Colorado’s healthcare community is experiencing unprecedented disruption – from the COVID-19 pandemic to lost revenue and furloughed colleagues to changes in policy related to delivering safe healthcare. These challenges will result in risks to the overall wellness of our health care providers, with a direct impact to their personal, behavioral and physical health.
Discouragingly, the state of Colorado is taking away an important piece of the support program that prioritizes physician health and well-being, helping them to provide better quality of care to their patients.
For the last 35 years, the state has held a long-standing precedent of ensuring that all physicians, physician assistants and anesthesiology assistants who voluntarily seek help through a state peer assistance program, funded through physician licensing fees, will receive confidential treatment as long as they remain compliant with their treatment plan.
Without explanation or consultation with the medical community, the Colorado Department of Regulatory Agencies (DORA), decided to make a change that will end a proven and effective peer-to-peer support program that helps doctors. The head-scratching, bureaucratic change goes into effect later this year and requires all physicians who voluntarily seek treatment through this program to sign a release of privacy information.
The result? Doctors will cease using the program and patient safety could suffer.
Check out these news articles on the issue:
Why We Should Care?
The peer assistance program provides direct assistance services for licensed physicians, physician assistants and anesthesiology assistants who are facing any emotional, psychological or medical challenges. The program helps with all medical conditions including burnout, depression including suicidality, behavioral concerns, chronic medical illnesses/disorders, and substance abuse. Following a request for proposals, a new provider was awarded the peer assistance contract to begin on Nov. 1, 2020, and the state has requested that the new vendor release the privacy for participants, thereby creating an immediate barrier for participation for front-line doctors.
The Journal of American Medical Association (JAMA) found that about 27 percent of medical students and 29 percent of resident physicians experience depression or depressive symptoms over the course of their training. Also, physicians have a higher risk of suicide than the general population. It’s too early to tell, but the stresses of COVID-19 are sure to increase these numbers.
Signing away privacy and sharing mental health histories or treatment plans with the state can cost doctors their reputations and their ability to practice medicine. The current program’s voluntary track, developed over decades with the Colorado Medical Board’s awareness and involvement, results in doctors seeking evaluation and getting the help they need, while ensuring confidentiality.
Indeed, a study done for the Mayo Clinic found that “Nearly 40 percent of physicians reported that they would be reluctant to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure.” This is why confidentiality for physicians seeking support is critical.
Concerning Recent Trends and Statistics
Work Stress is increasingly causing medical licensees to seek peer health assistance. The top three reasons for referring to the peer assistance provider during the 2020 July-Sept quarter were psychiatric concerns (25%), behavior problems (17%), and workplace stress (13%). Although psychiatric and behavior have been consistently in the top three reasons for presenting, workplace stress has not ranked often in the top three concerns. Typically, workplace stress makes up an average of 3% of new referrals to the program, so 13% is a significant increase. We believe this is directly related to COVID-19 and the stress physicians face every day.
Medical licensees are not accessing help. New referrals to the peer assistance program are at their lowest level since 2004. The past two quarters were 44 and 45, respectively. This is a reduction of 37% from the average of 70 referrals per quarter. Physicians are facing incredible stress during these unprecedented times. Our medical community is in crisis from burnout, COVID-19 and, most recently, the devastating wildfires. Physicians, physician assistants and anesthesiology assistants are in urgent need of support and assistance. The record decrease of medical licensees seeking help is indicative of a concerning crisis.
Supporters of Maintaining Confidentiality
American Academy of Addiction Psychiatry
Citizens for Patient Safety
Colorado Academy of Physician Assistants
Colorado Hospital Association
Colorado Medical Society
Colorado Permanente Medical Group
Colorado Psychiatric Society
Northern Colorado Hospitalists
Primary Care Partners
Red Rocks Community College Physician Assistant Program
Rocky Vista University College of Osteopathic Medicine
University of Colorado School of Medicine Graduate Medical Education
University of Colorado Anschutz Medical Campus School of Medicine
Want to be added as a supporter? Email us!
Q & A
Peer assistance programs provide life-saving support to physicians, who as part of their state licensing fee, receive the benefit of receiving wellness care when they need it.
- If a doctor’s actions or well-being impacts personal and patient safety, they will be referred to the Colorado Medical Board for action.
- The peer assistance program which has been in place for decades has a voluntary self-referral track, which allows for confidentiality for physicians who are safe to practice so long as they remain compliant with the program’s monitoring and treatment plans.
- The program’s voluntary track, developed over decades with Colorado Medical Board awareness and involvement, results in licensees seeking evaluation and getting the assistance they need while ensuring confidentiality.
Physicians benefit from the confidentiality guarantees as they are more likely to seek care if they know it will not adversely impact their license as long as they remain compliant.
- Without confidentiality guarantees in place, it has been proven that doctors are less willing to seek help.
- A confidential peer assistance program is for doctors who need preventative support, so they can get help before it becomes a larger problem.
Patients benefit from increased safety and better care by allowing physicians to confidentially seek care before an issue impacts patient safety.
- Voluntary participation promotes patient safety and physician well-being.
Across the health care spectrum, health care providers and organizations understand that having an accessible peer assistance program will result in better patient safety and better outcomes.
Colorado’s long-standing support program is recognized as a proven benchmark in how these programs should be structured to provide confidential and effective care for physicians that addresses their well-being and contributes to improved health care.
A Confidentiality Agreement signed by a participant of the peer assistance program is not synonymous with a confidentiality guarantee, but explains confidentiality limitations that are in place to protect participants and patients. Situations in which a medical licensee may be reported to the Colorado Medical Board are explained and include:
- Danger to self or others
- Risk to patient safety or
- Specific violations of the Colorado Medical Practice Act
The state is recommending a new peer assistance program that requires every participant sign a Release of Information (ROI) to the Colorado Medical Board before receiving help, whether they are voluntarily seeking or mandatorily referred. The medical licensee would have to sign ROI which does not have any restrictions on when information could be provided to the Colorado Medical Board in order to get assistance. This will have a drastic impact any physician’s willingness to come to the program.
Effective care of physicians addressing their wellbeing is only accomplished with physicians evaluating those seeking help.
- An essential element of a peer assistance program is the determination of whether or not a health condition may affect patient care; this can only be accomplished by an experienced medical doctor (MD).
- Colorado’s long-standing support program has collectively 80 years of expertise in these decisions, has five physicians on staff and keeps patient safety at the forefront.
- Research shows that physicians are more willing to accept help from peers.
The Medical Practice Act clearly states, “the [Colorado Medical] Board shall select one or more peer health assistance programs as designated providers.” C.R.S. § 12-240-131(1)(b).
- Although the Colorado Medical Board does not have distinct contracting authority within State provisions of procurement, the Colorado Medical Board has always been involved in decisions concerning contracts with and selection of the best peer assistance program.
- The most recent selection recommendation was made without consultation with or approval from the Colorado Medical Board physicians, physician assistants or public members.
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