Leonard Hertzberg, MD
[Fall 1998; Vol.25 No. 2]
Dr. Klee has kindly invited me to share some of my thoughts and to describe some of my experiences as l997-98 President of the MPS. In today’s rapidly changing health care environment, it is still very much an honor to serve as the president of a professional society, but it is also a second workload to those of us who have to earn a livelihood and to maintain family commitments. It quickly becomes clear that serious demands will be made on resources of time and energy.
I frequently found it advisable to act on the recommendations of others. Years of solo private practice in general and forensic psychiatry had made me comfortable with individual decision-making, but this required some different skills. Fortunately, the MPS has a dedicated, knowledgeable staff. We also have more than 15 committees and they have contributed greatly to our success. The Executive Committee and the Council have consistently acted wisely so as to advance our profession; the political acumen of their members has been particularly important because of the complexity of many issues.
Each year, one or two major issues dominate our concerns. In recent years, the confidentiality issue—informed consent for the release of medical data—had rallied our membership. This year, it was the problems with staffing, authorization, and Medicaid payments. Some of our members who are in public psychiatry were willing to speak out openly in challenging those changes we perceived to be detrimental to the public welfare.
We are practicing in a period of medical history in which fortunes are being quickly made and sometimes precipitously lost by the development of healthcare systems. Unfortunately, many physicians are experiencing prosperity or financial hardship primarily as a function of their network affiliations and business decisions rather than their clinical competence. However, I think that the combination of recent advances in neurobiology coupled with psychiatrists’ ability to listen meaningfully and to counsel wisely, bode well for our long-term future. We must resist the pressures of managed care to abdicate counseling and patient management. Our ability to help our patients hinges not only on scientific advances, but also on our skill in healing our patients’ inner suffering.
During the past year I have heard many psychiatrists express frustration with managed care pressures; they are being compelled to work harder and harder with fewer resources. This is similar to what has been happening to other people who are being “downsized” out of positions or who are having to work longer hours in order to earn close to what they had been making in the past. But, unlike other fields that vanish with change, the mental health professions will always be needed. People will always require the kind of help that psychiatrists can best provide.
We have seen major obstacles blocking patients who try to access care and blocking psychiatrists who try to provide it. The MPS has been working hard to protect patient rights and to respond to our members’ concerns. If psychiatrists are to regain control of the care that we provide and if we are to overcome the sense of demoralization that has afflicted many physicians, it must occur through a strong organizational voice. That voice becomes even stronger when the MPS can act in alliance with the APA, Med-Chi, the AMA, and other groups. Such alliances must include the Suburban Maryland Psychiatric Society, our colleagues in Montgomery and Prince George’s Counties. I think that this will be even more critical in the years ahead.
In the Spring/Summer l998 issue of The Maryland Psychiatrist, Dr. Marianne Benkert articulately discussed our need to safeguard the medical ethics rooted in the physician-patient relationship. An essential function of the MPS is to resist attacks on our professionalism. We must actively promote the best interests of our patients.
It is also important to recruit and to retain more early-career psychiatrists and IMGs (who comprise about one-half the Residents and Fellows in training). The MPS must represent the professional concerns of our diverse membership so that we can ensure the future integrity of our field.
It has been a privilege to serve the MPS as President and I look forward to working with many of you in the years ahead. We have many members within our ranks who have made a major difference. It has been gratifying to see them work tirelessly for the future of our profession. The MPS continues to be challenged by many socio-political forces impacting on our profession, but our leadership and membership are strong. I remain confident that our perseverance will be rewarded in maintaining psychiatry’s efforts to provide the best possible care to our own and future generations.
Dr. Hertzberg is the immediate past president of the Maryland Psychiatric Society. He is currently chair of the MPS Council.