Frequently Asked Questions
The Legislation and Protections
After conversations with hundreds of physicians, PAs and clinicians across Virginia, the Medical Society of Virginia (MSV) learned that providers:
Fear their employer and their licensing Board may alter their employment and/or license status if they discuss their personal burnout
Fear their mental health will be used against them if legal issues arise
Do not feel protected when they seek help for behavioral health
Without providing legal protections and changing the law, those suffering will continue to live in a culture of silence and fear.
Too often, a clinician’s mental health and behavioral health history are easily discoverable by their employers, their state licensing Board, and the legal system.
Many states have mandatory reporting laws for health providers—meaning, providers must report to their licensing body if either themselves or a colleague may have knowledge of that may affect patient care. In many states, this is enforced very strictly. For example, a physician who is aware of a colleague struggling with anxiety or depression may feel that they have a legal obligation to report that colleague to their state board (because anxiety or depression may make them less likely to do an exceptional job practicing medicine). This creates a ‘culture of silence’ amongst healthcare providers.
In Virginia, the MSV heard personal stories of physicians seeking behavioral healthcare and it being used against them in court proceedings, including divorce or medical malpractice. Many of these cases had nothing to do with the fact that the clinician had sought treatment—but the reality of seeking treatment was used against them anyway.
Since the launch of SafeHaven, it has become obvious that nearly every type of healthcare provider experiences similar issues and needs additional protections.
The first SafeHaven law was created in Virginia. Since then, the program has grown to several states, with thousands of providers enrolling in the program. While each state has different criteria, no matter where you live or work, SafeHaven hopes to provide greater confidentiality for those who need help.
In Virginia, providers enrolled in SafeHaven are exempt from mandatory reporting to Board of Medicine unless there is a danger to themselves or patients, and all communications between the provider and counselor are considered privileged.
Each state has different protections. Any provider enrolling in any state needs to check their individual state statute and/or contact their state medical society to know what protections they may or may not have.
Yes! The MSV recommends starting with Georgia’s legislation, GA HB455. The Georgia legislation was passed in 2024, and mirrors Virginia’s legislation. We also recommend reviewing the amendments that Virginia has enacted to protect licensed clinicians, including nurses, pharmacists, dentists, and the students for those professions. In 2025 Virginia will be working to expand SafeHaven legislation once again, to provide protections to all clinicians licensed by the Department of Health Professions.
When the MSV introduced SafeHaven legislation in 2020, we had worked extensively with state lawmakers, the Trial Lawyers Association, the Virginia Health Practitioners’ Monitoring Program, and the Virginia Hospital and Healthcare Association. This ensured that the proposal would be supported by entities whose members would be affected by the legislation. By including these individuals and associations in the process, the MSV was able to address their questions and concerns proactively, as well as incorporate additional perspectives and needs into the legislation. The result? A bill that was passed unanimously by the Virginia General Assembly.
It is critical to identify key stakeholders, including the legislator who will carry the bill for your state, who would be interested in the passage of SafeHaven protections. We recommend you connect with your state’s various medical associations, the Physician Health Program, the Trial Lawyers Association, and lawmakers who tend to support or oppose healthcare-related legislation.
SafeHaven is a voluntary program. The legislation provides protection for counseling and coaching under the SafeHaven umbrella. Our resource partners provide proactive, preventative well-being resources for burnout, career fatigue and mental health. Long-term psychotherapy, substance use treatment, or medication management are not provided.
SafeHaven offers several referral options for an employer who needs or requests a diversionary program as a condition of retaining employment. An employee taking part in a diversionary program does NOT enjoy the confidentiality protections (or other protections) of SafeHaven, since such programs are mandated by an employer and may be reportable to HR. Protections like privileged communications or from reporting to the board are not available in a diversionary program. However, some protections may be available under laws governing a state Provider Health Program (PHP) or related laws in a state. We recommend a clinician seek advice on these matters from legal counsel if there are questions about such a program.
Yes, SafeHaven and our vendors are mandated to report to a state PHP if the provider is believed to be a danger to themselves, the public, or their patients. We take this responsibility seriously. To date, SafeHaven in Virginia continues to work to assure public trust and safety with our state PHP, and no errors or omissions have been reported. SafeHaven enrollees are made aware of the protections when they sign up, and are reminded regularly through onboarding, employer training, in communications including emails and websites. All state medical societies and national societies are offered education and resources about the program, its protections, and services.
Processes are also in place to inform clinicians if a handoff from SafeHaven to another service interrupts or ends protections. In addition, SafeHaven works closely with its vendors to train all coaches and counselors on SafeHaven legal protections in an event they need to communicate or educate.
No, State Medical Societies (SMSs) have multiple levels of responsibility including professional, moral and/or legal responsibility to lead, guide, and advocate for physicians as well as report bad actors to their licensing boards and relevant authorities. In Virginia, the MSV governs SafeHaven and takes reporting responsibilities very seriously, as it has over its 200+ year history.
The Program
The SafeHaven cost for individuals and small practices is listed here.
The SafeHaven cost for larger independent practices and Health Systems vary depending on a variety of factors, such as how many overall staff will participate, how many physicians and APPs versus nurses, the length of the agreement, etc. Please contact us here if you would like more information on how to bring SafeHaven to your practice.
The SafeHaven program does have a nominal revenue share component built into the retail price. It is meant to cover staff costs and other ancillary expenses which will allow each state medical society to invest back into their mission of supporting their physicians as well as the overall healthcare profession.
State Medical Societies should not expect SafeHaven to become a significant source of non-dues revenue, but rather expect a reliable source of underlying program support to offset related costs. We designed the program to be sustainable because our members’ mental health is too important to depend on fluctuating grants or other funding.
SafeHaven welcomes partnerships with PHPs and other state resources to ensure the right care is provided at the right time. The over-arching goal shared among all these entities is to address clinician mental health and well-being before there are serious, life-altering impacts. Just as there are a wide and varied spectrum of needs, there are a variety of ways to treat and support those needs. Increased awareness and understanding of the unique roles each entity plays to positively affect mental health and well-being is a goal that unites us.
SafeHaven is designed as an approachable, front-end, non-diagnostic well-being resource. Because of this, most of these enrollees are experiencing earlier symptoms of the burnout loss spiral and less likely to be experiencing impairment or in current need of PHP intervention. A goal of SafeHaven—and a key reason for its creation—is that clinicians get help before they are bad enough to need a state PHP.
Further, many state PHPs focus on substance abuse disorder. To date, in Virginia, the MSV is not aware of a SafeHaven clinician dealing with this intense issue. As required by law, were it to arise during treatment or coaching, they would immediately be referred to the state PHP. However, SafeHaven counselors and coaches have historically provided referrals to employers for diversion services approximately 1 to 2 times per quarter upon request.
The SafeHaven Difference
SafeHaven is designed to address the issues affecting the stigma of getting help. SafeHaven encourages early intervention so that healthcare professionals can continue to care for patients safely. A goal of SafeHaven—and a key reason for its creation—is that clinicians need help before they are bad enough to need a state PHP. The legal protections provided by SafeHaven help to break the culture of silence around clinician mental health, and encourages more providers to get the help they need when they need it. State PHPs are often government sanctioned programs meant to provide assessment, referral to treatment, resources and monitoring for healthcare professionals, who may be at risk of impairment from mental illness, substance use disorders and other health conditions. Many state PHPs serve a dual function of both treating clinicians and protecting the public from bad actors—which may include suspending or taking away a clinicians license to practice.
SafeHaven is committed to identifying clinicians who find themselves in need of a state PHP. This may include issues substance use disorder, suicidality, and beyond. Some interventions might require leverage for clinicians to seek or receive treatment; however, we do not believe this is the majority.
No. SafeHaven services were developed using the foundations of a traditional EAP but have been enhanced to best meet the needs of today’s clinicians, particularly when addressing fatigue and burnout. The well-being resources chosen by SafeHaven are comprehensive, highly vetted, and closely managed by our vendors. Our vendor network includes organizations with 40+ years’ experience and 20+ with healthcare clinicians specifically.
Through SafeHaven, a clinician can reach a trained professional 24/7/365, which is especially important for practitioners navigating shift work and grueling on-call schedules. A concierge service has been added to encourage clinicians needing help with everyday life responsibilities so they can concentrate on taking care of patients. Importantly, in addition to highly trained master-level counselors, SafeHaven provides access to physician and nurses who are certified peer counselors, to help navigate the special challenges, moral injury and other emotional effects of these unique professional roles.
After assembling this robust selection of services for clinicians, we added special protections to encourage providers to access services early without fear of termination, legal ramifications, or putting their licensure in jeopardy.
Physician residents report a clear preference for therapy and coaching to address their burnout and stress [1]. Peer and professional coaching for the healthcare community is an emerging research field, yet initial studies have indicated improved job satisfaction and self-efficacy among clinicians who participate in such interventions [2,3,4,5].
The SafeHaven model is built on the success and best practices of confidential, voluntary coaching and counseling resources in other safety-sensitive occupations, including the US Army Coaching Program, and Counseling Team International’s Peer Support Program, used by police departments across the US.
Importantly, we believe a sense of safety and protected speech has been the difference maker in improving use of these important services.
SafeHaven’s engagement numbers speak to clinicians’ willingness to benefit from the program: about 17% of those enrolled use coaching and counseling services, while a total of 48% access its services to improve their work-life balance and feelings of burnout. This level of utilization and improvement by the healthcare clinicians and other providers is unprecedented!
Without changing the law and offering legal protections to healthcare workers, those suffering will continue to isolate vs. seeking help. This will not only hurt practitioners but will negatively impact patients and the entire healthcare system.
SafeHaven provides proactive, preventative, well-being resources for burnout, career fatigue and mental health. Historically, the core-function of EAPs does not include diagnosis or treatment.
[1] Wu, A., Parris, R. S., Scarella, T. M., Tibbles, C. D., Torous, J., Hill, K. P. (2022). What gets resident physicians stressed and how would they prefer to be supported? A best-worst scaling study. Postgraduate Medical Journal, 98(1166): 930-935.
[2] Ammentorp, J., Jensen, H. I., Uhrenfeldt, L. (2013). Danish health professionals experiences of being coached: a pilot study. The Journal of Continuing Education in the Health Professions, 33(1):41–7.
[3] Gattellari, M., Donnelly, N., Taylor, N., Meerkin, M., Hirst, G., Ward, J. E. (2005). Does peer coaching increase GP capacity to promote informed decision making about PSA screening? A cluster randomised trial. Family Practice, 22(3), 253-265.
[4] Gazelle, G., Liebschutz, J. M., Riess, H. (2014). Physician burnout: Coaching a way out. Journal of General Internal Medicine, 30(4): 508-513).
[5] Sekerka, L. E., Chao, J. (2003). Peer coaching as a technique to foster professional development in clinical ambulatory settings. The Journal of Continuing Education in the Health Professions, 23(1):30-7.
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