Issue 117 Massachusetts Psychiatric Society, 40 Washington Street, Wellesley Hills, MA 02481 Phone: 781-237-8100 Fax: 781-237-7625 September 2011 EXECUTIVE COMMITTEE the DEVIL in the DETAILS……... Donald B. Condie, M.D. By the timed you read this the official summer season President will be over and Labor Day past. School will have started Alex Sabo, M.D. and beach chairs not so busy. MPS however has been President-Elect working through the summer on a number of fronts. Marie H. Hobart, M.D. Immediate Past-President More issues about parity and our patients in ERs are be- Cornelia Cremens, M.D. ing addressed. John Palmieri, new to MPS Council but Secretary not to administrative struggles has agreed to represent Sarah Langenfeld, M.D. MPS on a DMH working group to look at why ER stays are Treasurer so long for our patients. There are several other groups working simultaneously on this issue and we will re- Anthony J. Rothschild, M.D. connect with the ER docs in the fall—coming on fast—to Sr. APA Representative 2011-2014 make common cause with them to advocate for better APA REPRESENTATIVES procedures for our patients. Caroline Fisher, MD, PhD Donald B. Condie, MD APA Representative 2010-2013 A major reorganization in children’s psychiatric services Gregory M. Harris, MD, MPH in Massachusetts has been proposed as part of a larger APA Representative 2010-2013 plan to reorganize DYS, DCF, DPH, DMH and other ser- John Palmieri, M.D. vices for children within the larger state organization of Visit the MPS Website APA Representative 2011-2014 Executive Office for Human Services (EOHS). Similar MPS COUNCILORS plans have been discussed as far back as the early www.psychiatrywww.psychiatry----mps.orgmps.org Sheldon Benjamin, M.D. 1980s in Massachusetts (as far as my memory goes) 2011—2014 and I’m sure even longer. Another part of these proposed reorganizations would reform the CHINS process for Chil- Inside this issue: S. Nassir Ghaemi, MD, MPH 2009—2012 dren In Need of Services. MIT Corner Pages 3 James Harburger, M.D. 2010—2013 For those not familiar with that acronym, it refers primari- Updates Page 4 ly to the juvenile court process where children whose Mark J. Hauser, M.D. behavior ---either through truancy (and a school referral), 2011-2014 APA News Page 5 minor delinquent acts (through a police referral to the Janet E. Osterman, MD, MS court), or direct referral from a parent to the court for 2009-2012 behaviors such as running away or breaking curfew, is MPS Classifieds Pages 6-11 Arthur Papas, M.D. considered to be not only problematic but possibly ame- 2010-2013 nable to some form of therapeutic intervention can be MPS Calendar Page 12 court ordered to receive such interventions. Member In Training Representative Isis Burgos-Chapman, M.D. 2011-2013 If the above paragraph is confusing, so is the CHINS pro- SOUTHEASTERN MASS. CCHAPTERHAPTER cess it attempts to summarize, hence the wish to simplify Marc A. Whaley, M.D., President and clarify that process as well as referrals for all sorts of children’s services. WESTERN MASS. CHAPTECHAPTERRRR Stephen G. Kessler, M.D., President MPS STAFF All such reorganization efforts mean well but “the devil is Beverly Sheehan Dupuis in the details.” MPS has offered to participate in the chil- Executive Director dren’s reorganization in several ways and we now hope to participate in the Behavioral Health working group. As Mayuri Patel Executive Office and Membership usual, simply getting to the table to discuss such issues Administrator takes considerable effort and lobbying skill (thank you Julie Kealey (Continued on page 2) Continuing Medical Education Coordinator Page 2 MPS Bulletin—September 2011 (President’s Report—Continued from page 1) Lisa Simonetti) and once at the table we must ally ourselves Marie Hobart and Alex Sabo continued to be active in their with like minded groups. roles as past and future presidents representing MPS in sev- eral places where the future organization of healthcare in Peter Metz current president of NECCAP has been particu- Massachusetts continues to be discussed. We continue to larly helpful regarding child issues. Although most members be in close contact with the Massachusetts Medical Society of MPS might not treat children directly, the paradigm for around their efforts since by making common cause with reorganizing services for this most vulnerable population will them we fully participate in these discussions. I will attend apply as well when the larger issues of payment reform and the MMS Inter-specialty Committee meeting in September health care reform in general come back before the Legisla- and update you after that. ture in the fall. The same principle of working cooperatively with as many groups as possible to magnify our advocacy for patients and the profession applies to both areas. Hope the summer went well. A recent letter to the editor in Annals of Internal Medicine regarding a survey conducted by Cambridge Hospital intern- ists has generated many requests for interviews. The letter summarized–for those who missed its coverage in the press– Donald B. Condie, MD how difficult it was for callers to psychiatric practices to ob- President tain an initial appointment within 2 weeks. A vignette was used by the callers specifying that they had been seen in a local ER and advised the services. Since the report comes in Western Mass Residents Luncheon the form of a letter, it is not clear what details were given as part of this vignette, but it is clear that very few places of- fered availability to the callers (representing themselves as patients) within 2 weeks. The perception that access to psychiatric services remains too difficult for patients is a major concern for MPS since it relates to the ER issues discussed above and in previous newsletter postings, and it can lead to the well-intentioned but possibly harmful proposal of “solutions” that might only succeeded in making the process more complex and cumber- some. One proposal that MPS supports both for ER patients as well as less acute outpatients, would be for insurance companies to participate more actively in finding services for the people they cover. At the present time, some insurers continue to have “Phantom panels” that appear to have many more par- ticipants than are actually affiliated. In the age of electronic real-time access to banking records, utility bills, and other Welcome to Massachusetts services, faster updating of insurance company lists should be possible, perhaps with indications of available patient to allallall thethethe slots. incoming Residents!! This would of course constitute a major change in the way insurance companies and providers on their panels would do business but proactive suggestions of this type should be Membership Appreciation Night discussed as a way to recognize the problem and propose possible solutions as a starting point for discussion. October 17, 2011 If Accountable Care Organizations (ACOs) do become part of Stockyard Restaurant, Brighton, MA the Massachusetts healthcare landscape greater efficiency in accessing all psychiatric services will be one of their goals. Reception at 6:30 Dinner to follow Massachusetts Psychiatric Society ♦ 40 Washington Street, Suite 201 ♦ Wellesley, MA 02481-1802 Phone: (781) 237-8100 ♦ Fax: (781) 237-7625 ♦ Email: [email protected] MPS Bulletin— September 2011 Page 3 MemberMember----inininin----TrainingTraining Corner developed by the physician during his virile years; so that in the afternoon and evening of his life they will sustain and Isis BurgosBurgos----Chapman,Chapman, MD comfort him…” 2. Others such as Mohsen Bazargan PhD who Medice, Cura te Ipsum: Physician, Heal have examined the personal health and lifestyle behaviors of Thyself physicians have postulated that physicians who are able to create a healthy lifestyle are more likely to provide better It is Friday night! I have been looking care for their patients 1. forward to a respite from work all week and I am on the couch thinking, “did I For a long time I have postponed doing certain things be- document all my patient encounters cause of the thought that “I am too busy but someday I will properly? I haven’t seen Ms. X in a have more time.” As a third year resident I am realizing that while, I need to call her. Did I check my there is always going to be a sense of not having enough voicemail? Note to self, remember to time. Likewise the habits that we develop now as residents read up about side effects of medication X…” After an inde- will likely be the habits that we will carry on with us in the terminate amount of time second guessing and questioning future wherever our careers lead us. Having accepted that myself, my husband interrupts my train of thought to ask, we will be lifelong learners, there will always be more work to “What do you want to do tonight?” I look at him and remem- do and more to learn. Knowing the time constraints that ber, oh right, I’m not at work anymore and force myself to come from this we need to ensure that we find time to care forget about work and enjoy my time off. Does this sound for ourselves and to avoid getting caught up in feeling as familiar? though our entire lives need to revolve around our being psy- chiatrist. I urge each and every one of you to make time each Somehow in the midst of years of studying, medical school day to take care of yourself but also to make an effort to and residency training I have become unbalanced and have identify the individuals in your life, in my case my husband, incorporated, rather than refrain from, the bad habits my pa- who remind you of the importance of living a well-balanced tients often disclose.