Dr. Jonnalagadda
In a May 18 article published in the Journal of the American Medical Association (JAMA), North Carolina had the singular distinction of being recognized for its work to address systemic barriers to mental health and/or substance use treatment for licensed medical professionals.
The JAMA article noted that NCMB is the ONLY state medical regulatory board that has fully implemented national recommendations to both remove license application and renewal questions that require the disclosure of medical and mental health conditions, and to include language encouraging clinicians who need treatment to get it. The JAMA review included medical regulatory boards in all 50 states, as well as the regulatory authorities in the U.S. territories of Washington, DC; Guam; the Northern Mariana Islands; and the US Virgin Islands.
Specifically, NCMB removed questions related to mental and physical health conditions from its annual renewal in January 2017 and from its initial license application in October 2018, replacing them with a statement encouraging licensees to seek appropriate treatment for any physical or mental health condition. I was a new Board Member in fall of 2016, when NCMB was just starting this work. As a practicing psychiatrist and recovery ally, I remember feeling proud to be part of an organization that is willing to take a hard look at its processes and make needed changes in the interest of supporting licensee wellness and removing stigma.
Now, as Board President, I can say that NCMB’s work is far from over when it comes to clinician wellness. If anything, the need for this work is greater than ever. In an
article published in this newsletter last year, Dr. Clark Gaither discussed how the pandemic has worsened all the drivers of job-related burnout, among them work overload, lack of control, and breakdown of community.
The hard truth is, COVID changed all medical practice environments.
Out of necessity, we sacrificed personal connection to prevent the spread of the virus. COVID separated us from our supportive colleagues and our therapeutic patient relationships. We converted patient appointments to telephone or video and assessed cases normally seen in person. We extended our shifts at hospitals and care centers wearing personal protective equipment in our interactions. We lost the facial connection, the empathic smile of care and understanding.
I believe the full impact of these necessary concessions are yet to be realized. The abbreviated grief cycle from the many deaths of patients and loved ones, and the cancelled milestones and celebrations of all humanity prevented normal development and closure for us all. The number of cases of burnout, relapse, and retirement from practice are testament to the struggle we are facing and will be facing for some time.
If there were easy solutions to these and other systemic issues burdening the medical profession, surely someone would have already found them. I want to assure you that NCMB recognizes the enormity of the ongoing problem and is committed to continuing to look for ways it can make a positive impact for licensees and patient care in the face of such drastic circumstances. As NCMB President I established a Wellness and Burnout Workgroup this year to focus on three objectives:
1. Continuing examination of NCMB licensing and renewal questions to ensure they do not create potential barriers to treatment;
2. Moving beyond the four recommendations discussed in the JAMA article to consider all 10 Federation of State Medical Board (FSMB) recommendations related to clinician wellness and burnout; and
3. Working collaboratively with stakeholders to enhance the resources available on NCMB’s website to provide a robust resource for clinicians in North Carolina and beyond. Visit the existing page at
www.ncmedboard.org/wellness and feel free to email me suggestions for resources or information you think would be helpful additions.
As a regulatory body with a mandate to protect patients, NCMB will remain appropriately focused on ensuring safe and quality medical care. We recognize medical safety and quality can only be best provided by healthy, flourishing licensees.
Be well.
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forum@ncmedboard.org.
