Doctors face unprecedented levels of stress, but they often grapple with a cruel irony — the profession’s innate stressors are compounded by numerous barriers to seeking relief.
The stigmatization of mental health care within the medical community is a significant hurdle. According to the Physicians Foundation survey, about half of all doctors reported knowing peers who were hesitant to seek mental health care, and a staggering four out of five concurred that there was substantial stigma surrounding mental health care within their profession.
This stigma is not merely a perception. Institutional practices, including punitive measures for physicians seeking care, can have dire consequences. The tragic case of emergency medicine doctor Lorna Breen, who took her life during the early days of the Covid-19 pandemic, serves as a poignant example. Breen, who had been pushed to the brink of physical and mental exhaustion, harbored concerns that seeking mental health treatment might jeopardize her lifelong career aspirations. Tragically, her fears were not entirely unfounded.
In many states, medical licensing boards, excluding New York, require physicians to disclose past or current mental health care, and hospitals often impose similar requirements for credentialing. While this information might not be used to bar a physician from practicing, the mere perception that it could be used in such a manner adds to the stigma.
Breen’s experience is not unique. The Physicians Foundation survey indicates that approximately 40 percent of doctors fear or know of colleagues who fear seeking mental health care due to questions on medical licensure, credentialing, and insurance applications.
The mental health strain linked to their work significantly predicts a desire among doctors to leave the profession. This sets off a perilous cycle in which more physicians depart, increasing the workload on those who remain and raising the risk of burnout among them.
If not addressed, these conditions that breed burnout and depression, while obstructing their prevention and treatment, could eventually erode the medical profession.
To meaningfully reduce physician depression and burnout, it is crucial to facilitate access to mental health care while addressing the root causes. Companies employing doctors can simplify access to mental health care by assessing their employees’ ability to access such treatment. This includes questions about provider availability and sick leave policies that address behavioral health disorders.
Moreover, eliminating invasive questions about mental health when doctors apply for jobs or licensure is essential for improving access to care. Following Lorna Breen’s tragic passing, her sister and brother-in-law established the Dr. Lorna Breen Heroes Foundation, which advocates for these changes. Their efforts have led to over 25 state licensing boards removing intrusive mental health questions from their applications, with 11 more in the process of doing the same.
The report highlights two key tools to enhance physician mental health. First is peer support, which can take the form of hotlines, grassroots groups, and health care system programs. These initiatives engage physicians in recognizing and supporting colleagues experiencing mental distress. Such programs also help alleviate unsafe working conditions that often trigger emotional harm.
The second tool involves untangling inefficient processes that consume physicians’ time. Creating “accountable care teams” (ACTs) that work together to identify and resolve patient care issues has shown promise. These teams can streamline workflows and reduce the burden on physicians and patients alike.
Efforts to enhance physician mental health should also involve reducing employee harassment, a prevalent issue within the healthcare sector. This necessitates increased training and support for those experiencing harassment, taking complaints seriously, and fostering transparency when addressing such incidents.
In conclusion, the medical community must not only focus on providing counseling and support but also on streamlining the administrative burdens doctors face. By lightening these loads and fostering a connection to meaning and purpose in their work, the baseline mental health of healthcare workers can be significantly improved. Ensuring physician well-being is not just a moral imperative but a practical necessity for maintaining high-quality healthcare.
