At Happiness 1st Institute, a Thrive More Now Company we’ve been attempting to help physicians, nurses, and other healthcare professionals improve their mental health for over five years but have encountered reticence to engage. This morning I was reading an article that I believe explains why medical professionals have been so hesitant to admit and seek help with burnout, depression, anxiety, and even stress.
Until recently, North Carolina Medical Board’s license renewal application, question 4, asked the applicant if he/she “was aware of any medical condition that impairs or limits your ability to practice medicine safely?” Medical conditions included “… psychological conditions or disorders …”
When weighed against the potential loss of the ability to work in their chosen occupation it is understandable that medical professionals would be hesitant to seek the help they would then be required to disclose. It seems mental health stigma was alive and well in North Carolina.
With the help of Dr. Bob Henderson and Miriam Schwarz and others, the North Carolina Medical Board has changed question 4 to one that mandates physician self-care. This is a favorable change.
Based on an article Dr. Henderson wrote, A Change in Policy Regarding Physician Burnout the new language reads:
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 healthcare 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.
I am very happy to see this policy change and hope that other states with policies that inhibit physicians from taking care of their own health needs, especially mental health, stress management, burnout prevention, depression, anxiety, and other highly preventable and curable issues take note and follow their lead.
Early warning signs of stress
Warning signs of stress can come in the form of physical, mental, cognitive, and/or behavioral symptoms that exist along a continuum that worsens with duration and the intensity of the experienced stress including the following indicators of stress:,
(This chart is an excerpt from Rescue Our Children from the War Zone: Teach them Social and Emotional Skills to Improve Their Lives.)
This letter from a physician was sent to his parents about a year before he took his own life:
“…Yet on certain days, when our patients do not do well, the trade-off seems untenable. How are we to protect ourselves from the emotional hazards of the practice of medicine? How are we to stand with our patients through the very worst while avoiding depression, significant stress reactions, and even substance abuse or addiction? Love, Greg?”