ISQUA17-3046REGULATORY ACTION TO REDUCE BURNOUT AND BARRIERS TO TREATMENT-SEEKING AMONG PROVIDERS

Abstract

Objectives: Participants at this session will be better able to: 1. Describe how burnout affects provider wellness and presents threats to competence and patient safety, 2. Explain how regulatory processes can impede provider willingness to report and seek treatment for issues of mental health, substance use, or other symptoms of burnout, and 3. Discuss an emerging evidence-informed medical regulatory initiative from the United States that highlights best practices for identifying potential risks to patients without increasing stigma associated with treatmentseeking among providers. Methods: The presenter will describe the current state of physician burnout, including prevalence among medical specialties, contributing factors, and proposed solutions. The position of the medical regulatory authority with respect to burnout will then be considered, using illustrations from discussions of the Federation of State Medical Boards' (FSMB) Workgroup on Physician Wellness and Burnout. The chief responsibility of any medical regulatory authority is to protect the health and safety of patients through licensing, disciplinary, and other regulatory processes for physicians. In scenarios involving burnout, however, protection of public health occurs by focusing first on the health of the provider. This is a challenging shift of perspective for many regulators and forces them to achieve a difficult balance between seeking enough information from physicians to be capable of adequately identifying risks to patients, without increasing stigma around burnout and treatment-seeking, thereby inadvertently causing a barrier to wellness among physicians. Application questionnaires used during licensing processes are an area being looked at in the United States by the FSMB, as this is the primary means by which medical regulators gather information about physicians seeking licensure. Participants in this session will be provided with an overview of licensing processes in American jurisdictions with emphasis on levers for assessing potential risks to patients based on provider health. Best practices will be highlighted for phrasing questions in a way that does not lead to greater stigma about symptoms of burnout, including focusing only on impairment that can interfere with a physician's ability to practice medicine safely, rather than seeking information about a history of illness that may not impact patient care. Regulators must also be mindful of recent data demonstrating a reluctance on the part of providers to report symptoms of burnout for fear they may impact their ability to obtain unrestricted licensure. Results: Session participants will be shown concrete examples of licensing and registration questions that address impairment, but avoid contributing to further stigma around burnout or present barriers to reporting and treatment-seeking. Conclusion: Medical regulatory authorities' duty to protect the public includes a responsibility to ensure physician wellness. While numerous systems factors contribute to the prevalence of burnout among healthcare providers, regulators are working to address burnout by focusing first on the processes related to licensure and discipline that are under their sole purview. Lessons from this ongoing work will be applicable to other areas of healthcare governance, including accreditation and employment processes.