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CHICAGO -- Physicians ought to be able to get help for a mental health problem without putting their careers in jeopardy argued members of the resident and psychiatry community who requested changes to policy at the American Medical Association's House of Delegates meeting on Sunday.
Grayson Armstrong, MD, MPH speaking for the resident and fellow section said some physicians avoid getting help for a mental health issue out of fear that receiving a diagnosis or treatment will impact their licensure.
Amid reports of high rates of burnout and suicide among physicians, Armstrong and his colleagues in the RFS crafted asking the AMA to encourage state medical boards to treat mental health problems more like physical ones.
The RFS further recommended that previous AMA policy on licensure confidentiality be revised.
Instead of encouraging that state licensing boards require disclosure of a history of psychiatric treatment, the RFS recommend state licensing boards require disclosure of a mental or a physical condition only in situations where the licensing board believes the illness "is likely to impair the physician's practice of medicine or present a public health danger."
Most physicians in the audience lauded the proposed changes.
Humayun Chaudhry, MD, president of the Federation of State Medical Boards (FSMB) said his organization is currently drafting its own policy recommendations on this issue, and while not endorsing the residents proposal, he said he "applauded the effort."
A brought forward by Ariel Carpenter, a delegate from the Medical Student Section targeted the "knowledge gap" in mental health among students and included a request for data collection on the rates and risk factors of mental illness among undergraduates pursuing a medical education.
The two pronged resolution suggested that the AMA:
- "encourage study of medical student mental health, including but not limited to rates and risk factors of depression and suicide"
- "encourage medical schools to confidentially gather and release information regarding reporting rates of depression/suicide on an opt-out basis from its students."
Carpenter, who recently lost a classmate because of mental health problems said similar tragedies are being repeated across the country.
"We lose a class of medical school every year to suicide, said Mark Ard of the PAC West, who supported the MSS resolution, particularly the inclusion of an opt-out for students.
Luke Selby, MD, an RFS delegate suggested including an additional clause recommending that medical schools work with "other interested parties" to research ways to identify "modifiable risk factors" for depression, burn-out and suicide .
There's plenty of research on the high rates of burn-out among medical students and physicians, but many of their challenges are rooted in factors not amenable to modification,
Selby said.
"We're Type A people who don't like to fail, don't get enough exercise, don't get to spend enough time with our families. None of that is going to change in the near future," he said.
Hence, the need for strategies to target modifiable risk factors, "So that the Type A people who don't want to fail, get strategies to help them when they have a bad test score, when they have a bad patient outcome. Things like this help us get through these crises."
Neither resolution will be considered policy unless it is approved by the House of Delegates, which will begin voting on a series of resolutions on Monday.