Viewpoint: Systemic overhaul needed to support physician mental health

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Hospitals and health systems must take responsibility for physician mental health and establish initiatives and resources to improve well-being, according to an op-ed published Sept. 19 by The Hill.

The editorial was penned by Michelle Williams, PhD, dean of the faculty at Boston-based Harvard T.H. Chan School of Public Health; Corey Feist, co-founder of the Dr. Lorna Breen Heroes' Foundation and CEO of the University of Virginia Physicians Group; and Shekhar Saxena, MD, professor of the practice of global mental health at Harvard T. H. Chan School of Public Health.

U.S. physicians die by suicide at twice the rate of the general population, an issue that has reached crisis proportions amid the pandemic, the authors wrote. Many physicians have cut back hours, while others simply leave the field. For every one-point increase in reported burnout, physicians were 30-40 percent more likely to leave the profession within the next two years, according to a recent Rochester, Minn.-based Mayo Clinic study cited in the op-ed. That's the equivalent of losing the graduates from seven medical schools annually, reported the authors.

Four ways to overhaul the system and improve physician well-being, per the authors: 

1. The House of Representatives should immediately pass the Dr. Lorna Breen Health Care Provider Protection Act, which the Senate unanimously cleared last month. The bill would establish grants to health systems to help improve mental well-being. It also allows for grants to medical schools to train students on strategies to strengthen mental health and resiliency. The bill would establish a comprehensive study on physician mental health, as well.

2. Everyone has to support the health workforce in prioritizing their own well-being, which is the aim of #FirstRespondersFirst, an initiative started by the Harvard T.H. Chan School of Public Health with Thrive Global and the CAA Foundation. The initiative provides front-line healthcare workers with additional resources, from personal protective equipment to mental health support.

3. Medical boards should follow Federation of State Medical Board guidelines and eliminate probing questions about mental health that may deter physicians from getting help.  

4. The onus for physician mental well-being must shift from personal to systemic. Hospitals must implement more evidence-based interventions that are effective against burnout, including: 

  • Reducing administrative tasks. 
  • Appointing dedicated wellness officers.
  • Removing mental health questions from malpractice applications, credentialing applications, licensure applications and the commercial insurance credentialing process.
  • Adapting the SafeHaven model regarding legal discovery during lawsuits.
  • Allowing physicians to seek mental health outside their healthcare systems.  

"Fortunately, we are starting to see signs of change," the authors concluded. "We're encouraged every day by how this pandemic has created newfound momentum to tackle deep-seated problems in public health. This crisis must be one of them."

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