Depressed, going into residency in NC, terrified of the NCPHP

[Mass Effect]

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regarding #2, rational discrimination is allowed. However, procedural due process must be followed and the prospective licensee must be given a hearing etc.

As cited in above link, state licensing boards violate the ADA in asking such questions that don't pertain to CURRENT level of function. That's really all there is to it.

 

[rokshana]

As cited in above link, state licensing boards violate the ADA in asking such questions that don't pertain to CURRENT level of function. That's really all there is to it.

 

[DisorderedDoc417]

Fun note as I am currently renewing my licensure I thought I might add the exact question asked:

"Have you been treated for or do you have a diagnosis for any mental health condition. (If yes, please ask your treating provider to send a status letter to the Board office).

 

[DisorderedDoc417]

Whats more hilarious is the next question is: Does your alcohol use prevent you from providing care to your patient's.... Guess the alcoholic with poor insight gets the free pass.

 

[Mass Effect]

Fun note as I am currently renewing my licensure I thought I might add the exact question asked:

"Have you been treated for or do you have a diagnosis for any mental health condition. (If yes, please ask your treating provider to send a status letter to the Board office).

State? I'm making a list.

 

[michaelrack]

As cited in above link, state licensing boards violate the ADA in asking such questions that don't pertain to CURRENT level of function. That's really all there is to it.

Agreed, but whether state medical license boards are bound by the ADA is a constitutional question that has not yet been decided

 

[Raryn]

State? I'm making a list.

Someone beat you to it. There's even a map:
Doctors fear mental health disclosure could jeopardize their licenses

 

[VA Hopeful Dr]

I've been reading a lot about this recently and it makes me absolutely sick. The hypocrisy of stigmatizing mental illness in doctors who must face the worst that life can throw at a person on a daily basis while working 80 hours a week is unbearably obsurd and honestly makes me want to jump off a bridge instead of go into medicine. Dont worry though, I won't jump off a bridge because my mental illness has been TREATED for years now! The medical boards can **** off

Make sure you tell them that when applying for a license

 

[500miles]

Make sure you tell them that when applying for a license

To **** off, or that I have a mental illness? Or both?

 

[AdmiralChz]

To **** off, or that I have a mental illness? Or both?

For sure, both. Especially if you don't want to work there.

 

[500miles]

For sure, both. Especially if you don't want to work there.

I'll let ya know how it goes

 

[Psai]

I've been reading a lot about this recently and it makes me absolutely sick. The hypocrisy of stigmatizing mental illness in doctors who must face the worst that life can throw at a person on a daily basis while working 80 hours a week is unbearably obsurd and honestly makes me want to jump off a bridge instead of go into medicine. Dont worry though, I won't jump off a bridge because my mental illness has been TREATED for years now! The medical boards can **** off

Did your provider send a letter to the medical board about this condition?

 

[VA Hopeful Dr]

I'm just really worried that this will hinder my career after all the work it will take getting into and going through med school.

It won't

 

[500miles]

It won't

That's good to hear.. what do you think about treatment for addiction? I was prescribed benzos as a teenager for my anxiety and depression, which I became addicted to. I went to a 30 day treatment at 18 for chemical dependency. I have never done anything illegal and have no criminal record, just this treatment when I was 18. When I have to apply for licensure it will be about 12 years since this incident. But I have maintained going to counseling and have been on antidepressants(and plan to continue) since this event. Any thoughts on how they may view this? since it seems that a number of them(my state unfortunately) asks about these things open ended, unlike some that say "in the last 5 years..". I really appreciate any insight into this you might have, I'm terrified that this could be held against me in the future.

 

[VA Hopeful Dr]

That's good to hear.. what do you think about treatment for addiction? I was prescribed benzos as a teenager for my anxiety and depression, which I became addicted to. I went to a 30 day treatment at 18 for chemical dependency. I have never done anything illegal and have no criminal record, just this treatment when I was 18. When I have to apply for licensure it will be about 12 years since this incident. But I have maintained going to counseling and have been on antidepressants(and plan to continue) since this event. Any thoughts on how they may view this? since it seems that a number of them(my state unfortunately) asks about these things open ended, unlike some that say "in the last 5 years..". I really appreciate any insight into this you might have, I'm terrified that this could be held against me in the future.

Addiction is trickier. It sounds like you've done everything right so it's probably not a big deal, but that would make me a little bit more nervous than being treated for anxiety or depression would by itself.

Once you've matched, talk to your program about that as the sort of thing is very state-specific

 

[VA Hopeful Dr]

Thanks for the input. I've steered away from asking about this in the premed forum because everyone just says "that's an ADA violation and HIPPA blah blah" but the more I have learned it seems that this is not entirely true. I guess it's hard to say until your actually applying for the license? I guess I just dont want to get through it all and have no way forward. Any advice on how to get more information on this? Thanks!

You could contact your state's medical board and just ask them.

Alternatively, do a Google search. Wouldn't surprise me if there are blogs or news reports about people in similar circumstances.

You could also talk to a lawyer who specializes in medical board cases.

 

[Sagafemina]

To be fair to them, I was curious and looked up the ostensible NC board's actual position

Unfortunately, the cited article from NCMB refers to renewal applications only.

NC still asks the ADA impermissible question on initial application as illustrated by Mass Effect, to wit,
... "which in any way limits or impairs or, if untreated, could limit or impair your ability to practice medicine in a competent or professional manner."
Inquiring about theoretical impairment in the absence of treatment is discriminatory against persons who are, or who may be regarded as having, a disability.
This question should read "which currently limits or impairs your ability to practice medicine in a competent or professional manner."

 

[Sagafemina]

Fun note as I am currently renewing my licensure I thought I might add the exact question asked:

"Have you been treated for or do you have a diagnosis for any mental health condition. (If yes, please ask your treating provider to send a status letter to the Board office).

Blatantly impermissible under the ADA. Just for fun, send a copy to the state and federal DOJ Office of Disability Discrimination.

 

[Sagafemina]

Agreed, but whether state medical license boards are bound by the ADA is a constitutional question that has not yet been decided

Yes, they are. However, the DOJ is not going to go out fishing for agencies to sue. Someone has to be brave enough to bring a complaint. Here's an excellent case study on Medscape Consult "Stable Depression in a Physician Faculty Member" whose URL SDN will not allow me to post. He brought the case to the DOJ without a lawyer and prevailed against the MN Board. You might possibly find a similar case by searching EPM "Don't Hold it Against Me".

 

[VA Hopeful Dr]

Yes, they are. However, the DOJ is not going to go out fishing for agencies to sue. Someone has to be brave enough to bring a complaint. Here's an excellent case study on Medscape Consult "Stable Depression in a Physician Faculty Member" whose URL SDN will not allow me to post. He brought the case to the DOJ without a lawyer and prevailed against the MN Board. You might possibly find a similar case by searching EPM "Don't Hold it Against Me".

According to the article, it actually hasn't. The DOJ has their opinion but the case never actually made it to trial of any kind. The current DOJ could easily issue the exact opposite opinion tomorrow.

So no, it's not settled at all.

 

[Sagafemina]

I agree with you that the question as worded runs counter to current legal interpretations of the ADA, which disallow questions about past conditions. I was pointing out to TableMD that his revulsion over the OP's worry is silly since the OP's worry was unfounded in the first place. It's like my wife getting mad at me for making our son cry over an A-, when in fact I only asked whether or not he got an F.

I do think it's reasonable to ask about current impairment. Past mental health problems are off limits according to the ADA, but current ones aren't. As far as asking about the potential for impairment if treatment lapses, I lack the background knowledge to have an informed opinion about whether such a question would run counter to the ADA.

I do have some relevant background and have also consulted a disability lawyer who has dealt with medical boards. He says that the wording of the NC question is "problematic" from an ADA perspective. Essentially, the ",if untreated," language is, under legal deconstruction of English, a parenthetical (rather than a restrictive) statement that can for all intents and purposes be ignored. In other words, the sentence may be read as if it had no such statement. It would then read, "In the past five (5) years, have you had, or have you been told you had, a mental health or physical condition (not referenced above) which in any way limits or impairs or could limit or impair your ability to practice medicine in a competent or professional manner?".
Such a question would be impermissible under the ADA.

Not to mention that it is asking an applicant to predict the future! Let's see, any doc over 50 probably has several physical conditions (occult ASCVD, HBP, DM, etc) that could AT SOME POINT limit or impair their ability to practice medicine in a competent or professional manner. Are they going to haul everyone in for total body scanning, etc. (or simply send them all off to drug rehab for megabucks? Google "Diagnosing for Dollars")

This is going to be discussed in a panel at the upcoming FSMB meeting April 27 in Charlotte (Sheraton La Meridien, Breakout Session #3 9:15-10 AM) that will include the Chief Counsel for the NCMB, who probably wrote the question. If anyone is nearby, just walk in (there's usually no security) and if asked say you are a medical student and want to get a glimpse of medical regulation in progress, and to see what your Federation is doing about your wellbeing.