Candidate for Speaker-Elect

Joseph Rubin, M.D.

Biographical Statement

I have been in the private practice of general adult psychiatry for 28 years, in Portland, Maine. I have coverage colleagues whom I trust and office-sharing companions with whom I have been affiliated for many years, all being extremely supportive of my APA activities.

For more than 28 years I have worked one day a week in a community mental health center. Treating these seriously and chronically ill patients has been especially rewarding. Additionally, I am the medical director of a busy skilled nursing care facility, Cedars Nursing Care Center, in Portland.

Now in my 24th year in the Assembly, I was the representative from Maine for many years, the Area 1 representative for five, and the chair of the Committee on Planning for one year, and I am now recorder and a member of the Joint Reference Committee. For more than 15 years I was Assembly liaison to the Council on Aging, have been the Area 1 Rules Committee representative, and have served on reference committees and numerous work groups.

In Maine I have been a member of the Executive Committee of the Maine Psychiatric Association for 26 years. I have held every office we have, except treasurer, including the presidency two times (we are a small district branch, and it has sometimes been hard to find volunteers). I am currently secretary.

When I completed medical school in 1972 at the University of California, San Francisco, my professors told me I was throwing away my career by moving to Maine. My classmates told me I was throwing away my career by going into psychiatry. Previously my undergraduate advisors at the University of Chicago had told me I was throwing away my career by going to medical school out West. In fact, I feel very fortunate in the choices I have made.

Candidacy Statement

Last year when I ran for recorder, I wrote about my love of the Assembly, its diversity and energy, and the importance of the special groups that are now represented in addition to our traditional representation by geography. As APA is growing to become more of an umbrella organization representing all of psychiatry, including its increasing number of special-interest organizations, the Assembly will continue to be the principal place where voices can be heard from all corners of our field. In recent years this has meant gradual growth in the size of the Assembly. Perceived as a problem by some, I do not feel that it has been so to date. We get our business done, and our agenda remains an open invitation to new positions and ideas. The Assembly is a wonderful institution, often lively and always interesting. I remain opposed to uniform term limits for Assembly representatives. Too much of our commonly held wisdom and memory could be lost, and I would not wish to try to dictate to the district branches (DBs). I am also convinced that we have done our fair share of careful budgeting. In fact, the Assembly has goaded other segments of APA to do the same.

Scope-of-practice and patient-safety issues remain important for me. I understand the pressures that mental health centers, hospitals, clinics, and other caregivers are under to reduce the expense of treatment. It is so tempting to see psychiatrists as prescribers alone and then want to employ prescribers who do it more cheaply, who see more patients per hour, or who are not even medically competently trained. Others may join us in fighting for quality, but none will be as vocal and determined as we must be ourselves. This term we have our first bill in Maine that mentions psychologist prescribing, so I’m feeling especially sensitive right now about this. We have some strengths to help us; an excellent relationship with the Maine Medical Association, some access to Board members of NAMI/Maine, and a nascent consultation program to help bring psychiatric expertise to rural family practitioners throughout the state. This fight will not go away, and we have to remain aggressive. If elected, as speaker-elect and speaker I will be carrying my conviction about the importance of scope-of-practice definition and patient safety wherever those positions take me within APA.

I want to mention the recent developments in some of our district branches that are trying to stem the decline in their memberships and revenues. These challenges are worrisome to all of us. It is exciting to think that the national and also local membership numbers are beginning to change for the better, and I hope this proves to be a sustained trend. However, inasmuch as plans and decisions have to be made to address the problem, I feel strongly that we must do nothing to disrupt the unity of our organization. APA and the DBs must remain tightly joined through dual membership. I am aware there are differing interpretations among us regarding whether various plans threaten that unity. We need to recognize that even as we disagree, we all want the same outcome: the strongest possible voices for psychiatry and its patients in all national and local forums. The survival of our profession and well-being of our patients depend upon our firmness and clarity of vision. If elected, I will continue to work to keep us together. Fresh ideas and approaches must be encouraged, even if not adopted. Your votes have already accorded me the privilege of participating and representing you in meetings of the Assembly officers, the Assembly Executive Committee, and the Joint Reference Committee. This year I ask for your vote and support of my candidacy for speaker-elect. Thank you. ▪