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This CPPPH newsletter aims to keep readers abreast of current developments and relevant information about physician health and wellbeing in California.
All past issues are available from the CPPPH website: www.CPPPH.org.
Definitions
Wellness activities address quality of life and professional satisfaction for all physicians.
Wellbeing activities focus on an individual physician and provide resources for identifying, evaluating, referring, treating, and monitoring for physicians when addiction, mental health, behavioral issues, and the effects of aging are a concern.
Confidential Assistance Over the Phone
The Physicians’ and Dentists’ Confidential Assistance Line is a 24-hour phone service providing completely confidential doctor-to-doctor assistance for physicians experiencing substance use or mental health issues. Call:
Send Us Your Comments
We want to hear from you. Send comments to gjara@cppph.org.
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AB 408 – California’s Effort to Get a Physician Health Program
The proposed legislation that would authorize the Medical Board of California to establish a physician health program was assigned to the Senate Committee on Judiciary to be heard in January. You can see the full text of the bill and track the progress through the Senate HERE.
Amendments were made on July 8, 2025 to address some of the concerns of both advocates and opponents. Because some concerns remain, more amendments are expected. Reji Varghese, Executive Director of the Medical Board of California, has said, “We first have to get the policy straight. That step requires getting all stakeholders aligned and in support of a bill – which we understand will involve some tweaking to the language we have now.” Those were Mr. Varghese’s words in July when he spoke at the Riverside County Medical Association’s annual meeting on Wellbeing Committees.
There are many steps still to come. If AB408 is passed by the Senate and signed by the Governor, attention will move to “getting the funding structure in place” before the Medical Board can prepare a request for proposal from a contracting agency to implement the new program. (AB408 does not include any provision for how a new program would be funded.) Mr. Varghese said “we are looking at a couple of years minimum after the Governor signs this new legislation.”
Barriers
What keeps physicians from acknowledging a need for help and being willing to get it?
A 2025 report, Clinician perceptions of barriers to access mental health care breaks down the information from a large, well-designed research survey of 2,000 health care professionals asking about their experience related to seeking care for mental health issues. The authors explain in the introduction that the survey questions and the analysis use the language “mental health care” but cover all the types of conditions treated, including substance use disorders.
The survey was designed to gain a deeper understanding of the structural and cultural barriers to accessing mental health care. The sample included 750 physicians (MDs/DOs), 251 physician assistants (PAs), 765 registered nurses (RNs), and 250 nurse practitioners (NPs) with a response rate of 36% and an incidence rate of 93%.
The survey asks, To what extent do you believe each of the factors in this survey create a moderate or greater barrier for health workers if they need or want to access mental health care? (moderate, prohibitive or significant barrier)
No summary could convey the nuance in all the details that are shown and analyzed in this 54-page report, but authors Liz Boehm for the Heart of Safety Coalition and Stefanie Simmons, MD, of the Dr. Lorna Breen Heroes’ Foundation do provide key findings:
➤ Costs and schedule inflexibility
The cost of mental health services without insurance and lack of schedule flexibility to keep appointments created the greatest logistical barriers to accessing mental health care for all clinicians.
➤ Personal and interpersonal stigma and judgment create cultural barriers to care access and further privacy behaviors.
One in ten MDs/DOs and roughly one in 20 other clinicians said they would have concerns about a colleague’s ability to practice in a competent, ethical and professional manner if they learned that colleague accessed mental health care.
➤ Licensure, credentialing and job application practices build stigma and perceptions of discrimination.
More than 40% reported concerns about professional insurance and license renewals if they seek care. In all cases, MDs/DOs had the highest concerns.
➤ Low awareness of physician or professional health programs (PHPs) limits access to resources.
Fewer than one in five MDs/DOs, NPs, PAs and RNs said they had a good understanding of PHPs.
Recommendations for Reducing Barriers
A JAMA Special Communication of August 14, 2025 titled Reducing Barriers to Mental Health Care for Physicians: An Overview and Strategic Recommendations is from three deeply involved leaders in medicine:
Daniel Saddawi-Konefka,MD, MBA, an anesthesiologist, Harvard Medical School, is co-founder of The Emotional PPE Project Helping to Heal the Healers.
Jesse M. Ehrenfeld, MD, MPH, an anesthesiologist, was President of the American Medical Association 2023-2024.
Christine Yu Moutier, MD, a psychiatrist, is Chief Medical Officer of the American Foundation for Suicide Prevention.
They say that “external regulators” can drive change by mandating specific resources for removing barriers that physicians experience. For example, the Joint Commission — in addition to Standard 11.01.01 which mandates that a medical staff must implement a process to identify and manage matters of individual health — could require a function to address physicians’ barriers to seeking help, as described in TJC Workforce Safety and Well-Being Resource Center. They also say that the Accreditation Council for Graduate Medical Education could require protected time for seeking help.
For hospitals and health care organizations, they say that financial incentives could be developed for implementing and evaluating systemic interventions for reducing barriers to seeking help. See the 2024 publication from the National Institute for Occupational Safety and Health, Impact Wellbeing™ Guide: Taking action to improve healthcare worker wellbeing 95 pages from NIOSH and CDC. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication 2024-109.
New from the FSPHP
The current issue of Physician Health News, the Official Newsletter of the Federation of State Physician Health Programs, is a particularly meaty 44-page one. Among the many helpful articles, there are summaries of each of the presentations made at the Federation’s 2025 Annual Conference in Seattle in April (pages 18 to 32).
Two Short Videos You Can Use
The newsletter includes a LINK to the 6-minute video of a section of the CBS Morning Show that aired on October 8: “Program Helps Doctors Recover From Substance Abuse.”
There is information about a 3-minute video created by the Federation titled Trusted Help for Health Care Professionals. It is designed for use with audiences being introduced to the work of PHPs. The newsletter says, “We invite you to watch our new video and see inspiring stories from PHP graduates and heartfelt reflections from the leaders of PHPs across the country. We encourage you to share this video widely to help break the stigma we continue to see.”
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