Stefanie Simmons, MD, was once asked whether she would be worried if a physician caring for her or a loved one had depression or anxiety.
Dr. Simmons, the chief medical officer at the Dr. Lorna Breen Heroes’ Foundation, answered with no hesitation.
"I would be thrilled to have a physician for myself or a family member who had gone through the process of treating a mental health condition because they would have a sense of compassion and understanding of what others may be going through," Dr. Simmons said in a recent episode of “AMA Update.”
"It's important to view seeking mental health care as a sign of strength in health care workers," she added.
But many physician credentialing applications stigmatize mental health care, and they don't have to.
In February, Massachusetts launched a state-wide effort to eliminate stigmatizing questions and support physician well-being, becoming the first state to undertake such a coordinated effort.
During this episode, Dr. Simmons and Steven Defossez, MD, vice president of clinical integration at Massachusetts Health & Hospital Association, discussed how other hospitals, health systems, health plans and states can emulate Massachusetts' efforts and support physician well-being. These efforts also included other health professionals who are subject to the internal credentialing process such as nonphysician providers.
Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.
Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.
An AMA issue brief, “Confidential care to support physician health and wellness” (PDF), provides model legislative language and other recommended policy actions for states as well as resources for physicians and state medical associations.
Understand what is stigmatizing
When physicians apply to work in a hospital or health system, they are asked a variety of questions, including some designed to assess their ability to practice in that organization.
In many health care organizations, one of those questions relates to the applicant's history of mental health diagnosis and treatment.
“This is really rooted in an antiquated view of mental health care as a signifier of a moral or ethical fault, as opposed to a necessary part of self-care for a health care worker,” Dr. Simmons said. “These questions have … a chilling effect on physicians' willingness to seek mental health care, even therapy, when they want it."
Part of the stigmatization comes from the location of the question. Dr. Simmons explained that the mental health care question is asked alongside questions about a history of felonies, malpractice or lawsuits.
Another factor relates to who gets access to the applicants' answers. Dr. Defossez said credentialing answers may be seen by potential colleagues on the hospital's credentialing committee, the hospital leaders on the medical executive committee, and the Board of Trustees.
“When you're answering these questions, you're cognizant of the fact that dozens and dozens of other people are going to see these,” Dr. Defossez said. “And obviously, all these people don't need to be privy to your private health situation.”
Removing invasive or stigmatizing language around mental health and substance use disorders in an organization’s credentialing applications and process is a part of the AMA Joy in Medicine Health™ System Recognition Program.
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Identify areas for improvement
The key to driving a coordinated effort in removing invasive questions on credentialing applications is having support from a variety of constituents, including of course physicians, said Dr. Defossez.
The most grueling, yet necessary, part of the initiative came next. That involved reviewing every single credentialing question at every hospital in the state and asking: “Does this represent a barrier to clinicians obtaining necessary health care?” he said.
The Dr. Lorna Breen Heroes’ Foundation can be a partner in the process. “It takes people from all parts of health care coming together to be able to make these changes for organizations," Dr. Simmons said.
Learn more about how the AMA advocates for support of physician mental health needs.
“AMA Update” is your source for physician-focused news. Hear from physicians and other experts on trending public health concerns, practice issues and more—because who’s doing the talking matters. Catch every episode by subscribing to the AMA’s YouTube channel or listen to all AMA podcasts at ama-assn.org/podcasts.
