Awareness of deep emotional struggles physicians experience is increasing... but we need more
Awareness of the deep emotional struggles healthcare
If you're a healthcare provider and you aren't struggling with your mental health, I'd love for you to contact me personally to let me know how you're coping so well. I've struggled personally with my mental health over the years and know life would've been so much easier, with so much less heartache, anguish, and physical pain, if there'd been more openness in the medical community before now in my career. Better late than never, I suppose. If you really want to make a dent in physician suicide, talk about your own feelings. Share your hardships. Even if you're not suicidal today, you're at serious risk. You spend all your waking hours trying to ensure the longevity and well-being of everyone around you. It's time to look inward. It's also time to realize that your hiding your emotional life from everyone around you is perpetuating the problem. You're part of the problem, not the solution. If you aren't sharing your difficult feelings, you're reinforcing an environment that keeps others from sharing theirs. Talking about your own hard feelings opens the door and grants others permission to do the same. And it truly will save lives. Repressing your own hard feelings doesn't make them go away. You already know this. You see it every day in your patients, the havoc wreaked by not addressing what's really going on in their lives. What makes you think you'll get by unscathed? Vulnerability, showing how you really feel, is the only way out. Shame grows in the dark. Shame spoken, heals. I'm relieved to see that 40 physician groups have combined to create this Joint Statement supporting Clinician Health in the Post-COVID Pandemic Era:
The COVID-19 global pandemic is an unprecedented modern public health crisis. The extent and nature of lingering health effects of the pandemic on providers, whether or not they themselves have been infected, are not yet known. In order to minimize the loss of life from COVID-19 and its sequelae, and from other current and future public health threats, and to ensure future patient access to medically necessary care, it is vital that we work to preserve and protect the health of our medical workforce.
Optimal physical and mental health of physicians and other clinicians is conducive to the optimal health and safety of patients. The wellness of our medical workforce, physical and mental health, is necessary to ensure patient care.
Physicians and other clinicians must be able to safely secure treatment for mental or other health issues, just as any other individual. A provider’s history of mental illness or substance use disorder (SUD) should not be used as any indication of their current or future ability to practice competently and without impairment.
Discrimination based on disability, as defined by the Americans with Disabilities Act (ADA), is prohibited under federal law and applies to professional licensing bodies1. We therefore support states that ask questions that do not violate the intent of the ADA not to discriminate against individuals. We strongly urge states that ask inappropriate questions to immediately modify them to be consistent with the principles of the ADA. Specifically, see recommendations and position statements of the American Medical Association (AMA), the Federation of State Medical Boards (FSMB), American Psychiatric Association (APA), American College of Physicians (ACP) and the American College of Emergency Physicians (ACEP).
Licensing and credentialing applications by covered entities should only employ narrowly focused questions that address current functional impairment.
Additionally, we strongly support The Joint Commission (TJC) statement on Removing Barriers to Mental Health Care for Clinicians and Health Care Staff. TJC, “supports the removal of any barriers that inhibit clinicians and health care staff from accessing mental health care services.” TJC also encourages organizations not to inquire about previous history of mental health conditions or treatment.
For most physicians and other clinicians, seeking treatment for mental health triggers legitimate fear of resultant loss of licensure, loss of income or other career setbacks. Such fears are known to deter physicians from accessing necessary mental health care. Seeking care should be strongly encouraged, not penalized.
Additionally, we support the use of non-clinical mental health support, such as social or peer support. Social and peer support provide a sense of belonging to those with shared experiences. Individuals who are able to express frustrations and share coping strategies to address mutual challenges and provide hope to one another are invariably healthier than those without such support. Social support systems of all types are useful adjuncts that associations can provide to their members.
Additionally, credentialing agencies should support and expand access to treatment programs, such as including the ability of a physician to self-refer, without fear of reprisal.
JOINT STATEMENT Supporting Clinician Health in the Post-COVID Pandemic Era 1 Americans with Disability Act, 28 Code Fed. Reg. § 35.130 JOINT STATEMENT | Supporting Clinician Health in the Post-COVID Pandemic Era Co-signers American College of Emergency Physicians (ACEP) American Academy of Allergy, Asthma & Immunology (AAAAI) American Academy of Child and Adolescent Psychiatry (AACAP) American Academy of Family Physicians (AAFP) American Academy of Hospice and Palliative Medicine (AAHPM) American Academy of Neurology (AAN) American Academy of Ophthalmology (AAO) American Academy of Physical Medicine and Rehabilitation (AAPMR) American Association for Emergency Psychiatry (AAEP) American Association of Suicidology (AAS) American College of Obstetricians and Gynecologists (ACOG) American College of Physicians (ACP) American College of Preventive Medicine (ACPM) American College of Radiology (ACR) American College of Surgeons (ACS) American Epilepsy Society (AES) American Foundation for Suicide Prevention (AFSP) American Geriatric Society (AGS) American Medical Association (AMA) American Psychiatric Association (APA) American Society for Clinical Pathology (ASCP) American Society of Anesthesiologists (ASA) American Society of Colon and Rectal Surgeons (ASCRS) American Society of Hematology (ASH) American Society of Nephrology (ASN) American Society of Plastic Surgeons (ASPS) American Thoracic Society (ATS) American Urological Association (AUA) Coalition on Psychiatric Emergencies (CPE) Council of Residency Directors in Emergency Medicine (CORD) Council for Medical Specialty Societies (CMSS) Depression and Bipolar Support Alliance (DBSA) Dr. Lorna Breen Heroes’ Foundation Emergency Medicine Residents’ Association (EMRA) Emergency Nurses Association (ENA) Federation of State Medical Boards (FSMB) Infectious Diseases Society of America (IDSA) National Alliance on Mental Illness (NAMI) North American Spine Society (NASS) Society for Academic Emergency Medicine (SAEM) Society of Emergency Medicine Physician Assistants (SEMPA) Society of Hospital Medicine (SHM) Society of Interventional Radiology (SIR) Society of Thoracic Surgeons (STS) The Physicians Foundation