CLEAR

Mental health questions on license applications

Recent posts on social media by licensed healthcare providers affected by mental health issues have drawn attention to the need "to destigmatize mental health and help-seeking in the medical profession." This article discusses the issue and includes a focus on how licensure applications and questions about mental health can be a barrier to healthcare providers seeking help. Studies cited show that healthcare providers are reluctant to seek mental health care for fear that it could affect their license.

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For more on the topic: CLEAR recently hosted a webinar focused on the Law Society of British Columbia's Mental Health Task Force and recommendations.

Scope of practice after the pandemic

This article highlights some of the healthcare scope of practice changes that have been or are being allowed in response to the coronavirus pandemic. The article considers how these changes should be handled post-pandemic, noting the effect on healthcare practitioners' job satisfaction and professional well-being, as well as telehealth and patient access to care. The article urges an evidence-based approach to future decisions about scope of practice and clear communication of the evidence for the decisions in order to mitigate perceptions of unfairness.

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Mental health professionals expect rise in cases

The National Alliance on Mental Illness and mental health professionals are expecting a rise in cases as people face the stress of the COVID-19 emergency, calling it the "mental health crisis curve." They warn that the anxiety caused by the situation can result in relapse of mental health diagnoses or substance abuse and also foresee an increase in healthcare workers experiencing acute stress disorders.

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Utah governor signs professional regulation laws

Utah's governor has signed into law several bills related to professional regulation. HB285 establishes a health program as an alternative to public disciplinary action for healthcare licensees with substance abuse disorders. HB24 adds to the definition of healthcare professions' unprofessional conduct to include entering false or misleading information or altering medical records. HB87 allows for education loan repayment assistance to geriatric or healthcare professionals who agree to practice in underserved areas.

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Australia: higher threshold for reporting concerns about impairment

The mandatory reporting requirements for doctors who treat other health practitioners have changed, with the threshold raised to "substantial risk of harm" to the public. The previous threshold was "risk of harm."  The Australian Health Practitioner Regulation Agency recognizes that "mandatory notifications are an important part of patient safety" but also wants to "ensure that practitioners with health issues feel safe to seek treatment."

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Law Society of BC passes recommendations from mental health task force

The Law Society of British Columbia has passed all seven recommendations of their mental health task force:

1. Improve information sharing with BC law schools about mental health supports within the profession
2. Improve Bencher orientation materials and expand mental health-related training for articled student interviews
3. Host a town hall event to discuss mental health within the profession
4. Develop guidance on the use of non-stigmatizing and non-discriminatory language in all future Law Society publications and communications
5. Conduct a voluntary, confidential member survey exploring mental health and substance use among BC lawyers
6. Amend BC Code Rule 7.1-3 (“duty to report”) and the associated Commentary
7. The medical fitness questions in Schedule A of the LSAP Application Form be removed

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UK NMC launches Careline pilot project

The Nursing and Midwifery Council in the UK has launched a 12-month pilot project called Careline, a free and confidential phone, chat, or email support service for nurses and midwives going through the fitness-to-practice process. The Careline is staffed with trained counsellors experienced in handling sensitive topics who can offer advice on general concerns and refer professionals to appropriate health or well-being services for their individual needs.

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Illinois proposes changes to pharmacist regulation

A task force in Illinois recently looked at why dangerous drug interactions were not being caught by pharmacists. The task force found pharmacists overwhelmed by "an assembly-line process at busy pharmacies where hundreds of prescriptions are filled in a single shift." The task force's recommendations focused on easing stress by creating a requirement for one uninterrupted 30-minute meal break and one 15-minute break for a 6-hour shift and an additional 15-minute break for a 12-hour shift. The task force also looked at additional employer requirements on pharmacists, such as soliciting new business and meeting production quotas. The task force recommends that pharmacies be disciplined for not allowing sufficient time for tasks such as reviewing patient's history and answering customer questions. They also recommend expanding the scope of practice for pharmacy technicians.

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Highlighting approaches to addressing health practitioner shortages

A report by the Association of American Medical Colleges projects a shortage of 120,000 doctors by 2030. This article highlights some approaches being implemented by hospitals and healthcare systems, including:

• launching training and residency programs in rural areas and impoverished cities and encouraging graduates to practice locally;
• employing more advanced practice professionals, such as physicians assistants, nurse practitioners, nurse anesthetists and nurse midwives, as part of care teams;
• expanding telemedicine to allow real-time examination and monitoring of patients in areas where specialists are in short supply; and
• relieving or reducing clerical burdens associated with electronic health records and introducing programs to promote mental well-being, both aimed at reducing risk of burnout and early retirement.

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Changes proposed to USMLE scoring

A multi-stakeholder invitational conference was held in March 2019 to consider current and emerging issues related to undergraduate medical education to graduate medical education transition system and the role of the United States Medical Licensing Exam. As more organizations rely on USMLE scores for residency screening and selection, medical students are becoming focused on USMLE score maximization perhaps to the detriment of other educational and curricular offerings and to the detriment of students' own well-being. Some suggestions coming out of the conference include shifting all or part of the USMLE to a pass/fail score, changes in timing of score release and to whom they are released, and improving other existing tools or developing new tools for GME screening and selection.

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