In 2004, Washington physician Suzanne J. Fiala, MD, risked the humiliation and stigma of medical board scrutiny when she published her firsthand account of a practicing physician living (and working) with bipolar illness.8 Dr. Fiala correctly pointed out in her article that statistics indicate as many as one in five physicians suffers from a diagnosable mental disorder. Nonetheless, until meaningful changes are made to this repressive system, the threat of medical board investigation and other adverse professional consequences will continue to be powerful deterrents to seeking appropriate treatment.
Explore This IssueACEP Now: Vol 37 – No 12 – December 2018
Ten years after her article was published, Dr. Fiala was sanctioned by her medical board following a retaliatory complaint from a former patient arising from a custody dispute over a dog.9 This complaint would never have resulted in formal board action and a negative report to the National Practitioner Data Bank had she not revealed her history of mental illness.10
Acute episodes of mental illness (grief, dysthymia, depression, anxiety, insomnia, post-traumatic stress disorder, adverse medication reactions, etc.) can strike anyone at difficult times in their lives. People like me, Dr. Miles, Dr. Hason, Dr. Fiala, and thousands of others with recurring acute or chronic mental illness learn over time how to manage exacerbations of their symptoms, just as with any other chronic disease (eg, diabetes, asthma, arthritis, heart disease, etc.). Just as with other chronic health problems, mental illness has the potential to cause impairment in the workplace when it is not properly recognized and treated. However, unlike with other chronic health problems, in most states, physicians with any history of mental illness may be automatically assumed by their medical licensing board to have occupational impairment based simply upon their diagnosis.
This assumption, by definition, is prejudice. Because my state medical board chose to sanction my license, the stigma that is perpetuated by this prejudice will follow me for the rest of my professional career. I never wanted any of this to become public, but silence only perpetuates these inappropriate actions against our colleagues. I hope my openness ultimately translates to meaningful change and the rational and compassionate approach to mental health disclosures.
Dr. Haney is an emergency physician at Curry General Hospital in Gold Beach, Oregon.
- Brown ES, Chandler PA. Mood and cognitive changes during systemic corticosteroid therapy. Prim Care Companion J Clin Psychiatry. 2001;3(1):17-21.
- DuPont RL, McLellan AT, White WL, et al. Setting the standard for recovery: physicians’ health programs. J Subst Abuse Treat. 2009;36(2):159-171.
- The twelve steps of Alcoholics Anonymous. Alcoholics Anonymous World Services, Inc. website. Accessed Nov. 19, 2018.
- Rothstein L. Impaired physicians and the ADA. JAMA. 2015;313(22):2219-2220.
- Miles SH. A challenge to licensing boards: the stigma of mental illness. JAMA. 1998;280(10):865.
- Sfikas PM. Disabled physician denied license: Supreme Court to rule on whether doctor may sue under AwDA. J Am Dent Assoc. 2003;134(3):370-371.
- New York State Department of Heath Office of Professional Conduct, determination and order in the matter of Michael Jeffrey Hason, MD. New York State Department of Heath website. Accessed Nov. 19, 2018.
- Fiala SJ. A piece of my mind. Normal is a place I visit. JAMA. 2004;291(24):2924-2926.
- State of Washington Department of Health statement of allegations against Suzanne J. Fiala, MD. Accessed Nov. 19, 2018.
- State of Washington Department of Heath stipulation to informal disposition of case against Suzanne J. Fiala, MD. Washington State Department of Health website. Accessed Nov. 19, 2018.