Advocating for You and Your Health

Happy Anniversary, Regs & Eggs! This week marks one year since the first Regs & Eggs blog post was published.

Over the past year I have tried to lay out how federal regulations impact you and the patients you serve—and how ACEP has advocated for you to ensure that you have the regulatory flexibility and resources you need to effectively do your jobs. From promoting ACEP’s alternative payment model, to highlighting key portions of the major Medicare physician fee schedule (PFS) reg, to discussing major barriers to the treatment of patients with opioid-use disorder, to tackling the many challenges you have faced responding to the COVID-19 pandemic, Regs & Eggs has covered a variety of critical regulatory topics.

On a personal note, taking a step back and looking at what’s we’ve accomplished over the past year makes me realize how fortunate I am to have the opportunity to advocate on your behalf. If you feel like joining me on taking a trip down memory lane, you can check out the Regs & Eggs archive here.

One of my first posts focused on addressing physician burn-out, which unfortunately is as relevant today as it was a year ago. Even before the COVID-19 crisis hit, emergency physicians have historically had higher rates of career burnout and post-traumatic stress disorder (PTSD) than other medical specialties. Upwards of 65 percent of emergency physicians and emergency medicine resident physicians report experiencing burnout during their career. While approximately 15 to 17 percent of emergency physicians, and upwards of 20 percent of emergency medicine residents met the diagnostic criteria for PTSD in 2019. Further, in the last year, as many as 6,000 emergency physicians have contemplated suicide and up to 400 have attempted to take their own life.

Now with the pandemic on us, these unsettling trends in emergency medicine will only get worse. While you and your colleagues bravely serve on the frontlines, some of you have probably seen things that you thought you would never see over the course of your medical careers. And, unfortunately, although you should be encouraged to ask for help and seek counseling and other mental health services when you need them, the way the system is designed leaves many legitimately afraid to do so.

Overall, physicians seeking mental health treatment are concerned about possibly losing their medical licenses or facing other professional setbacks. Some state licensing boards continue to ask questions about physicians’ mental health histories or past treatment that appear to violate the intent of the American Disabilities Act—which prohibits discrimination against people with disabilities, including psychiatric disorders. These intrusive questions about whether physicians have any psychiatric history have discouraged many who need psychiatric treatment from seeking it because of fear of the questions down the road. Practicing physicians with histories of psychiatric disorders or mental health counseling have at times also faced discrimination with respect to receiving hospital credentials and privileges.

This has to change, and I am proud to say that ACEP has made it a top priority to address this issue. Here are the some of the recent steps we have taken:

• Earlier this week, ACEP spearheaded the development of a joint statement with over 40 leading medical organizations, including the American Medical Association and the American Psychiatric Association, that outlines recommendations for removing existing barriers to seeking treatment, including the fear of reprisal, and better encouraging professional support and non-clinical mental health initiatives, such as peer support, for physicians. See ACEP’s press release on the statement here.
• In April, ACEP met with the Joint Commission to discuss current barriers physicians face seeking mental health treatment. Just a few short weeks later, the Joint Commission put out a statement encouraging organizations to not ask about past history of mental health conditions or treatment and supporting the elimination of policies that reinforce stigma and fear about the professional consequences of seeking mental health treatment.
• We are also working on this issue on the legislative front, as ACEP is championing the bipartisan effort by 90 members of Congress to secure more resources for health workers’ mental health.
• ACEP also has free mental health counseling sessions, peer-to-peer support meditation guides, a 24-hour support line, and other tools and resources. ACEP members can find out more about these services here.

Finally, we have been in touch with Dr. Lorna Breen’s family on how to improve access to mental health treatment for physicians. Like you, ACEP mourned Dr. Breen’s tragic passing. The Dr. Lorna Breen Heroes’ Foundation, an organization established by her family to help support physicians’ mental health, signed onto ACEP’s joint statement referenced above.

We recognize that more work needs to be done, but rest assured, ACEP will continue to be here to advocate for you and your health—and the Regs & Eggs blog will be here to help keep you informed on the important issues that you continue to face as an emergency physician.

Also, we want to continue hearing from you on what is happening on the frontlines. ACEP’s public relations team is always collecting members’ perspectives and you are welcome to email them at pr@acep.org if you wish to share your story.

Until next week, this is Jeffrey saying, enjoy reading regs with your eggs!