Physician Health Weekly Vol #4

Remember, September is National Suicide Prevention Awareness Month, Sept 8 - 14 is National Suicide Prevention Week and September 17th is National Physician Suicide Awareness Day

Physician Wellbeing News & Updates - August 25, 2025

Research & Clinical Insights

JAMA Publishes Comprehensive Mental Health Care Strategy

This timely publication in JAMA Network addresses Reducing Barriers to Mental Health Care for Physicians: An Overview and Strategic Framework. This comprehensive analysis represents one of the most thorough summaries to date of the systemic barriers preventing physicians from seeking mental health care and provides evidence-based strategies for overcoming them.

Key Barriers Identified: The article systematically catalogues the multiple obstacles physicians face when seeking mental health support, including licensing and credentialing concerns, professional stigma, confidentiality fears, and structural healthcare system barriers. The authors emphasize that these barriers operate at individual, institutional, and regulatory levels, requiring coordinated interventions across multiple domains. 

Strategic Framework Components: The paper presents a multi-pronged approach focusing on policy reform, institutional culture change, and individual support mechanisms. Key recommendations include:

•   Reforming licensing board questions about mental health treatment - This addresses one of the most significant barriers to physician help-seeking behavior

•   Implementing confidential physician health programs - Creating safe pathways for early intervention and support

•   Establishing safe reporting mechanisms - Protecting physicians who seek help from professional repercussion

•   Creating organizational policies that explicitly protect physicians seeking mental health care

•   Developing peer support programs within healthcare institutions

•   Training leadership in mental health literacy to reduce stigma and improve support

Progress on Licensing and Credentialing Reform: The article's emphasis on reforming licensing board questions builds on significant advocacy work already underway, with substantial progress made nationwide. Following the 2018 recommendations by the Federation of State Medical Boards to eliminate discriminatory mental health questions from licensing and credentialling applications, numerous states have reformed their licensing processes. It should be noted that California was among the earliest states to implement these changes.                        

Most recently, California strengthened its commitment to reducing barriers through AB 2164, signed into law in September 2024. This landmark legislation, sponsored by the California Medical Association (CMA), prohibits both the Medical Board of California and the Osteopathic Medical Board of California from requiring applicants to disclose certain mental health information on their licensure applications. Under AB 2164, physicians no longer have to report:

•   A condition or disorder that does not impair their ability to practice medicine safely

•   A condition or disorder for which they are receiving appropriate treatment and which, due to the treatment, no longer impairs their ability to practice safely

This law represents a significant step toward reducing the stigma surrounding mental health care for physicians and removing one of the primary barriers to help-seeking behavior. It should be noted that the bill’s sponsor was Assemblymember Marc Berman, who is also the sponsor of AB 408 (Physician Health Program).

The Dr. Lorna Breen Heroes' Foundation has been instrumental in advancing these reforms nationwide, working systematically to eliminate discriminatory mental health questions from medical licensing applications and credentialing processes across multiple states. As highlighted in our recent coverage, states like Rhode Island have passed comprehensive privacy protection legislation, while Pennsylvania has been recognized for implementing progressive credentialing changes.

The Foundation's "Wellbeing First Champion" initiative specifically targets credentialing reform, working with healthcare institutions to implement policies that encourage rather than discourage physician help-seeking behavior. These efforts demonstrate the practical application of the JAMA framework's recommendations and provide concrete examples of how systematic barrier reduction can be implemented at state and institutional levels.

Evidence Base: The analysis draws on extensive research demonstrating that physicians experience higher rates of depression, anxiety, and suicide compared to the general population, yet are significantly less likely to seek appropriate treatment. The authors present data showing that fear of professional consequences is the primary deterrent to help-seeking behavior, creating a dangerous cycle where those most in need of care are least likely to access it.

Implementation Pathways: The framework provides concrete steps for healthcare institutions, regulatory bodies, and policymakers to reduce barriers systematically. These include developing peer support programs, training leadership in mental health literacy, creating anonymous assessment tools, and establishing clear pathways to confidential care.

This publication provides crucial evidence-based support for initiatives like California's AB 408, demonstrating the scientific consensus around the need for systematic approaches to physician mental health care access.

Technology Solutions for Burnout Prevention

A Mayo Clinic study published in Medical Economics reveals that smartwatches are linked to reduced physician burnout. The research suggests that wearable technology may offer practical tools for monitoring and potentially mitigating burnout among healthcare professionals, representing an innovative approach to physician wellbeing. It should be noticed that the study results focused only on reducing burnout and that there was no statistical improvement in rates of depression, overall quality of life of sleepiness.

Self-Forgiveness and Moral Injury Recovery

New research highlighted in the Journal Self and Identify explores why forgiving yourself is so hard and how to finally do it. The study examines how moral injury can trap individuals in the past while others manage to move forward, offering insights particularly relevant to healthcare professionals dealing with patient care complications and medical errors.

Training and Work Environment

Residency Directors Weigh in on Work Hour Reforms

A peer-reviewed study in Advances in Medical Education and Practice examines perspectives of residency program directors regarding optimal duty hours. The research addresses supervisors' overtime requirements to uphold trainee limits and analyzes the impact of overtime on physician well-being, providing crucial insights for ongoing medical education reform efforts.

Global Perspectives and Comparative Analysis

International Physician Mental Health Report

Medscape has released its comprehensive International Physician Mental Health & Well-Being Report 2025, offering comparative data on physician mental health across different healthcare systems. The report provides valuable benchmarking data for understanding how physician wellbeing varies globally and what factors contribute to better outcomes in different countries. Some interesting findings:

·      71% of US physicians felt that self-care was a priority or very important, second only to France with 88%

·      US led the other countries (63%) in being willing to accept a paycut for improved work-life balance

·      Everyone thinks vacations are important!

·      But France, Germany and Argentina led in how much vacation is taken (> 60% took 5-6+ weeks for these countries)

·      Attention to Exercise and diet, which was generally high as expected, was similar in all countries studied 

Policy and System-Level Concerns

Healthcare Policy Impact on Physician-Patient Relationships

Physicians for a National Health Program (PNHP) has published an analysis warning that policy changes will make it harder for doctors to give patients the care they need. The piece addresses themes of betrayal, burnout, and moral injury in the context of healthcare financialization, examining how system-level changes affect both physician wellbeing and patient care quality.

Key Themes Emerging This Week

Technology Integration: The Mayo Clinic smartwatch study represents growing interest in leveraging technology for physician wellbeing, suggesting that wearable devices might offer new avenues for burnout prevention and early intervention.

Moral Injury and Recovery: The self-forgiveness research adds to our understanding of moral injury—a critical factor in physician mental health that goes beyond traditional burnout models.

System-Level Interventions: The JAMA strategic framework publication indicates growing recognition that addressing physician mental health requires comprehensive, systematic approaches rather than individual-focused solutions alone.

Training Reform Continuation: The residency work hour research demonstrates ongoing efforts to balance physician training needs with wellbeing considerations, reflecting continued evolution in medical education approaches.

Global Context: The international comparative data helps contextualize US physician wellbeing challenges within broader healthcare system structures and policies.

Looking Ahead

This week's collection of research and analysis pieces reflects the maturation of physician wellbeing as a field of study, with increasingly sophisticated approaches to measurement, intervention, and policy analysis. The combination of technological solutions, psychological research, policy analysis, and international comparisons suggests a comprehensive approach to understanding and addressing physician mental health challenges.

The emphasis on system-level factors—from healthcare financialization to training reform—indicates growing recognition that physician wellbeing cannot be separated from broader healthcare policy and organizational decisions.

These developments continue to inform ongoing discussions about physician health programs, including California's AB 408, by providing evidence-based insights into effective interventions and systemic approaches to supporting physician wellbeing.

Disclaimer: The views and opinions expressed in this blog are solely those of the author and do not necessarily reflect the official policy or position of any organization, institution, or entity with which the author is or has been affiliated.

#Physician wellbeing #PHPs #Physician health #AB 408 #LornaBreenFoundation #Physician Suicide