Assembly Honors Psychiatrists For Courageous Stand

Last May, after considering not-very-veiled threats to their jobs, four Vermont psychiatrists decided to testify at a public hearing against a proposal by their employer to move the inpatient psychiatric unit miles away from the rest of the medical campus. For taking this risk on behalf of patient care, the group won the APA Assembly’s 2002 Profile of Courage Award.

Scott Waterman, M.D., Terry Rabinowitz, M.D., Paul Newhouse, M.D., and Richard Bernstein, M.D., are all on the faculty of the University of Vermont medical school and employed by Fletcher Allen Health Care, which runs the state’s only academic medical center.

Fletcher Allen had already run into considerable opposition to its plan to relocate psychiatric care away from the main medical center, including from APA, the Vermont Psychiatric Association, and citizen advocates. The protests led to a hearing by the state’s Public Oversight Committee at which the four psychiatrists agreed at the last minute to be witnesses against Fletcher Allen’s plan (Psychiatric News, June 7). Their testimony played a significant role in the oversight committee’s unanimous decision to rule against the hospital’s request to segregate psychiatric care.

Newhouse said he was accepting his award “on behalf of all individuals and groups who came together to fight this misguided plan,” which Waterman said was destined “to undermine the clinical and academic work psychiatrists do.” Rabinowitz added that the “real heroes are the psychiatric patients who chose to ‘out themselves’ to ensure their voices were heard.” Bernstein singled out advocate Ann Donohue for praise, calling her the “unsung hero” of the battle. Donohue was just elected to the Vermont legislature.

In other actions Assembly members voted to

• approve adding an “educational option” to the possible sanctions a district branch can impose in response to an ethics-violation charge. This alternative would not require the district branch to hold a proceeding to determine if a member has violated APA’s ethics code or that the member be reported to the National Practitioner Data Bank. The district branch would determine what type of educational program the member would be required to complete, which could include courses, reading, and consultation. The Board of Trustees was scheduled to take up the new ethics option at its November 23-24 meeting.

• support the formation of an APA office on psychiatric emergency mobilization. The office, with an estimated annual cost of $65,000 to $85,000, would support the work of the Committee on Psychiatric Dimensions of Disasters by providing for “a national mechanism of mobilization and coordination of psychiatric manpower in the event of terrorist attacks and disasters.” It would also make it easier to ensure that there is psychiatric involvement at the local, state, and national levels after a disaster.

• approve a dues-relief plan for Canadian members. With the Canadian dollar worth about $0.64 in U.S. dollars, and Canadian members not having access to certain membership benefits such as liability insurance, no-fee credit cards, and federal lobbying efforts, the Assembly agreed that a “rebalancing” of dues was warranted. Canadian members would be assessed at a dues level currently equivalent to $450 Canadian for 2003 if the Board approves the plan, which is estimated to cost APA about $50,400 next year.

• join a national class-action lawsuit charging managed care companies with violating federal racketeering laws. The medical societies in five states are suing nine large managed care companies.

• adopt an APA position statement endorsing the right of same-sex couples to adopt and co-parent children. Similar statements have been approved by the American Academy of Child and Adolescent Psychiatry and American Psychoanalytic Association.

• endorse an APA position statement on “Inclusion of Substance-Related Disorders as Psychiatric Disorders in Any Program Designed to Assure Access and Quality of Care for Persons With Mental Disorders.” It is designed to ensure that legislation such as insurance parity proposals specifically include substance-related disorders in their definition of mental illness. Many of these proposals have exempted these disorders from parity coverage.

• have APA investigate the increasing problems in accessing treatment services that Medicare and Medicaid beneficiaries with serious and persistent mental illness are facing.

• have APA develop a strategy for drawing attention to the needs of people with severe and persistent mental illness and increase its advocacy work on their behalf.

• have APA develop a resource document to assist members in becoming compliant with HIPAA regulations. It would be distributed in printed form and on APA’s Web site. Several Assembly representatives pointed out, however, that some of the rules will vary among states, and psychiatrists will still need to consult their state medical societies.

• encourage district branches to assist their resident members in recruiting their colleagues to join APA.

• ask the Council on Medical Education and Lifelong Learning to explore ways in which APA could help members prepare for the board-certification and recertification exams.

• postpone consideration of a proposal to reduce APA dues by $100 for psychiatrists who also belong to the American Academy of Child and Adolescent Psychiatry (AACAP). The plan hinged on AACAP’s agreeing to reciprocate with its members who also belong to APA. Intended as a strategy to recruit and retain APA members in the face of declining membership numbers, the proposal’s failure to include other allied psychiatric organizations and its estimated cost to APA of about $400,000 annually led the Assembly to postpone consideration until its May 2003 meeting.

In addition, Assembly members applauded one of their past leaders, former speaker Dale Walker, M.D., who was this year’s recipient of the Area 7 Warren Williams Award. Each of the seven APA Areas can give the award annually to honor a psychiatrist or other individual in that region who has made significant contributions locally, statewide, or nationally.

A draft summary of the actions from the November Assembly meeting is posted in the “Members Corner” area of the APA Web site at www.psych.org/members/assembly/summaryactionsfinal110902.cfm. ▪