Based on feedback from groups that support physician wellness, the North Carolina Medical Board (NCMB) has decided to cease the practice of asking renewing licensees to disclose whether they are in treatment for any medical condition that might impair or limit their ability to practice safely. NCMB hopes that doing away with the renewal question will encourage any licensee struggling with a medical or mental health issue to get appropriate attention, without fear of repercussion by the Board.
Beginning sometime in December or January, the Board will replace the current renewal question with a statement of NCMB’s expectation that licensees appropriately address personal health conditions, including mental health and substance use issues, without disclosing specific details. The wording of the statement (see below) was developed by NCMB in collaboration with the North Carolina Medical Society (NCMS) and the NC Physicians Health Program (NCPHP).
The Board voted in September to replace the current renewal question that asks licensees to state whether they are under treatment for a condition that may adversely affect their ability to practice with the following language:
Important: The Board recognizes that licensees encounter health conditions, including those involving mental health and substance use disorders, just as their patients and other health care providers do. The Board expects its licensees to address their health concerns and ensure patient safety. Options include seeking medical care, self-limiting the licensee’s medical practice, and anonymously self-referring to the NC Physicians Health Program (www.ncphp.org), a physician advocacy organization dedicated to improving the health and wellness of medical professionals in a confidential manner.
The failure to adequately address a health condition, where the licensee is unable to practice medicine with reasonable skill and safety to patients, can result in the Board taking action against the license to practice medicine.
For approximately the last two years, the Board has spent time considering whether the renewal question may be an obstacle to licensees seeking assistance. Forgoing treatment can contribute to burnout, impact quality of care or, in extreme cases, lead to major depression or suicidal thoughts. This is a growing problem among medical professionals across the nation, as well as in North Carolina. The Board is committed to doing its part to encourage licensees to seek the help they need without fear of repercussion.
As the Board considered its existing renewal question, it became clear that the question is sufficiently broad in its definition of “medical condition” that licensees frequently over-report health concerns. This results in unnecessary staff review of renewal applications in which there is no true threat to patient safety. After thoroughly considering the matter, NCMB concluded the existing renewal question wasn’t effective at identifying licensees who may need review, and might actually be actively deterring individuals from seeking help.
The NC Consortium for Physician Resilience and Retention has been instrumental in bringing together stakeholders, including the NCMS, Cone Health, the NCPHP, the NCMB and other organizations that deal with the impact of this trend. The Consortium is committed to identifying opportunities to address mental health, wellness and burnout among medical professionals in the state.
Some of the other initiatives the Consortium, which came together early in 2016, initially discussed also are close to fruition including adding an Employee Assistance Plan (EAP) to the NCMS Employee Benefit Plan, creating an online, searchable directory for mentors or peers outside of a physician’s or physician assistant’s own health system to provide local peer help and support to those in early stages of burnout or crisis. The group also has discussed targeting residency programs as well as physician and PA spouses and family members for education and training on wellness and resiliency and developing a Physician Wellness Symposium to be held in conjunction with the 2017 M3 Conference in Raleigh next September
If you would like to support this work please make a contribution here. To be added to the Consortium’s distribution list, contact Pam Highsmith at the NCMS, 919-833-3836 or [email protected]. The Consortium has started a Facebook page to share resources. Please join us here on Facebook.
Instead of removing this language from the renewal process, the Board should mandate a random drug screen for license renewal.