Are licensing/credentialing bodies required to probe into past mental health or substance use?

This resource is part of the AMA's Debunking Regulatory Myths series, supporting AMA's practice transformation efforts to provide physicians and their care teams with resources to reduce guesswork and administrative burdens.

Neither The Joint Commission nor the Federation of State Medical Boards (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
• Download the myth (PDF).

1. The Joint Commission. The Joint Commission Statement on Health Care Worker Mental Health. The Joint Commission. Published 2021. Accessed November 15, 2022. https://www.jointcommission.org/resources/patient-safety-topics/healthcare-workforce-safety-and-well-being/resources-from-the-joint-commission/
2. 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
3. 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
4. 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

Visit the overview page for information on additional myths.

Disclaimer: The AMA's Debunking Regulatory Myths (DRM) series is intended to convey general information only, based on guidance issued by applicable regulatory agencies, and not to provide legal advice or opinions. The contents within DRM should not be construed as, and should not be relied upon for, legal advice in any particular circumstance or fact situation. An attorney should be contacted for advice on specific legal issues. Additionally, all applicable laws and accreditation standards should be considered when applying information to your own practice.

Page last reviewed in December 2022.