles because physicians are supposed to be immune from personal crises.
“I was young, ambitious and devoted to my career,” said Dr. Simmons. “I loved being an ED physician because I was in the middle of the action and helped save lives in traumatic situations. What I didn’t realize, however, is that I needed support—and that I wasn’t alone.”
Dr. Simmons continued as an emergency physician but recognizes that her experience of depression lasted much longer than necessary because of her lack of care. As she recovered, she learned more about the resources available and began to look at how she could help her colleagues. As her career progressed, she realized that she could not only model the types of actions that would help her students and colleagues, but that broader action was needed.
“I eventually started to help develop physician coaching and peer-support programs through my medical group—sharing my story when appropriate and listening to what my clients were going through. It’s difficult to ‘teach’ a physician that it is OK to say, ‘I’m not OK,’ when there’s trauma or stress. One of the keys is that there needs to be a place to say it,” said Dr. Simmons.
“We need to build peer relationships, model supportive behavior, and build hospital and health system cultures that encourage clinicians to seek care,” she added. “When we take care of ourselves and each other, we’re in a better position to care for our patients and community members who rely on us.”
Scrutinizing credentialing questions
Dr. Simmons acknowledged that a fully-developed wellness program to accomplish these goals takes time, investment and institutional support. While her coaching work grew, she also realized that her hospital’s credentialing application asked prospective applicants to reveal whether they ever had a past diagnosis of a mental illness—information that has no bearing on whether a physician has a “current” impairment that adversely affects patient safety or demonstrates a physician’s ability to safely practice medicine.
“Physicians are justifiably concerned that if they are forced to disclose that they have received treatment or counseling in the past that they will be judged harshly by their peers and institution,” said Dr. Simmons.
“I had no idea that I would need help after the birth of my baby, but I was acutely aware that revealing it could hurt my career. It took me longer to recover without care and could have led to impairment,” she said. Many life events, including traumas incurred in the process of providing medical care to patients, can cause a clinician to need mental health care. Clinicians are not immune to mental health conditions.
Dr. Simmons has been determined to change the system for the better. As the vice president of clinician engagement for Envision Healthcare’s national medical group comprised of thousands of physicians and other clinicians, Dr. Simmons worked with senior administrative and physician leaders to build a comprehensive wellness and mental health program that empowers clinicians to thrive.
Part of that program includes ensuring Envision’s credentialing application does not require physicians or other health professionals to reveal a history of a mental illness.
“They understood the importance, and it wasn’t really all that difficult to make sure we have the most appropriate questions. We just had to have an open, honest discussion,” said Dr. Simmons.
Making change nationwide
Changing the questions from a focus on “past diagnosis” to one on whether there is a “current impairment” sends a clear message to everyone that it is safe to seek care, said Dr. Simmons, who delivers this message across the country in her newly added role as the chief medical officer of the Dr. Lorna Breen Heroes’ Foundation.
In that role, Dr. Simmons is leading with a physician’s perspective on the foundation’s goal to educate, advocate and advance solutions to health care worker burnout and to reduce health care worker suicide.
“It’s exciting to take what we did throughout Envision and work with other national leaders to make these changes in other states and other health systems,” said Dr. Simmons. “This is work that will help make us a healthier country.”
As part of its “Debunking Regulatory Myths” series, the AMA has set facts straight on licensing and credentialing bodies’ inquiries about physician mental health. The AMA also has developed an issue brief (PDF) to provide a wide range of advocacy and other resources to help support mental health and wellness.
