Hansen T E, Goetz R R, Bloom J D, Fenn D S
Department of Veterans Affairs Medical Center, Portland, OR 97207, USA.
Psychiatr Serv. 1998 Feb;49(2):202-6. doi: 10.1176/ps.49.2.202.
This study examined the nature of questions about previous mental illness, physical illness, and substance abuse asked on applications for state medical licensure, partly to determine if questions focused more appropriately on any current, rather than past, disability.
In 1993 and 1996 the 66 members of the Federation of State Medical Boards of the United States, Inc., were asked to provide copies of the forms they used for medical licensure applications and renewal. The forms were reviewed to determine the presence of questions about previous mental illness, physical illness, and substance abuse and whether the questions specifically addressed the effects of the condition on the ability to practice medicine.
On initial licensure applications, medical boards commonly asked questions about mental illness. Seventy-five percent of responding boards did so in 1993, and 80 percent did so in 1996. The proportion of boards that inquired about whether the mental illness might affect the applicant's ability to practice medicine increased from 42 percent in 1993 to 75 percent in 1996. Applicants were asked about substance abuse by 83 percent of the boards in 1993 and by 94 percent in 1996. Boards asked about physical conditions less often than mental conditions but were more likely to ask about physical conditions in 1996 (65 percent) than in 1993 (49 percent). Questions about physical illness almost always addressed the effect of the condition on medical practice. On license renewal requests, medical boards were less likely to ask questions about mental conditions, substance abuse, and physical illnesses than on the original applications. Among boards that asked about mental illness on renewal forms, the proportion of boards that asked about the effect of mental conditions on ability to practice medicine increased from 60 percent in 1993 to 90 percent in 1996.
Medical boards commonly ask questions about mental illness on licensure application and renewal forms. In many states, such questions changed between 1993 and 1996 to emphasize impairment resulting from mental illness and to use similar wording for mental disorders and physical conditions.
本研究调查了州医学执照申请中有关既往精神疾病、身体疾病和药物滥用问题的性质，部分目的是确定这些问题是否更适当地聚焦于任何当前而非过去的残疾情况。
1993年和1996年，美国各州医学委员会联合会的66名成员被要求提供他们用于医学执照申请和续期的表格副本。对这些表格进行审查，以确定是否存在有关既往精神疾病、身体疾病和药物滥用的问题，以及这些问题是否具体涉及疾病状况对行医能力的影响。
在初次执照申请中，医学委员会通常会询问有关精神疾病的问题。1993年，75%的回应委员会这样做了，1996年这一比例为80%。询问精神疾病是否可能影响申请人行医能力的委员会比例从1993年的42%增至1996年的75%。1993年，83%的委员会询问申请人有关药物滥用的问题，1996年这一比例为94%。委员会询问身体状况的频率低于精神状况，但1996年（65%）比1993年（49%）更有可能询问身体状况。有关身体疾病的问题几乎总是涉及疾病状况对医疗实践的影响。在执照续期申请方面，医学委员会询问精神状况、药物滥用和身体疾病问题的可能性低于初次申请。在续期表格中询问精神疾病的委员会中，询问精神状况对行医能力影响的委员会比例从1993年的60%增至1996年的90%。
医学委员会通常在执照申请和续期表格中询问有关精神疾病的问题。在许多州，此类问题在1993年至1996年间发生了变化，以强调精神疾病导致的损害，并对精神障碍和身体状况使用类似的措辞。
