By Bruce Hershfield, MD
[Summer 2007; Vol. 33, No. 3; Pg. 11, 15]
Q:
“How do you manage your time so that you can do so much at once?”
Dr.
H: “It’s
really managing attention to certain issues and understanding the issues that
need to be addressed. It’s not necessary that I address every issue
myself–-just making sure that they are being addressed, and at a certain level
of detail.”
Q:
“I know that you have good people to work with.”
Dr.
H: “Absolutely.
It was a gift to have Marty Wasserman , who is both an MD and a JD, come
in as Executive Director just a few weeks before I became President of Med-Chi.
He knows so much about so many things about health care in Maryland. He
and I get along like cousins.
It’s like you live next door to your cousin and you do everything
together and you’re competing with each other, so he does something and the
next time you do something and he says, “I could have done that better” and
he goes back and does it better the next time.
We have had this competitive relationship, but it’s a positive one.
Each of us is envious of the other and astounded and grateful.
We make up a wonderful team.
Q:
“It’s also an opportunity to learn all sorts of things.”
Dr.
H: “The best training ground to be President of Med-Chi is to actually be the
President of Med-Chi.
Q:
“How is the fact that you are a psychiatrist useful to you in handling the
hierarchy of Med-Chi?”
Dr.
H: “Other physicians at Med-Chi have come to me and told me that they thought
that I bring a lot to understanding the process of Med-Chi by being a
psychiatrist.
It’s not that I do that overtly, to psychoanalyze, it’s just that
when you’re aware of processes and systems, you understand the process better
and respond to it better.
I was having dinner with a Past-President a couple of weeks ago and he
looked at me with amazement that I was able to understand a certain process that
was going on that he had not. He said, “When was the last time that we had a
psychiatrist as President of Med-Chi?”
Q:
“You’ve been preparing for this for some time.”
Dr.
H: “For quite a few years.
Tom Allen, who was the last psychiatrist to be President, has been a
tremendous mentor all along.
I got involved with the MPS when Tom was its President.
He had a reception at his house for new members and I decided to go to
it. He
asked me if I’d ever thought of being on a committee.
So I thought that it was special, to be allowed to be a member of a
committee.
I asked what committees existed and he mentioned the Legislative
Committee.
In my math and science education I didn’t pay as much attention to the
social sciences as I would have liked , so I thought that this would be a great
opportunity to learn about my community and the legislative process, so I said
I’d love to join it.”
Q:
“What was that like?”
Dr.
H: “Mayer Liebman was the Chair.
I learned a lot about bills.
I also joined the Baltimore County Medical Association legislative
committee, so I learned different styles of Chairs.
Bill Wimmer asked me to be Chair of the MPS committee.
I was Chair for about four years and it was during that time that the
mental health parity bill came to Maryland.
That was immediately challenged by the insurers, and then we had two
efforts going on–-one to address the case in the courts and the other to
possibly offer a different bill that would get through the legislature,
particularly if our suit failed in the court.
That’s how we had the mental health coalition, which included the
Mental Health Association and NAMI.
It was a wonderful group.
There were about five of us who worked tirelessly.
I was in Annapolis two days per week, lobbying legislators during the
session.
Q:
“You got a lot accomplished.”
Dr.
H: “Tremendous amount.
The bill went through.
It was a tremendous experience, working with that group of people. It was
that experience that led me to the position of being Area 3 Rep to the Joint
Committee on Governmental Relations at the APA.
Then I was the first Early Career Psychiatrist delegate to the Assembly,
representing Area 3.”
Q:
“What kind of relief for our patients and ourselves can we look for now in the
legislature?”
Dr.
H: “The two things on the agenda are basically patients having access to care
and physicians being able to have
financially viable practices.
If a physician cannot have a financially viable practice, the office
closes and it doesn’t matter what insurance plan the patients have, they’re
not going to get care.”
Q:
“Psychiatry has changed a lot since you were working on the legislative
committee in the early ‘90s.”
Dr.
H: “It’s
funny, how important parity was at the time and that Maryland led the nation.
President Bush came out a year ago , saying that Federal employees should
have parity.
Too bad that he didn’t say that when it was actually important.
It doesn’t matter what your insurance coverage is if there isn’t a
psychiatrist who accepts it.
That’s more and more the case today.”
Q:
“Do you get the sense that legislators are interested in our issues?”
Dr.
H: “I don’t think that they’re specifically interested.
They’re looking at the total financing package.
I don’t think that they so much separate mental health from the rest of
medical care. They’re just trying to figure out how people can have access to
care and how it’s going to be funded.
There
are two physicians in the legislature now–-Dan Morhaim on the House side and
Andy Harris on the Senate side. Having colleagues in the legislature is
phenomenally important.
During my presidential year I’ve been down to Annapolis about once per
week.
They have this thing called “Doctor of the Day” and I’ve done that
about five times.
When the various county medical societies have gone down for their
”Physician’s Day” in Annapolis–-years ago, it used to be a single day ,
then it was “Physicians and Patients Day”, and now it’s “Components
Day”–-I’ve gone to all of those days.
Q:
“How can the psychiatrists cooperate best with Med-Chi?”
Dr.
H: “I don’t think that the specialties should have a niche to come from, to
bring their issues to the table, to be sure that their issues get addressed.
I think that the specialties should come together, offering their
perspectives, to add to the discussion.
Unfortunately, it sometimes looks like people are trying to look after
their turf.
That just leads to fighting and divisiveness and nothing gets done.
I’d prefer to see people add their perspectives to the debate, to
strengthen everyone else’s debate–-“one for all and all for one”.
I’d
also like to acknowledge the role of the two “Larrys”–Larry Sack and Larry
Kline–and of Jeremy Lazarus, who is Vice-Speaker of the AMA House of
Delegates. Larry Kline approached me around 1994 with an idea that patients
should have clearly defined rights.
Together, we wrote a 10-point “Patients Bill of Rights”. We brought
that through the general medical societies and then through the psychiatric
societies. That became an APA document, then Steve Sharfstein referenced that
when he worked on the Federal level for the President’s Commission.
I also want to say something about how people
contribute. The first is a desire to
get involved, then you actually have to step forward to do it.
Larry Kline and I didn’t set out to set up a national debate about a
patients bill of rights. We had had
personal experiences and we’d heard stories from our colleagues.
We just wanted to get thoughts together–-what rights should there be?
Q: “How has Jeremy Lazarus
been helpful?”
Dr. H: “He certainly gives a face to
Psychiatry within General Medicine. I
can tell you that whenever he sits at the table or walks through the door,
everyone knows that American Psychiatry is in the room.
That’s invaluable.
I’ve never met with
any remarks that were in any way antagonistic or diminishing towards
psychiatrists or towards psychiatry. In
fact, just the opposite–-a tremendous regard for the work that we do and for
what we bring to the table–-a certain perspective and a certain way of
thinking about things that adds to the discussion.”