A licensed health professional is required to report to the appropriate disciplining authority conduct by another provider that may constitute unprofessional conduct. The provider is also required to report to the disciplining authority (or a voluntary substance use disorder monitoring program such as the Physicians Health Program) when another provider is potentially unable to practice with reasonable skill and safety to consumers as a result of a mental or physical condition. Under rules adopted by the Department of Health, other persons and entities must make similar reports, including health care institutions, insurers, and employers.
Certain entities are exempt from the reporting requirement, including certain voluntary substance abuse monitoring programs, such as the Physicians Health Program, while the provider is actively participating in the program. The exemption does not apply if the provider's conduct constitutes a clear and present danger to the public health, safety, or welfare. Program records relating to the programs are generally confidential.
A physician well-being program is exempt from the requirement of reporting potential unprofessional conduct or inability to practice with reasonable skill and safety if the provider is competent to practice with reasonable skill and safety. If the provider is not competent to practice with reasonable skill and safety, or if a patient has been harmed, the provider must be reported to the provider's disciplining authority or, if permitted, to a physicians health program or voluntary substance use disorder monitoring program.
Physician well-being program records relating to program participants created specifically for, and collected and maintained by the program, are confidential and exempt from disclosure. The records are not subject to discovery by subpoena or admissible as evidence. This privilege does not protect facts, information, communications, or documents available from other original sources and does not protect any document outside the scope of the privilege. The information subject to the privilege may not be reasonably discoverable from other non-privileged sources. The privilege does not apply to the program's organizing documents or contracts establishing the program.
The privilege does not apply to information introduced into evidence in any civil action by the provider regarding the provider's participation in the program, the restriction of the provider's staff privileges due to a mandatory report, or termination of the provider's employment due to a mandatory report.
A physician well-being program is defined as a formal program established for the purpose of addressing issues related to career fatigue and well-being in physicians, osteopathic physicians, and physician assistants that:
A quality improvement program is not a physician well-being program.
The substitute bill:
(In support) The practice of medicine has become uncertain. Providers know what their responsibilities are, but do not know what is legal or illegal. This is creating incredible stress, which is resulting in providers leaving the profession. Providers witness a lot of pain and help families with life's toughest moments, which is a privilege but takes a toll. Providers of reproductive health are particularly stressed because their practice is being restricted or criminalized, which impacts families and communities. Stigma often prevents providers from seeking help. Individual providers feel like they are the only ones going through this. Emotional exhaustion can negatively impact patients. Safe spaces are needed. Providers need to care for themselves in order to care for others. This bill is about workforce retention. Investments in training and retention are expensive, and this bill will help providers have long, healthy careers. The investments in the provider pipeline must be coupled with retention strategies. The bill is an attempt at creating a space for peer-to-peer support with people who understand stress. Providers will be connected to resources, which will allow them to continue to provide needed services to communities. This bill will break the stigma on mental health. Confidentiality will encourage participation.
(Opposed) None.
(Other) This bill has good intentions and noble goals. Burnout and retention need to be addressed. These professionals dedicated their lives to serving their communities and deserve support. However, the root cause of these issues is the manner in which the business of health care is being managed. Implementation of this bill may mask the systemic challenges that are causing burnout.
(In support) Representative My-Linh Thai, prime sponsor; Hyolyn Yang; Alex Wehinger, WA State Medical Association (WSMA); Anne-Marie Amies Oelschlager, MD, WA Chapter of the American College of Obstetricians and Gynecologists; and Andrea Kalus, MD.