‘It makes doctors human’: Massachusetts hospital to stop asking clinicians about past mental health conditions, addictions

Massachusetts hospitals and health insurance companies have agreed to stop asking doctors and other clinicians about their histories of mental illness and addiction, joinWorking to eliminate stigma and reduce widespread burnoutamong health care workers.

Every two to three years, cliniciansComplete forms to maintain their medical eligibility with hospitals and insurance companies. These forms often include questions about past mental health conditions and substance use to help determine whether clinicians can safely do their jobs.

But a growing number of state and national health care organizations argue that such issues violate privacy and prevent people from getting much-needed mental illness and substance abuse treatment.

Hospitals and insurance companies in various states now say they won’t pay attention to a person’s past behavioral health conditions. Instead, they ask about current medical issues that may impair a clinician’s ability to care for patients.

The changes mean doctors will no longer be required to disclose whether they receive treatment for depression or whether they are recovering from drug or alcohol addiction.

Dr. Barbara Spivak, president of the Massachusetts Medical Society, said if you are currently able to practice medicine and can take care of yourself, then we should be interested in what you are interested in rather than what you have done before. This is a big step forward.

This is especially important in today’s world, she says, where we see so many doctors suffering from varying degrees of burnout and where the stress of medicine really interferes with the joy of medicine and perhaps even the joy of life.

Doctors who admit to having mental health or addiction issues on a certification form are often required to share more details and undergo reviews such as monitoring or regular drug testing.

Many doctors also worry that admitting to mental illness or drug abuse will completely incapacitate them from practicing medicine. In a recent survey, more than 40% of doctors said they would not seek help for burnout or depression because they feared medical boards or employers would discover the condition.

Dr. Steven DeForseth, vice president of clinical integration for the Massachusetts Health and Hospital Association, said people believe their livelihoods are at risk.

Defosset said medical culture has traditionally held doctors to unrealistic standards of being super men and super women. This means you don’t get hurt, you don’t have emotions. When you get a cut, you don’t bleed. But none of this is true.

He said it would be healthier if clinicians could get the behavioral health care they need, whether it’s psychological care for stress, anxiety or depression, or care for substance use disorders. We’re removing barriers so clinicians can do this.

Medical licensing boards in more than two dozen states, including Massachusetts, have stopped asking broad questions about mental health on their licensing forms. All hospitals and insurance companies in Massachusetts have committed to doing the same with their certification forms, and some have already done so.

Dr. Peter Greenspoon, a primary care physician at Massachusetts General Hospital who was not involved in the decision to change the hospital and insurance formats, said it’s a big step in the right direction. It makes doctors human. It allows them to deal with their problems without adding a whole layer of punishment.

Greenspoon suffered from opioid addiction, temporarily lost his medical license, and has been in recovery for 15 years. He said doctors suffering from addiction and mental illness deserve compassion.

People in recovery are great doctors, he said. They are the ones who have reached the other side. They are truly humble, connected, attentive doctors who listen to their patients.

Burnout among health care workers has been growing for years, and the coronavirus pandemic has exacerbated the crisis by forcing medical professionals to deal with surges in patient volumes, longer hours, supply shortages and an increase in harassment and violence.

According to the U.S. Centers for Disease Control and Prevention, nearly half of health care workers reported feeling frequently burned out in 2022, compared with 32% in 2018. Surveys show physician burnout rates are even higher. In response, some healthcare professionals are leaving their jobs or reducing their hours.

Healthcare workers, especially female doctors, are at extremely high risk of suicide compared with other workers. It is estimated that 300 to 400 doctors commit suicide each year.

Dr. Lorna Breen was an emergency room doctor in New York City during the early days of the pandemic, when hospitals were overwhelmed with critically ill COVID-19 patients. She was under the stress of working long hours and realized she was struggling, becoming so depressed that she couldn’t move. She confided in her sister, who helped her get psychiatric treatment in another state. But Brin worried about what others would think. She fears she will lose her job.

Her brother-in-law, J. Corey Feist, said she was not in good health. When we got her stabilized, she said, “Now my career is over.” Now I’m done.

Brin committed suicide in April 2020.

Feaster is the CEO of a foundation in Bullins’ memory dedicated to improving the well-being of health care professionals. The Dr. Lorna Breen Heroes Foundation has been pushing state medical boards and hospital leadership to update their licensing and credentialing forms.

For example, don’t ask a clinician: Have you ever been treated or diagnosed with any mental health conditions? Feaster said hospitals should ask them if they currently have any untreated illnesses that impair their ability to practice medicine.

“Any organization we share this information with, they go back and look at their questions and are often shocked by what they’re asked,” Feaster said. Change is actually happening at a pretty rapid pace.

Local health care groups supporting the updated form include the state’s medical society, the hospital association, the Massachusetts Association of Health Plans and Blue Cross Blue Shield of Massachusetts.

Several national groups, including the American Medical Association, and state and federal health officials have also called for an end to questions they say contribute to the stigma of seeking behavioral health care.

These changes come amid a broader shift toward treating mental illness and addiction like other illnesses. There seems to be no strong opposition to the movement to update the tables.

The National Council for Quality Assurance, which accredits health plans, recently eliminated a requirement that plans ask clinicians about prior medication use. This change allows Massachusetts insurance companies to update their forms.

“We hope NCQA’s elimination of this outdated question will reduce stigma for health care providers and patients,” Liz Leahy, senior vice president of the Health Plans Association, said in a statement.

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