Do State Medical Board Applications Violate the Americans With Disabilities Act?

ArticleinAcademic medicine: journal of the Association of American Medical Colleges 84(6):776-81 · July 2009with14 Reads
DOI: 10.1097/ACM.0b013e3181a43bb2 · Source: PubMed
Abstract
To determine whether medical licensing board application questions about the mental or physical health or substance use history of the applicant violate the Americans with Disabilities Act (ADA) of 1990. Content analysis of 51 allopathic licensing applications (50 states and District of Columbia) was performed at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School in 2005. Questions referencing physical or mental health or substance use were identified by a team of physicians and reviewed and categorized based on the ADA and appropriate case law by legal counsel. Of the 51 applications reviewed, 49 (96%) contained questions pertaining to the physical or mental health or substance use history of the applicant. Thirty-four of the 49 (69%) state medical licensing applications contained at least one "likely impermissible" or "impermissible" item based on the ADA and appropriate case law. Most state medical licensing applications contain questions that ask about the physical or mental health and substance use of physician applicants. Many licensing applications appear to be in violation of the ADA, even 19 years after enactment of the regulation. These questions do not elicit responses by which professional competence can be judged. The presence of these questions on licensing applications may cause physicians to avoid or delay treatment of personal illness.
    • "Notwithstanding, licensure, credentialing, and medical malpractice insurance applications routinely ask physicians to self-report whether they have ever been " evaluated or recommended for treatment for, diagnosed with, or treated for any [substance abuse], sexual addiction, or a mental illness. " While a few states and organizations limit this reporting to conditions that have resulted in disability, most do not place any limits on such reporting requirements [44, 45] and it is the great variation in practice that leaves physicians uncertain. Despite of this reality, some authors suggest that physicians overestimate limits in confidentiality. "
    Article · Jan 2016 · Academic medicine: journal of the Association of American Medical Colleges
  • [Show abstract] [Hide abstract] ABSTRACT: Physicians suffer from the same illnesses as others do, and some of these illnesses may limit their ability to safely practice medicine. Individuals with of some of these same illnesses may also suffer from denial, blinding them to their limitations. Data support that, while many of these physicians do voluntarily limit their practices or seek help, not all do. Schroeder and colleagues demonstrate in this issue that in their attempts to protect the public, state medical licensing boards may have asked questions prohibited by the Americans with Disabilities Act. They point out an ethical tension between nonmaleficence (protecting the public from harm) and individual autonomy (respecting the rights of each individual physician), amplified by the different approaches lawyers and physicians use to address conflicts. The classic legal approach is adversarial, whereas the classic medical approach is collaborative. Both are valid approaches, but neither works well in tandem with the other. The time has come for all sides of the licensure debate to acknowledge the legitimacy of the others' concerns, to recognize the different approaches they each take, and to work together with others to find a common solution. The solution must allow boards to identify individuals with illnesses that impair their ability to practice safely and that also lead to denial of these very limitations. The solution must respect the autonomy of the individual licensee with a disability who can practice safely with an accommodation and who respects the need for that accommodation. The solution must protect the public.
    Article · Jul 2009
  • [Show abstract] [Hide abstract] ABSTRACT: Several recent articles, including the one by Schroeder and colleagues in this issue, document violations of the Americans with Disabilities Act (ADA) by state medical boards that ask applicants for initial licensure and relicensure whether they have any history of mental illness. The authors of these articles argue that the boards' violation of the ADA is a disincentive for applicants to seek treatment, especially for depression. This commentary discusses the behavior of the boards, and efforts to address it, in the larger context of what organizations that educate, examine, license, certify, credential, and represent physicians are doing to improve the accountability of members of the profession and, as a result, the quality of their services.
    Article · Jul 2009
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