The Virginia Board of Medicine Perspective on Mental Health Treatment

This item is in response to a psychiatric colleague’s recognition that healthcare practitioners are reluctant to seek mental health treatment when they need it.

We all know that practicing the professions licensed by the Board of Medicine can be stressful, and at times that stress can be additive to other circumstances occurring in our lives. This has been particularly evident during the COVID-19 pandemic. According to The Physicians Foundation 2021 Physician Survey: COVID-19 Impact Edition: A Year Later, more than half of physicians (57%) have felt inappropriate feelings of anger, tearfulness or anxiety because of COVID-19. 46% of physicians have withdrawn or isolated themselves from others. 34% have felt hopeless or without purpose. Despite these symptoms, only 14% of physicians sought medical attention. Board Briefs does not know if these numbers are characteristic of the other professions licensed by the Board of Medicine, but it would not be surprising if they give similar responses. These numbers may show that even when the individual knows he/she needs some help and wants to get that help, there is reluctance to do so for fear of a licensing sanction from the Board of Medicine. So, Board Briefs hopes the following is helpful.

The mission of the Board is to protect the public. Part of that mission is to protect the public from impaired physicians and other healthcare providers that may not be safe to practice due to mental health issues. Obviously, the Board wants all its licensees to be safe to practice and heartily supports mental health treatment for all who feel they need it. A healthier, happier healthcare professional is more likely to be safer and more effective. And mental health treatment can help accomplish that.

Everyone should understand that the Board is about conduct. Its mission is to ensure licensees are able to safely and competently conduct their practice. It is not about a diagnosis that they may carry, especially a diagnosis “in remission”.

As you may know, the Board’s disciplinary system is complaint and report driven. Healthcare professionals that treat other healthcare professionals have reporting requirements that perhaps have been misunderstood by those who want to access mental health treatment.

A treatment provider has the responsibility to report a licensee in treatment to the Board “unless the attending practitioner has determined that there is a reasonable probability that the person being treated is competent to continue in practice or would not constitute a danger to himself or to the health and welfare of his patients or the public.” The attending practitioner’s discretion is applicable to outpatient and inpatient treatment.

Some of this discretion for reporting has recently been extended to CEO’s and Chiefs of Staff in hospitals, as well as administrators of some other facilities. A healthcare professional is to be reported within 30 days if admitted voluntarily to a hospital “for treatment of substance abuse or a psychiatric illness that may render the health professional a danger to himself, the public or his patients.” Note that this language allows the CEO/Chief of Staff to coordinate with the attending practitioner on the decision if a patient meets the threshold for reporting by representing a danger to himself, the public or his patients. If the threshold for reporting is not met by the time of discharge, no report is required. However, if a licensee is involuntarily admitted to a facility, then the CEO or Chief of Staff must report within 5 days.

BOTTOM LINE: Get help if you need it. The Board wants its licensees in good shape to serve the patients of the Commonwealth.

The Virginia Board of Medicine’s perspective on Mental Health Treatment:

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