In 2018, the Federation of State Medical Boards (FSMB) adopted new recommendations about physician wellness and burnout, with specific attention to medical board and licensing questions.As summarized by Saddawi-Konefka et al in JAMA 2021, the relevant FSMB recommendations for licensing questions about mental health are as follows:
- Only if impaired" (if mental health questions are asked, they are limited to conditions resulting in impairment)
- "Only current" (if mental health questions are asked, they are limited to questions about conditions within the last 2 years)
- "Safe haven nonreporting" (if mental health questions are asked, safe haven nonreporting is offered [ie, allowing physicians to not report diagnoses or treatment history if they are being monitored by and are in good standing with a Physician Health Program])
- "Supportive language" (inclusion of supportive or normalizing language regarding seeking mental health care)
Where boards wish to retain questions about the health of applicants on licensing applications, the FSMB recommends that they use the following language:
- “Are you currently suffering from any condition for which you are not being appropriately treated that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical and professional manner?” (Yes/No)
As of 2021, only five states are inconsistent with any of the four FSMB recommendations, which is a considerable improvement from reports as recently as 2017. With that said, only one state is consistent with all four recommendations, and many states are adherent to two or fewer of the four recommendations.
