by Paul A. McClelland, M.D.
[June 1995; Vol. 22 No. 3]
It is a privilege to serve as MPS president for the next year. Each year, sooner or later, the president describes a list of challenges faced by our members and our profession. Because that list continues to grow, while our resources remain unchanged, our greatest challenge may be to choose which battles to fight. One of Craig Martin’s accomplishments as president over the past year was the appointment of a strategic planning committee whose charge was to examine MPS activities and priorities. This year’s membership survey has been designed to obtain input from general members in this area.
Even with this support, the Executive Committee and Council will need a strategy for assigning priority to new issues because of the speed with which they arise. My recommendation is that we focus on those which allow us to play an active role in defining our profession. For example, if next year’s legislative agenda includes a bill granting prescription privileges to psychologists, we should see this as an opportunity to explain the value of our medical training and to differentiate ourselves from other mental health providers. By choosing the proper strategy, we might also reinforce our ties with consumers, strengthen our relationship with Med Chi and bring our members closer together. Developing such a strategy will be time-consuming; we need to start now. On the other hand, we shouldn’t waste any of our resources by challenging any other group in areas which do not involve our vital interests. In fact, it is in our interest to forge stronger ties with other mental health providers so that we can speak with one voice on issues of shared concern.
Another key issue facing us is capitated care. This form of healthcare reimbursement is a serious threat to insurance and managed care companies because it encourages hospitals and physicians to band together and replace those companies. As such, this may not sound threatening, but it is clearly not just another form of managed care. The threat to our members and our profession is that it may put many of us out of work and require those left to practice a very different type of psychiatry. I find the potential changes in the doctor-patient relationship to be especially worrisome. We must study and debate all of its implications for our patients and for the future of our profession. Part of our September 23 Scientific meeting will be devoted to this topic. I also hope that the Ethics Committee will have time to devote to these issues.
There are many other important issues and the MPS, under Dr. Martin’s leadership, has tackled several over the past year. During the last week of the legislature, Drs. Scott Hagaman and Neil Warres and our lobbyist, Franklin Goldstein, Esq., blocked an attempt to eliminate wording in the current state law which prohibits the practice of medicine by psychologists.
In another recent development, Dr. Jeffrey Lafferman led the MPS in efforts to win parity mental health benefits for Medicare beneficiaries who are also impoverished. These efforts culminated in a lawsuit against the Health Care Financing Administration and the state’s Department of Health and Mental Hygiene. This battle is far from won, and we remain open to charges that our efforts are driven solely by our own financial interests. We need to emphasize the benefit to patients as we prepare for the future, which may include a costly appeal, if win in the lower court. We also have an opportunity to join forces with the psychologists because, having won the right to Medicare reimbursement last fall, they will benefit if we win this suit.
The Peer Review and Ethics Committees, led by Drs. Anne Lewis, Harry Brandt and Jeffrey Janofsky, continued their long hours and fine work. We have many hard working committees, but these two truly shape our professional identity by articulating standards of care and interpreting our principles of ethics.
Finally, a few months ago, Dr. Jennifer Katze and her husband, Anthony Kraus, Esq., convinced the state’s Health Care Access and Cost Commission to delay implementation of a statewide database system that would have seriously compromised patient confidentiality. This is a very important precedent because the Commission is a powerful body whose decisions will have far reaching effects for our patients and each of us. For the MPS, it also stakes out a position of leadership within Med Chi on this issue.
The above activities, involving the legislature, courts and regulatory bodies, illustrate the scope of MPS activities. They are also examples of our members taking an active role in defining the practice of psychiatry, instead of allowing outsiders to do so. I hope that we can celebrate similar successes next April.