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Florida Physician Boards Revamp Mental Health Questions

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In an attempt to destigmatize mental health counseling, members of two Florida licensing boards voted on Thursday to alter medical-history questions on physician licensure applications.

Instead of applicants having to answer six broad questions about mental health and substance abuse, the Board of Medicine and the Board of Osteopathic Medicine agreed to ask just two:

  • Has the applicant been treated for or had a recurrence of a diagnosed physical or mental disorder that impaired or impairs the ability to practice?
  • Has the applicant been treated for or had a recurrence of a diagnosed alcohol or drug abuse disorder that impaired or impairs the ability to practice?

Additionally, the boards agreed to include in the application a statement that makes clear licensure candidates don’t have to disclose whether they have sought counseling to assist with stress, mild anxiety, situational depression, family or marital issues.
But the boards, meeting jointly, overwhelmingly rejected a request by the Council of Florida Medical School Deans to provide a two-year safe harbor for medical students, physician residents and fellows. The safe harbor would have allowed those applicants to keep private whether they had successfully been treated while in school for physical or mental disorders that impaired them.

Board of Osteopathic Medicine Chairman Joel Rose, a Tampa physician, voted against the changes because of the lack of the two-year safe harbor.  He was the lone physician to do so.

“The deans are telling us that it is keeping students, residents and fellow students from seeking treatment sometimes. That’s the message I got from them,” Rose told The News Service of Florida following the meeting. “That’s what they were seeking to do. And I agree with them. They need a carve-out.”

The physician-specific safe harbor sought by the deans was opposed by the Florida Department of Health. Longtime department employee Jennifer Wenhold said 18 health-care related boards use the same licensure application and that any safe harbor needs to be generic enough to apply to all of the boards.

But Board of Medicine Vice Chairman Hector Vila, a Tampa doctor, argued that the physician boards had been discussing the medical-school deans’ request for two years and that a generic carve out shouldn’t be included, despite what the department maintained.

Board of Medicine Chairman Zachariah Zachariah, however, disagreed.

“I think if you really want to accomplish something, you have to accomplish something in conjunction with the department,”  Zachariah, a Fort Lauderdale physician, said. “I do not believe if you do something antagonistic with the department you are going to prevail.”

A 2014 survey conducted by the Florida Medical Association and the Council of Florida Medical School Deans of 862 medical students and residents found that 10 percent of respondents had thoughts of committing suicide in medical school or of believing they would be better off dead.

The report also found that 63 percent of those surveyed said their physical health had worsened since beginning medical school and 60.6 percent reported their psychological health had worsened. The survey also showed that 70.1 of respondents said they would benefit from psychological resources, but 60.2 percent admitted they had never used any services.

Concerns have focused on whether broad questions can actually deter people from seeking treatment they need. The boards have been grappling with how to change the questionnaire for years, with the deans pushing the boards for the last three years to include safe-harbor protections.

Elaine Wallace, dean of the Patel College of Osteopathic Medicine at Nova Southeastern University, told members of the boards Thursday that medical schools across the state are finding creative ways to encourage health and wellness among students.

She said the university established a wellness program four years ago that is now part of the required course curriculum. She also shared with board members anecdotes of students who realized on their own that they required assistance and stories of students who helped classmates seek assistance.

While there have been numerous success stories at Nova Southeastern, Wallace said two medical students with severe emotional distress in the last two years committed suicide.

“And what haunts me to this day is not whether or not these students could have attained a license in the state of Florida, but whether or not I could have identified them sooner and could have intervened with more aggressive therapy or offered them a more extensive platform that sees all care as accepted and important,” she said.