Mental health history questions on hospital credentialing

[spidermitchel]

Although data shows asking about mental health history is detrimental to physician well being and increases the likelihood of untreated physicians, somehow some hospitals still ask these questions and often add it in the same sentence as substance abuse and other illegal activities. People with very remote history of mild depression from a life event are required to answer yes to these questions opening them up for unfair scrutiny. Even thought the evidence shows asking these questions is detrimental to physician health and patients, and the AMA recommends against it, they continue to do it. It clearly must not be a violation of ADA because no one has successfully challenged it legally to my knowledge.

Does any one know the best way to navigate these questions? Do physicians have the right to not disclose?

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[RangerBob]

On all the applications I've filled out (for med school, internship, residency, fellowship, 3 state medical boards, all the hospitals I've worked at), the question was always phrased with the caveat of "... that affects your ability to safely care for patients." So you wouldn't need to list mild depression/anxiety/etc if it didn't/doesn't affect your ability to safely care for patients.

If the application asks simply "do/have you ever had a mental health diagnosis," then you could answer "mild depression after brother's death. Resolved. Did not and does not affect ability to care for patients" or something to that effect.

No one really cares about mild mental health diagnoses. Why it would be asked is beyond me, but likely at least half the physicians/staff reviewing your credentials had/still have some kind of mild mental health issue.

 

[HighwayVagabond]

I don’t know the answers to your specific questions, but you may find resources through the Lorna Breen Foundation that answer these. This foundation brings awareness to why these questions can be so harmful to physicians and advocates for legislation to remove this line of questioning from credentialing material. Here is their website. Hope you find it helpful. Dr. Lorna Breen Heroes Foundation | Dedicated to Protecting the Well-Being of Physicians and Health Care Professionals

 

[dozitgetchahi]

If you have a distant history of situational depression which has resolved, the answer is “no”.

My personal position is that physicians should almost always be answering these questions “no” unless there is an abundantly obvious reason to answer “yes”. These questions are ridiculously intrusive (and, under the ADA, are mostly probably illegal, although in many circumstances this hasn’t been properly litigated yet by physicians in the courts. Some legal experts argue that this nonsense would be shot down altogether, or at least heavily reformed, if it was.)

 

[spidermitchel]

On all the applications I've filled out (for med school, internship, residency, fellowship, 3 state medical boards, all the hospitals I've worked at), the question was always phrased with the caveat of "... that affects your ability to safely care for patients." So you wouldn't need to list mild depression/anxiety/etc if it didn't/doesn't affect your ability to safely care for patients.

If the application asks simply "do/have you ever had a mental health diagnosis," then you could answer "mild depression after brother's death. Resolved. Did not and does not affect ability to care for patients" or something to that effect.

No one really cares about mild mental health diagnoses. Why it would be asked is beyond me, but likely at least half the physicians/staff reviewing your credentials had/still have some kind of mild mental health issue.

I don't know why it is asked either. It seems to me the hospitals or boards believe they can mitigate risk by finding out even the slightest mental health history, but data now shows those questions actually discourage physicians from seeking mental health care, thus increasing the amount of untreated physicians practicing. That is worse for both physicians and patients and could well account for high rates of suicides among physicians. I assume some hospitals have not gotten around to following evidence the way they preach.

One could argue that hospitals who do not follow AMA recommendations of qualifying the questions with impairment actually put themselves at greater legal risk since they probably have a higher number of untreated physicians, and it is only a matter of time before lawyers connect those dots. Not to mention people answering yes instantly become a potential ADA headache for the hospital and litigation in that arena is more common. All this makes it strange why they continue to ask those questions.

I personally do not think it is a good idea to work for a hospital that asks those questions because that is probably a hospital more concerned about their own interests than patient/physician safety and well being.

 

[HemeOncHopeful19]

I personally do not think it is a good idea to work for a hospital that asks those questions because that is probably a hospital more concerned about their own interests than patient/physician safety and well being.

I have some potentially distressing news for you… you just described every hospital in America, and tbh probably the world.

 

[spidermitchel]

I have some potentially distressing news for you… you just described every hospital in America, and tbh probably the world.

Somewhat true but fortunately for me I had multiple job offers, some of which did not ask insulting mental health questions from the distant past. I simply chose another one.

 

[LucidSplash]

Somewhat true but fortunately for me I had multiple job offers, some of which did not ask insulting mental health questions from the distant past. I simply chose another one.

Glad you had that opportunity. Agree with above, however, that most of these questions are qualified so as to specify “that interferes with your ability to engage in patient care.”

Additionally, I have never had a credentialing application that does not ask something like this. So hopefully your new job does not have these once the credentialing process starts.

 

[gyngyn]

Additionally, I have never had a credentialing application that does not ask something like this.

Also, every letter of support for faculty credentialing includes a question like this.
Thus, there is an attestation from the person seeking hospital privileges as well as those providing an assessment of professionalism and skill.

 

[spidermitchel]

Also, every letter of support for faculty credentialing includes a question like this.
Thus, there is an attestation from the person seeking hospital privileges as well as those providing an assessment of professionalism and skill.

I dont think the issue is asking. The issue is when they don't qualify it. Most credentialing applications ask if you had/have mental health issues which impairs your ability to practice. The question the AMA discourages is the "have you ever" question with no qualifiers. That type of question will get a lot of unnecessary 'yes' answers which have no value, while discouraging people from getting help in the future. I have completed credentialing in 2 organizations who ask appropriate questions with reasonable qualifiers. You don't have to work for organizations who don't respect physician mental health.

 

[gyngyn]

Most credentialing applications ask if you had/have mental health issues which impairs your ability to practice.

That's right. I haven't seen one without the qualifier.

 

[timpview]

100% always answer No… regardless of your history

If you truly feel it’s a yes, rescind your request and deal with it.. then when you apply when you’re ready, answer no

 

[psycho-matic]

I have some potentially distressing news for you… you just described every hospital in America, and tbh probably the world.