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Organizational Background

History of The Maryland Psychiatric Society

The MPS Constitution was adopted on March 10, 1949. On April 9th, Dr. Theodore Lidz became the first MPS President, Dr. Isadore Tuerk, President-elect, Dr. Samuel Novey Secretary-Treasurer, and Dr. Manfred Guttmacher, councilor. The Society's organization arose as a result of a series of articles entitled "Maryland's Shame," which appeared in the Baltimore Sun. These articles exposed the horrible conditions that existed in the state hospitals. The MPS appointed a committee to meet with members of the Baltimore Psychoanalytic Society and the Maryland Association of Private Practicing Psychiatrists (MAPPPs) to influence public policy concerning mental health issues, particularly with regard to conditions in the state hospitals.

In fact, the MPS dates back to October 1908, when an organizational meeting was held at the MedChi building in Baltimore, followed by one at Sheppard Pratt on November 6, 1908 that was attended by 34 charter members. There was no permanent chairman; meetings were run by the hosting institution.

Dr. William Elgin and Dr. Harry Murdock, in a 1996 article, traced the history of the MPS from its pre-constitutional beginning until the mid-1960's. Subsequent meetings were held quarterly in various Maryland psychiatric institutions

Early meetings focused on the state's role in the care of the insane, the role of expert witnesses, and the place of occupation and recreation in the treatment of mental illness. The "Maryland Psychiatric Quarterly" was published from 1911 - 1923 with a focus on occupational and recreational therapy. Early membership included general practitioners, lawyers, psychologists, front-line caretakers at the hospitals, and charity workers. By 1923 the Society was composed primarily of institutional psychiatrists, as there were few private practitioners. From 1923, the organization continued as the Neuropsychiatric Section of the Baltimore City Medical Society until the formal establishment of MPS in 1949.

Distinctions among psychiatrists, neurologists, and internists were not well defined during the 1920’s and internists actively influenced the Society during that period. During the 1930's, private practice expanded, as did the Maryland Association of Private Practicing Psychiatrists (MAPPPs), under the leadership of Dr. Wendell Muncie. During this period, institutional psychiatrists were the predominant group represented within the organization. The Baltimore/Washington Society for Psychoanalysis also grew, and by the end of the 1930's, Maryland had three separate groups of psychiatrists with differing professional interests.

World War II resulted in a marked decline in Society activity, as many psychiatrists were away serving in the military. The war stimulated much interest in psychiatry. Afterwards, the GI Bill of Rights and the Mental Health Act created training grants. Many of the "new" psychiatrists and psychoanalysts entered private practice. Prior to World War II, the organization had focused on scientific issues as well as attempts to popularize psychiatry, rather than trying to influence legislatures for public concern. It was the national exposure of "Maryland's Shame" that created the momentum for the three psychiatric groups to work together on issues relating to state mental health policy.

In 1954, the MPS became a District Branch of the American Psychiatric Association. This resulted in significant revision of the MPS constitution and bylaws, as only members of the APA could vote and hold office in a District Branch. Later, Drs. Leonard Gallant and Gerald Klee played a major role in the reorganization of the MPS Constitution and By-Laws. Others influential in the unifying effort included Drs. Jerome Frank, Eugene Meyer, Kathryn Schultz, Virginia Huffer, Joseph Lichtenberg, Jerome Styrt, and Leon Eisenberg. A number of psychiatrists held membership in more than one of the state psychiatric groups; however, MPS, MAPPPs, and the Psychoanalytic Society each had its own committee regarding public mental health issues. The MPS Council was reorganized so that all three psychiatric groups were represented, enabling the Society to speak as the unified voice of Maryland psychiatrists (with the exception of those in Prince George's and Montgomery Counties who have always been part of the Washington Psychiatric Society).

The Inter-Society Council came to focus not only on scientific issues relevant to all psychiatrists, but on efforts to improve psychiatric education, training, and knowledge of psychiatry in the courts and schools. During the 1950's, leadership in the MPS swung away from those employed in the public sector to those in private practice. Since then, leadership has swung between private practitioners, academicians, and public sector psychiatrists.

Scientific programming has been a major component of Society activity for many decades. In the mid-1960's, monthly evening meetings were held in the MedChi building, but the private psychiatric hospitals also hosted occasional meetings. Subsequently, Sheppard Pratt hosted an annual fall dinner meeting. Many nationally and internationally renowned psychiatrists from all parts of the country provided outstanding scientific presentations for MPS members. An annual joint meeting with MAPPPs and the Maryland Psychoanalytic Society was held for over 30 years. During the past two decades, most of the scientific programs have been held at Sheppard Pratt; but the evening meetings were recently discontinued in favor of an annual scientific program.

With the development of the Inter-Society Council in the 1950's, the MPS expanded its concerns to include the reorganization of the State Department of Health and Mental Hygiene, the issue of privileged communication between patient and psychiatrist, and the development of community clinics. A major issue in the 1960's was privileged communication. Dr. Gerald Klee recalls that while he was Director of the Outpatient Psychiatry Program at University Hospital, lawyers would often obtain subpoenas to "browse through patient's psychiatric records." It became necessary to have two records for each psychiatric patient so that the general hospital record would not include historical or assessment information. Many psychiatrists, including Drs. Klee, Rappeport, and Bartemeier, testified before the legislature at hearings on a bill to establish a privilege for patients' psychiatric communications. The Maryland Psychological Association opposed this legislation for several years because their patients were not included; finally it was agreed that they would be. The Mental Health Association of Maryland and Delegate Jerome Robinson were important allies in finally gaining passage of this critical legislation.

The early 1970's continued to be an excellent period for private practice. Referrals were plentiful and an early career psychiatrist could open an office almost anywhere and anticipate a busy full time practice. Dr. Irvin Cohen recalls that when he was Chair of the Ethics Committee, it received no complaints. In contrast, during the past two decades, the MPS Peer Review and Ethics Committees have been very active. The Maryland Psychiatrist had its inaugural issue in 1974 under the editorship of Lino Covi, M.D., with Drs. Elihu Allinson and John Lion on the editorial advisory board. Then President, Dr. John Imboden’s article was titled “Questions, Questions, and More Questions.” It asked, “What is really happening to American psychiatry today? Is it undergoing an identity crisis? Can psychotherapy be done by just anybody?” By the mid-1970's, social workers were pursuing the right to provide psychotherapy independently without physician supervision. Franklin Goldstein, J.D., became our lobbyist and Dr. Lex Smith chaired the legislative committee. Along with many committee members, they testified against legislation that would allow social workers to do psychotherapy without psychiatric supervision. The social workers persisted until gaining legislative victory.

The 1980's were characterized by continued differences with social workers and psychologists regarding "scope of practice" issues. There were bills that would allow social workers the right to make psychiatric diagnoses and those that would allow psychologists to have hospital admitting privileges. MPS opposed such legislation, and many members have testified at legislative hearings. MPS News began in September 1987 as the Monthly News Bulletin, which was envisioned as a means to quickly reach the membership on a variety of current events, enabling the MPS to obtain member responses. This allowed separate mailings to be combined to reduce costs. The two-page bulletin expanded to four pages under the name MPS News with the July/August 1988 issue. In 1989, the MPS began publishing the Annual Membership Directory, which has become a valuable resource for member to member contact and referrals.

During the 1990's we developed closer ties with the APA, MedChi, and the Suburban Maryland Psychiatric Society, along with the parity coalition, Medicaid mental health coalition, the provider coalition, and other mental health professionals via the Maryland Joint Commission for Inter-professional Affairs (MJCIA). These alliances have unified opposition to many of the managed care injustices as well as efforts at reaching consensus on high-priority issues such as patient confidentiality. We have allied ourselves more closely with MedChi and the Suburban Maryland Psychiatric Society to ensure that patients receive appropriate medical supervision. In 1997 the MPS entered the Internet superhighway with the launch of its web site. David Gotlib, M.D., designed the web page, which includes an interactive “Find a Psychiatrist” search engine.

The MPS organizational structure has undergone enormous growth and development in the past decade. Not until Dr. Elihu Allinson's presidency in 1972 did the MPS have a staff secretary. Florence McGee served the organization from Dr. Allinson's office for over a decade. By 1978, the MPS had moved to the MedChi Agency building, where it rented office space. The current office in the St. Paul at Chase condominium was purchased in 1988, and its mortgage has been fully paid.

During Dr. Thomas Allen's presidency in 1989-90, major changes developed to handle the escalating organizational demands. The Executive Committee, consisting of the President, Council Chairman, President-Elect, and Secretary-Treasurer, along with the Executive Director, began meeting weekly. The Council, however, remains the governing body, while the Executive Committee acts on its behalf between the eight yearly council meetings. There are now many MPS committees carrying out many important tasks for the organization. Thanks largely to Dr. Allen's efforts, the MPPAC and The Maryland Foundation for Psychiatry have been set up and have meaningfully complemented MPS activities.

The MPS faces a challenge for the next millennium-- to truly represent the interests of all Maryland psychiatrists. Our future hinges on the ability to recruit and retain members with divergent interests into a unified, cohesive organization that can advocate effectively on behalf of its members and safeguard the best interests of patients. The first decade of the new millennium will be an adventurous one for Maryland's psychiatrists, and the MPS is well organized with capable leadership to meet the upcoming challenges.

[Adapted from The MPS at 50!, by Jonas R. Rappeport, M.D., and Leonard J. Hertzberg, M.D. in The Maryland Psychiatrist (Fall 1999; Vol. 26, No. 3; Pg 1, 16-18)]

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