Connect with us

Published

on

States are redefining when medical professionals can get mental health treatment without risking notifying the boards that regulate their licenses.

This story also ran on States Newsroom. It can be republished for free.

Too often, health care workers wait to seek counseling or addiction treatment, causing their work and patient care to suffer, said Jean Branscum, CEO of the Montana Medical Association, an industry group representing doctors.

They’ve invested so much time in their career, Branscum said. To have anything jeopardize that is a big worry on their mind.

Montana, like other states, has a recovery program for health professionals who have a substance use disorder or mental illness. However, medical associations say such programs often come with invasive monitoring, even for voluntary care. And gray areas about when a mental illness should become public breeds fear that seeking care jeopardizes a medical career.

Montana is among the states looking to boost confidential care for health professionals as long as theyre not deemed a danger to themselves or patients. In recent years, at least a dozen states have considered or created confidential wellness programs to offer clinicians help early on for career burnout or mental health issues. States have also reworked medical licensing questions to avoid scrutiny for providers who need mental health treatment. The changes are modeled after Virginia legislation from 2020.

During a legislative committee meeting last month, advocates for Montana medical professionals asked state lawmakers to follow Virginias lead. They say the goal is twofold: to get clinicians treatment before patients are at risk and to curtail the workforce burnout thats partly fueled by untreated stress.

Montanas existing medical monitoring program, the Montana Recovery Program, is run by the global company Maximus. Montanas professional advocates had backed another nonprofit to run Montanas program, which didnt win the state contract.

The Montana Recovery Program declined a request for an interview, instead referring KFF Health News to the Montana Department of Labor & Industry, which oversees the states medical licensing boards. Department staffers didnt comment by deadline. Email Sign-Up

Subscribe to KFF Health News' free Morning Briefing. Your Email Address Sign Up

In a Medscape survey released this year, 20% of physicians said they felt depressed, with job burnout as a leading factor. The majority said confiding in other doctors wasnt practical. Some said they might not tell anyone about their depression out of fear people would doubt their abilities, or that their employer or medical board could find out.

Health professionals are leaving their jobs. Theyre retiring early, reducing work hours, or switching careers. That further dwindles patients care options when there already arent enough providers to go around. The federal government estimates 74 million people live in an area without enough primary care services due to a workforce shortage.

Aiming to ensure patient safety, state medical boards can suspend or revoke clinicians rights to practice medicine if substance use or psychological disorders impair their work. Those cases are rare. One study found roughly 4,400 actions against the licenses of U.S. physicians for either substance use or psychological impairment from 2004 to 2020.

Nonetheless, workforce advocates say disclosure requirements cause some health professionals to dodge questions about mental health histories on licensing and insurance forms or forgo care altogether. Theyre worried divulging any weakness will signal they shouldnt practice medicine.

The mental health questions health workers are asked vary by state and profession. For example, nurses in Montana renewing their license are asked if they have any psychological condition or substance use that limited their ability to practice with reasonable skill and safety in the previous six months. Along with being asked about substance use on the job, doctors are required to say whether they’ve experienced a mental condition that might adversely affect any aspect of your ability to perform.

When I see that question on my renewal, do I have to report that I was depressed because I was going through a really tough divorce? Branscum cited as an example of workers uncertainty. You know, my life is turned upside down now. Am I obligated to report that?

A yes wouldnt immediately result in licensing problems. Those who do report mental health troubles would be flagged by state workers as a potential concern. They could end up before the boards same screening panel that recommends whether to revoke a license, or be referred to long-term monitoring with regular screening.

Additionally, health professionals are required to report when other clinicians show unprofessionalism or have potential issues that affect performance. Branscum said medical professionals worry that what they say in a counseling session could be flagged for licensing boards, or that a co-worker may make a report if they seem depressed at work.

Bob Sise, a Montana addiction psychiatrist and co-founder of the nonprofit 406 Recovery, told state lawmakers that job stressors are playing into workers mental health challenges, such as long shifts and heavy patient loads. And with the rising cost of health care, physicians feel theyre sacrificing their commitment to healing as they routinely substitute optimal treatment for lesser care that patients can afford.

Sise said his practice now has roughly 20 health professionals as patients.

They were able to access care before it was too late, Sise said. But they’re the exception.

In Virginia, doctors, nurses, physician assistants, pharmacists, and students can join the states SafeHaven program. Melina Davis, CEO of the Medical Society of Virginia, said the service offers counseling and peer coaching with staffers available to answer a call 24/7.

If you only have a moment at 2 a.m., or that’s when you had the chance to first process the death of a patient, then you can talk to somebody, Davis said.

Those in the program are assured that those conversations are privileged and cant be used in lawsuits. This year, the state is considering adding medical diagnoses under the programs confidential protections.

States that have followed suit have slight variations, but most create a safe haven with two types of wellness and reporting systems. Those who seek out care before theyre impaired at work have broad privacy protections. The other defines a disciplinary track and monitoring system for those who pose a risk to themselves or others. Indiana and South Dakota followed Virginias lead in 2021.

States are also narrowing the time frame that licensing boards can ask about mental illness history. The American Medical Association has encouraged states to require health care workers to disclose current physical or mental health conditions, not past diagnoses.

Last year, Georgia updated its license renewal form to ask doctors if any current condition for which you are not being appropriately treated affects their ability to practice medicine. That update replaces a request for seven years of mental health history.

Even outside the safe haven framework, some states are grappling with how to grant doctors privacy while guaranteeing patient safety.

The Medical Board of California is creating a program to treat and monitor doctors with alcohol and drug illnesses. But patients advocates have argued too much privacy, even for voluntary treatment, could risk consumers well-being. They told the state medical board that patients have a right to know if their doctor has an addiction.

Davis said states should debate how to balance physicians’ privacy and patients safety.

We in medical professions are supposed to be saving lives, she said. Where’s the line where that starts to fall off, where their personal situation could affect that? And how does the system know?

Acording to the Montana Recovery Program website, its not a program of discipline but instead one of support, monitoring, and accountability. Participants may self-refer to the program or be referred by their licensing board.

Branscum, with the Montana Medical Association, said the states monitoring program is needed for cases in which an illness impairs a clinician’s work. But she wants that form of treatment to become the exception.

Vicky Byrd, CEO of the Montana Nurses Association, said nurses dont tend to join the program until theyre forced to in order to keep their license. That leaves many nurses struggling in silence until untreated illness shows up in their work, she said.

Let’s get them taken care of before it has to go on their license, Byrd said.

Because after that point, she said, its hard to recover.

Katheryn Houghton: khoughton@kff.org, @K_Hought Related Topics Health Industry Mental Health States California Georgia Legislation Montana Substance Misuse Virginia Contact Us Submit a Story Tip

Continue Reading

Sports

Red Sox 1B Casas out for year after knee surgery

Published

on

By

Red Sox 1B Casas out for year after knee surgery

BOSTON — Boston Red Sox first baseman Triston Casas suffered a ruptured tendon in his left knee and is out for the remainder of the season, the team said.

The 25-year-old Casas ruptured his patellar tendon running to first on a slow roller up the line and fell awkwardly in Boston’s victory over the Minnesota Twins on Friday night. After laying on his back in pain — not moving the knee — he was carted off on a stretcher before being taken to a Boston hospital.

The team announced Sunday that he had surgery for a left patellar tendon repair at Massachusetts General Hospital. The surgery was performed by Dr. Eric Berkson.

“I talked to him last night,” chief baseball officer Craig Breslow said in a news conference on Saturday discussing the injury outside Boston’s clubhouse. “We exchanged text messages [Saturday]. We all care deeply about just his overall wellbeing.”

Manager Alex Cora said Casas worked hard during the offseason to play every day after missing a large amount of last year with torn cartilage in his rib cage.

“He did an outstanding job in the offseason to put himself in that situation. It didn’t start the way he wanted it to,” Cora said of Casas’ struggles. “He was going to play and play a lot. Now we’ve got to focus on the rehab after the surgery and hopefully get him back stronger than ever and ready to go next year.”

Casas batted just .182 with three homers and 11 RBIs, but Breslow said his loss will be felt, especially with the team’s lack of depth at the position.

“He certainly struggled through the first month of the season but that didn’t change what we believe his production was capable of being,” Breslow said. “It’s a big loss. In addition to what we think we were going to get on the offensive side, he was kind of like a stabilizing presence on the defensive side of the field — also a big personality and a big part of the clubhouse.”

During spring training, Casas talked about how his focus at the plate this season was being more relaxed.

“You really want it until you don’t,” he said, explaining his thoughts while standing at his locker. “Then you can’t want it that much.”

Now, he’ll have to focus on his recovery plan for next season.

Casas, a left-handed batter, was placed on the 10-day injured list Saturday with infielder/outfielder Abraham Toro selected from Triple-A Worcester.

Cora said Toro — a switch-hitter — will split time at first along with Romy Gonzalez. who bats right-handed.

Breslow said the team might be exploring a long-term replacement.

“This is unfortunately an opportunity to explore what’s available,” he said. “We’ll look both internally and outside as well.”

Cora said there are no plans to move Rafael Devers, who was replaced at third by offseason free-agent acquisition Alex Bregman and moved to DH.

“We asked him to do something in spring training that in the beginning he didn’t agree with it and now he’s very comfortable doing what he’s doing,” Cora said. “Like I told you guys in spring training, he’s my DH.”

Continue Reading

Entertainment

Police foil bomb plot targeting Lady Gaga’s biggest-ever show on Copacabana beach

Published

on

By

Police foil bomb plot targeting Lady Gaga's biggest-ever show on Copacabana beach

Brazilian police say they foiled a bomb attack planned for a Lady Gaga concert on Rio de Janeiro’s Copacabana beach that attracted an estimated 2.1 million people.

The plot was orchestrated by a group promoting hate speech and the radicalisation of teenagers, including self-harm and violent content as a form of social belonging, according to the Civil Police of Rio de Janeiro, which worked in coordination with the country’s justice ministry.

“The suspects were recruiting participants, including minors, to carry out coordinated attacks using improvised explosives and Molotov cocktails,” the force said.

The justice ministry said the recruiters identified themselves as Gaga’s fans, known as “Little Monsters”.

It said Operation Fake Monster was based on a report by the ministry’s cyber operations lab following a tip-off from Rio state police intelligence, which uncovered digital cells encouraging violent behaviour among teenagers using coded language and extremist symbolism.

Authorities carried out over a dozen search and seizure warrants, and a man described as the group’s leader was arrested in the southern state of Rio Grande do Sul for illegal possession of a firearm, and a teenager was detained in Rio de Janeiro for storing child abuse images.

Lady Gaga performing at the huge open-air concert. Pic: Reuters
Image:
Lady Gaga performing at the huge open-air concert. Pic: Reuters

Gaga’s biggest ever show

Some 500,000 tourists travelled to watch the concert, which was paid for by the city in an attempt to boost the struggling economy.

Saturday night’s two-hour show, which marked Gaga’s biggest ever, marked the first time she had played in Brazil since 2012, having cancelled an appearance at the Rock in Rio festival in 2017 over health issues.

Gaga, who released her seventh studio album, Mayhem, in March, opened with a dramatic, operatic edition of her 2011 track Bloody Mary, before launching into Abracadabra, a recent track.

Lady Gaga performs during her free concert on Copacabana Beach in Rio de Janeiro, Saturday, May 3, 2025. (AP Photo/Silvia Izquierdo)
Image:
Pic: AP

Lady Gaga, centre, performs during her free concert on Copacabana Beach in Rio de Janeiro, Saturday, May 3, 2025. (AP Photo/Silvia Izquierdo)
Image:
Pic: AP

“Brazil! I missed you. I missed you so much,” she exclaimed, before launching into Poker Face, one of her biggest hits.

The American pop star drew in a similar crowd to Madonna’s in May last year, who performed at the same beach, which is transformed into an enormous dance floor for the shows.

Addressing the crowd in English and through a Portuguese translator, Gaga became emotional as she said: “I’m so honoured to be here with you tonight.

People attend Lady Gaga's open concert at Copacabana beach in Rio de Janeiro, Brazil, May 3, 2025. REUTERS/Tita Barros
Image:
Gaga addresses the crowd. Pic: Reuters

Gaga seen performing on giant screens set up across the beach. Pic: Reuters
Image:
Gaga seen performing on giant screens set up across the beach. Pic: Reuters

“Tonight we’re making history, but no one makes history alone. Without all of you, the incredible people of Brazil, I wouldn’t have this moment. Thank you for making history with me.

“The people of Brazil are the reason I get to shine today. But of all the things I can thank you for, the one I most am grateful for is this: that you waited for me. You waited more than 10 years for me.”

She said it took so long to come back because she was “healing” and “getting stronger”. The pop sensation cancelled many of her shows in 2017 and 2018 due to her fibromyalgia condition, which can cause pain and fatigue.

It is estimated Gaga’s show will have injected around 600 million reais (£79.9m) into the economy, nearly 30% more than Madonna’s show.

People gather to attend Lady Gaga's open concert, in Copacabana beach in Rio de Janeiro, Brazil May 3, 2025. REUTERS/Pilar Olivares
Image:
Pic: Reuters

Read more:
John Lithgow on JK Rowling’s trans stance backlash
Why are the band Kneecap controversial?

The large-scale free shows are set to continue annually until at least 2028, always taking place in May, which is considered the economy’s “low season”, according to the city’s government.

A hefty security plan was in place, including the presence of 3,300 military and 1,500 police officers, along with 400 military firefighters.

‘A dream come true’

Fans find a spot to watch the show. Pic: AP
Image:
Pic: AP

The city has been swarmed with Gaga fans since her arrival on Tuesday, with some even keeping vigil outside of the hotel she has been staying at.

Many arrived at the beach at the crack of dawn on Saturday to secure good spots on the beach, despite the show not starting until 9.45pm.

An aerial view shows fans gathering on Copacabana beach ahead of Lady Gaga's arrival. Pic: Reuters
Image:
An aerial view shows fans gathering on Copacabana beach ahead of Lady Gaga’s arrival. Pic: Reuters

Ana Lara Folador, who attended with her sister, said it was “a dream come true”, and that Gaga had “really shaped a part of my personality, as a person and an artist”.

Ingrid Serrano, a 30-year-old engineer who made a cross-continent trip from Colombia to Brazil to attend the show, turned up in a T-shirt featuring Lady Gaga’s outlandish costumes over the years.

“I’ve been a 100% fan of Lady Gaga my whole life,” she said, adding the 39-year-old megastar represented “total freedom of expression – being who one wants without shame”.

A fan dons an unusual face mask. Pic: AP
Image:
A fan dons an unusual face mask. Pic: AP

A fan strikes a pose. Pic: AP
Image:
A fan strikes a pose. Pic: AP

Matheus Silvestroni, 25, an aspiring DJ and a Gaga fan since the age of 12, endured an eight-hour bus ride from Sao Paulo for the show.

He said it was Gaga who had inspired him to embrace his sexuality and pursue his dream of becoming an artist.

“I was bullied because I was a fat, gay kid, so I was an easy target,” he said. “Gaga was very important because she sent a message that everything was okay with me, I wasn’t a freak, because I was ‘Born This Way’.”

Rio is known for holding massive open-air concerts, with Rod Stewart holding a Guinness World Record for the four million-strong crowd he drew to Copacabana beach in 1994.

Continue Reading

Entertainment

John Lithgow on JK Rowling’s trans stance backlash: ‘She’s handled it fairly gracefully’

Published

on

By

John Lithgow on JK Rowling's trans stance backlash: 'She's handled it fairly gracefully'

John Lithgow is a man well aware of cancel culture and its ability to destroy careers in the blink of an eye.

The Oscar-nominated actor tells Sky News: “It is terrible to be so careful about what you say. Even in an interview like this. It goes into the world, and you can get misconstrued and misrepresented and cancelled in [the click of a finger].”

Pic: Johan Persson
Image:
Roald Dahl is the subject of West End play Giant, by Mark Rosenblatt. Pic: Johan Persson

It’s a theme that runs parallel with his latest work – the stage show Giant – which through the lens of one explosive day in children’s author Roald Dahl‘s life, poses the question, should we look for moral purity in our artists?

The writer of great works including The Witches, Matilda and The BFG, Dahl revolutionised children’s literature with his irreverent approach, inspiring generations of readers and selling hundreds of millions worldwide. But his legacy is conflicted.

Lithgow describes Dahl as “a man with great charm, great wit and literary talent. A man who really cared about children and loved them. But a man who carried a lot of demons.”

Specifically, the play – which explores Palestinian rights versus antisemitism – deals with the fallout from controversial comments the children’s author made over the Israeli invasion of Lebanon in 1982. Its themes couldn’t be more timely.

Lithgow explains: “Things are said in the play that nobody dares to say out loud… But God knows this is a complicated and contradictory issue.”

More on Jk Rowling

Pic: Johan Persson
Image:
John Lithgow plays Dahl – a man capable of ‘great compassion’ and ‘enormous cruelty’. Pic: Johan Persson

‘It didn’t start as an idea about Roald Dahl at all’

So controversial are some of the play’s themes, the 79-year-old star admits his own son warned him: “Prepare yourself. There’ll be demonstrations in Sloane Square outside the Royal Court Theatre.”

Indeed, the play’s first run carried an audience warning flagging “antisemitic language; graphic descriptions of violence; emotional discussion of themes including conflict in the Middle East, Israel and Palestine; and strong language”.

But it didn’t put audiences off. Following a sold-out run at the Royal Court, the role won Lithgow an Olivier. Now, it’s transferring to London’s West End.

The play was written by Mark Rosenblatt, a seasoned theatre director but debut playwright.

He tells Sky News: “It didn’t start as an idea about Roald Dahl at all. It was about the blurring of meaningful political discourse with racism, specifically when, in 2018, the inquiry into antisemitism in the Labour Party started to come out.”

Rosenblatt describes Dahl’s Revolting Rhymes and Dirty Beasts as the “wallpaper” of his childhood, and says he had no desire to “smash the Roald Dahl pinata”.

But despite the fond recollections, he was conflicted: “Understanding that [Dahl] also, possibly, didn’t like someone like me because I’m Jewish felt complicated.” It was Rosenblatt’s exploration of “how you hold those two things at the same time” that led to Dahl becoming the play’s focus.

Elliot Levey plays Dahl's Jewish publisher, and Aya Cash plays an American Jewish sales executive. Pic: Johan Persson
Image:
Elliot Levey plays Dahl’s Jewish publisher, and Aya Cash plays an American Jewish sales executive. Pic: Johan Persson

‘He’s not cancelled in our home’

Rosenblatt describes him as “a complex man, capable of great compassion, great passionate defence of oppressed people, and also capable of enormous cruelty and manipulation. He was many things at once”.

And as for Dahl’s place in his life now? Rosenblatt says: “I still read his books to my kids. He’s certainly not cancelled in our home.”

It’s likely that Dahl’s comments, if uttered today, would lead to swift social media condemnation, but writing in a pre-social media age, the judgment over his words came at a much slower pace.

Dahl died in 1990, and his family later apologised for antisemitic remarks he made during his lifetime. But the debate of whether art can be separated from the artist is still very much alive today.

Earlier this month, Lithgow found himself drawn into a different row over artists and their opinions – this time concerning author JK Rowling.

Author and Lumos Foundation founder J.K. Rowling attends the HBO Documentary Films premiere of ...Finding the Way Home" at 30 Hudson Yards on Wednesday, Dec. 11, 2019, in New York. (Photo by Evan Agostini/Invision/AP)
Image:
JK Rowling in 2019. Pic:AP

‘A matter of nuance’

Soon to play Dumbledore in the Harry Potter TV series, he has been criticised by some fans for working with the author known for her gender critical beliefs.

Lithgow told Sky News: “It’s a question I’m getting asked constantly. I suppose I should get used to that, but JK Rowling has created an amazing canon of books for kids…

“I have my own feelings on this subject. But I’m certainly not going to hesitate to speak about it. Just because I may disagree… It’s a matter of nuance… I think she’s handled it fairly gracefully.”

The actor ignored calls not to take the role.

He goes on: “Honestly, I’d rather be involved in this than not. And if I’m going to speak on this subject, I’m speaking from inside this project and very much a partner with JK Rowling on it.”

Demanding an eight-year commitment and a move to the UK for the part, the stakes are high.

And with a legion of Harry Potter fans watching on from the wings, only time will tell if the Lithgow-Rowling partnership will prove a magical one.

Giant is playing at the Harold Pinter Theatre in London until Saturday, 2 August.

Continue Reading

Trending