State Medical Board Licensing Questions Regarding Mental Health: Mission Not Yet Accomplished

In a recent issue of JMR, Areluba et al published their literature review of the potential impact of medical licensing questions on physicians' willingness to seek mental health treatment.¹ Their review serves not only to summarize current literature on this important issue, but it also maintains the necessary focus on the work yet to be done. Saddawi-Konefka and colleagues reviewed the publicly available initial medical licensing applications for US states and territories, as of July 2020.² Of the 2018 FSMB recommendations on physician wellness and burnout³ that were evaluable in these license applications, 5 states were still inconsistent with all 4 of the recommendations that apply to state medical licensure, and only 1 state was consistent with all 4.

While it is clear that several state licensing boards have revised their applications to become more compliant with FSMB's guidance, there is clearly much more to be done before all US physicians have the ability to seek mental health care without concern for its potential impact on their state licensure application or renewal.

The factors contributing to physician burnout are multi-factorial and complex. Aruleba and colleagues' review supports the assertion that although questions regarding mental health history on state medical licensing applications are not the only factor impeding the path for physicians to seek mental health care, they do seem to be 1 of the contributing factors.

As the COVID-19 pandemic drags on, physician burnout and intent to leave practice continue to rise—-to the alarmingly high levels of 60% and >40 %, respectively.⁴ Reversing this trend has no easy answers but removing barriers to our colleagues seeking mental health by minimizing their concern for its potential impact on their medical licensing, would be an important step toward improving physician wellness.