Supporting staff mental health is crucial for a healthy workforce, strong organizational culture and high-quality care. At Seattle-based UW Medicine, that commitment includes revising credentialing and professional review applications to remove questions that may discourage clinicians from seeking needed mental healthcare.
Applicants have historically been asked about sanctions, disciplinary actions, malpractice claims and other adverse events — along with questions about mental and physical health, including substance misuse.
“The assumption was that if we asked these questions, we would be able to screen out people that, were they to come to work under our jurisdiction, they would present a risk to our patients and a liability risk to the institution,” Brian Johnston, MD, a professor of pediatrics at the University of Washington School of Medicine, told Becker’s. Dr. Johnston oversees medical credentialing at Harborview Medical Center.
“And I think we’ve learned over the years that’s probably not true. Asking those questions doesn’t actually do what we think it would do.”
For example, UW Medicine forms previously asked: “In the last five years, have you had any physical condition, mental health condition, or chemical dependency condition that affects or will affect your current ability to practice?” Applicants who replied “yes” were prompted to provide further details.
“But the medical literature shows no evidence that asking about a past history of mental health or substance abuse treatment predicts your current ability to practice … no evidence that it protects patients, makes our care safer,” Dr. Johnston said.
He said UW Medicine also recognized that asking these questions could dissuade clinicians from seeking care.
“Because they know that they’re going to have to report that the next time they are re-credentialed. … It’s considered stigmatizing,” he said.
With this in mind, UW Medicine audited all credentialing applications and peer-review forms in 2024. The Office of Medical Staff Affairs then revised the questions to focus on current impairment — specifically whether the provider can safely, competently and ethically perform their duties, with or without reasonable accommodation.
“That’s really what we want to know,” Dr. Johnston said. “We don’t really need to know about your past history of treated conditions … if they’re adequately treated.”
New forms ask: “Are you unable to perform, with or without accommodation, any of the clinical privileges you have requested due to a physical, mental, or behavioral health condition that adversely impacts your judgment, skill, or competency, according to accepted standards of professional performance?”
UW Medicine also revised peer-reference forms to ask: “Are you aware of any active physical, mental, emotional, or behavioral issue in the applicant that currently impairs their ability to exercise any of the privileges requested or adversely impacts their judgment, skill, or competency, according to accepted standards of professional performance?”
Changes applied not only to physicians but to advanced practice providers, residents, fellows, and allied health professionals. The system also added a page to each application to provide context about why certain questions are asked.
“And it makes the trade-off a little more explicit,” Dr. Johnston said. “We’re not going to ask about treatment … because we don’t want to discourage you from seeking care when you need it.”
He emphasized that the health system encourages clinicians to seek help and includes a list of resources, such as employee assistance programs and peer-counseling services.
“Again, I think a lot of providers … are concerned that these physicians’ health programs are weaponized against them,” he said. “But in fact, they really are a safety net. … If you engage with the Washington Physicians Health Program … they have your back.”
On June 9, UW Medicine was recognized as a 2025 “Wellbeing First Champion” for its efforts by ALL IN: Wellbeing First for Healthcare, a coalition of healthcare organizations. Beyond the award, Dr. Johnston said the system hopes to lead by example.
“This is very doable,” he said. “It’s the right thing to do.”
