Oregon Psychiatric Physicians Association Current Issues Newsletter - July 2014 by Oregon Psychiatric Physicians Association

July, August, September 2014 | Vol. 30 No. 3

Current ISSUES President’s message 1

PRESIDENT’S MESSAGE

Maintenance of Certification: less and less enigmatic

Legislative report 3 Executive Council highlights 4 Fall conference preview 4 Fall conference program 5

by Annette Matthews, MD

OCCAP Awards 6

Success!! (but possibly still confusing). Let me see if I can explain. Your approach to maintenance of certification (MOC) in psychiatry likely falls into one of four categories: 1) Lifetime certification, not required to recertify, 2) 10-Year MOC Certification (MOC recertification candidates in 2015-2021), when you recertify you will enter the Continuous Pathway, 3) Continuous Pathway MOC Certification (certified on or after 2012), now paying annually to maintain certification, or 4) Not maintaining certification. For those in the first three categories, there have been a number of recent changes to the American Board of Psychiatry and Neurology (ABPN) recertification process that you should know about. Importantly, these changes came about through feedback from APA members to the ABPN. There are four components to maintaining certification: 1) Maintaining an active unrestricted medical license, 2) regular CME, 3) SelfAssessment CME (CME that gives you a report on how you compare to peers), and 4) a Performance in Practice (PIP) Unit – which used to include a chart review, peer feedback AND patient feedback.

In 2010 APA members started complaining that MOC was an onerous process, and in particular, the patient feedback requirement posed several problems for psychiatrists. One major problem with patient feedback was the ethical concern that the reason for asking the patient for feedback for MOC was a request by the psychiatrist to the patient with the goal of gratifying the needs of the psychiatrist. Another concern was that several subspecialties of psychiatry, for example some forensic practices, do not actually have doctor-patient relationships per se, so asking for patient feedback isn’t really applicable or appropriate in those relationships. Since 2010 the APA had been addressing these and other issues with the ABPN. There has been an APA Ballot Measure, an APA Presidential Task Force, an APA Assembly Work Group, a MOC Caucus at the APA Annual Meeting, and several meetings of APA officers and administrators with the ABPN Director and Board. And success! … there have been some changes. Diplomats in all categories no longer must complete patient surveys AND peer surveys to meet the feedback

module for Part IV of MOC (Performance in Practice, or PIP). For all those recertifying, the feedback part of the PIP can now include any ONE of the following options: • Five patient surveys • Five peer evaluations of general competencies • Five resident evaluations of general competencies • 360-degree evaluation of general competencies with five respondents • Institutional peer review of general competencies with five respondents • One supervisor evaluation of general competencies The components of “general competencies” that get reviewed in peer, resident, 360-degree, institutional peer review, and/or supervisor evaluations are: Patient Care, PracticeBased Learning and Improvement, Professionalism, Medical Knowledge, Interpersonal and Communication Skills, and System Based Practice. Sample forms are available at the ABPN web site www.abpn.com. For those of you in the 10-Year (Continued on page 2)

OPPA Execut ive Council President Annette Matthews, MD President–Elect Craig Zarling, MD Secretary Daniel Dick, MD Treasurer April Sweeney, MD Past Presidents David Conant-Norville, MD Chris Lockey, MD Satya Chandragiri, MD APA Representative Annette Matthews, MD APA Deputy Representative Amela Blekic, MD Councilors Stephanie Lopez, MD Neisha D’Souza, MD Simrat Sethi, MD At Large Councilors Denise Dion, MD Norwood Knight-Richardson, MD Child Psychiatry Representative Kirk Wolfe, MD Newsletter Editor Scott Reichlin, MD Lane County Chapter President Victor Richenstein, MD Psychiatric Residents’ Representative Kelly Cleaves, DO

Commit t ee Chair per sons CME Scott Reichlin, MD

President’s message (Continued from page 1)

MOC Program, the requirements have also changed. ABPN was phasing in the requirements, which resulted in about 15 different sets of requirements for those recertifying between the years of 20152021. Vastly simplified and consolidated into one set of requirements, these are now the requirements for all participants in the 10-Year MOC Program: • 300 Category-1 CME credits • 24 Category-1 CME credits from Self-Assessment Activities (can count toward the 300 total CME credits) • 1 PIP Unit (clinical module and feedback module) If you are in this category, however, once you complete your next 10-Year MOC recertification, you will enter the Continuous Pathway.

Legislative Daniel Dick, MD Member Assistance Program Henry Grass, MD Membership George Keepers, MD Program Lee Shershow, MD Public Information & Education Daniel Bristow, MD

OPPA Staff Executive Director Patrick Sieng Government Relations Director Amy Goodall Program Committee Coordinator Patti Legarda OPPA Contact: phone/fax: 503-406-2526 info@oregonpsychiatric.org

Another important thing to know about the MOC process is that it is possible to combine general psychiatry and/or neurology and/or one or more subspecialty examinations (up to three modules). This will reduce cost and inconvenience, but you have to pass all the modules you take. For those who are “grandfathered” into the general boards but are on a 10-year cycle for subspecialty boards, you do not need to redo the general boards, only your subspecialty boards. APA and the Oregon Psychiatric Physicians Association are both member driven organizations, so please speak up when you have an issue. As in the case of MOC, it can make a difference.

For those of you who have Lifetime Certification, you should also know about a subtle but important change in the way your certification status is displayed in the publicly accessible ABPN certification status web page (verifyCERT: excellence in psychoanalytic education https://application. abpn.com/  Psychoanalytic Training ‐ verifycert/ Apply now for our next class starting September 2014 verifycert.asp). The change is that  Continuing Education Classes ‐ the reporting of Marianne Robinson, PhD, MSW April 4, 7-9pm Lifetime Certificate Hearing/Primitive Elemental States of Mind holders includes “not required Salman Akhtar, MD May 17, 2014, 9am-4pm to participate in Listening, Not Listening, and Refusing to Listen MOC” behind the  Psychoanalytic Psychotherapy Program statement that they are “not  Fundamentals of Psychotherapy Series participating.”  Infant Observation Seminar This helps prevent someone accessing  Arts on the Couch the verifyCERT for more about these programs database from w w w . o r eg o n p s y ch o a n a l yt i c . o r g thinking that (503) 229-0175 you are “not

Ethics Victor Richenstein, MD

participating” but supposed to be and therefore not doing something you are required to do (since you aren’t).

LEGISLATIVE REPORT

Struggles with parity by Amy Goodall The OPPA legislative committee has been active this quarter. Four legislators have attended committee meetings to discuss upcoming legislative issues with our members. The committee is preparing for the upcoming session by participating in ongoing legislative efforts, monitoring campaigns, preparing for potential issues of opposition, and laying the groundwork to introduce an OPPA sponsored bill. The task force created to address the payment parity issues in primary care and mental health services that arose in the 2013 session has been meeting regularly. The bill requires insurance carriers to reimburse alternate providers such as nurse practitioners the same amount as physicians when providing the same service. The bill received much opposition, but an amended version passed that clarified that insurance companies cannot reduce physician payments, created a task force to discuss alternatives, and added a sunset in 2016. Three OPPA members, David Conant-Norville, MD, Daniel Dick, MD, and Kathryn Flegel, MD, presented at one of the task force meetings, expressing our concerns with the bill and answering questions about mental health services from the task force members. The task force has created a draft report for the legislature and may be introducing legislation in 2015. The group accepted feedback on their proposal that our members provided in July. On August 15 the task force will be reviewing all of the feedback that they received and will vote in September on what the proposed legislation will look like. At this point, because there has not been a clear solution agreed upon for how to address the issue, OPPA has expressed concern regarding legislation that would remove the sunset. There are still many details that have not been addressed and because the legislature will meet in 2016, there is an additional year to find alternative solutions rather than merely removing the sunset and leaving the statute as HB2902 rewrote it indefinitely. In September, when the task force agrees upon a bill, the legislative committee will determine how to proceed. The committee will also watch for other issues of concern that could arise, and continue working towards an OPPA sponsored bill. Several particularly relevant legislators will receive small PAC contributions throughout the campaign cycle as we continue to build stronger relationships with Senators and Representatives throughout the state.

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Executive Council Highlights

Enchantment abounds in Ashland by Lee Shershow, MD This fall’s OPPA conference in Ashland will be held September 19-21, and it is shaping up to be another stimulating and enjoyable event. Its title this year is “Enchantment: Natural & Unnatural.” As per our usual format, the speakers will be linked to two plays from the Oregon Shakespeare Festival: Richard III on Friday night, and Sondheim’s Into the Woods on Saturday night. At the end of the day on Friday and Saturday our popular drama professor, Dr. Daniel Pollack-Pelzner, will present his delightful play introductions, and on Saturday and Sunday mornings a group of actors from the plays will participate in a panel conversation with the conference attendees.

April 17, 2014– Tualatin The Executive Council met for the first time at its new location at Hayden’s Lakefront Grill in Tualatin. The move from the Oregon Medical Association event center was a cost-saving measure, expected to save the organization approximately $200 per meeting. This was the last meeting for outgoing President David Conant-Norville, MD. He said he would continue to be involved in membership recruitment after his term. The Council approved a new logo based on the recent name change to the Oregon Psychiatric Physicians Association. Daniel Bristow, MD, who formerly worked in the radio industry, was appointed as chair of the Public Information & Education Committee. He recently recorded several public service announcements about psychiatry and mental health that are airing in radio stations around the state.

The scientific program will interpret “enchantment” broadly, ranging from the natural – fairy tales, drama, the Internet, and poetry – to the unnatural, such as psychopathy, trauma, and intoxication. Doreen Dogen-McGee, PsyD, a national expert on the Internet, will speak twice; once on “Modern Enchantment: Digital Spaces,” and a second time on “Unnatural Enchantment: Excessive Use of Digital Spaces.” Cecille Bassen, MD, a psychoanalyst from Seattle, will speak on the fairy tales Cinderella and Snow White. A presentation on poetry will be led by Jed Myers, MD, a psychiatrist and poet from Seattle who spoke with great acclaim in Ashland before, and his daughter Lily Myers, who has become a popular young poet on the Internet.

July 24, 2014 – Tualatin Executive Council members did not meet in May because of the national APA meeting in New York, New York. There was also no meeting in June due to schedule conflicts. The July meeting was the first meeting for new President Annette Matthews, MD.

On the clinical side, Hank Grass, MD will speak on attunement between therapists and patients, Jon Emens, MD from OHSU will speak twice, on insomnia and on “Image Rehearsal Therapy,” which uses dreams to manage trauma, and Mark Kleiman, PhD from OHSU will talk on current marijuana research. Charles Scott, MD, a forensic psychiatrist from UC Davis, will present twice on psychopathy, once on moral amnesia and malingering, and once on current research and treatment of Antisocial Personality Disorder.

The council discussed the recent APA meeting in New York where several members and executive director Patrick Sieng attended. APA covers most of the travel costs for state executive directors. Daniel Dick, MD, was appointed as the council’s Secretary, filling the vacancy left by previous Secretary Mark Bradshaw, MD. Dick also serves as the chair of the legislative committee. He provided an update on recent meetings of the House Bill 2902 committee and work on a bill for the next legislative session.

Finally, we will have a Brian Buss Lecture entitled “Tragedy Leads to Lane County’s Physician Wellness Program,” with the CEO of Lane County Medical Society, Candice Barr, and its principal clinician, Tom Fauria, PhD.

Lee Shershow, MD, talked about the fall conference in Ashland. Registration is open and the program committee has been working hard over the last several months to put together an agenda. Conference expenditures were also discussed in an effort to keep within budget. Council members encouraged the use of local speakers.

Two important reminders: both plays this year will be seen in the outdoor Elizabethan Theater, and in late September Ashland evenings usually become cold, so come prepared to dress in layers and warmly. Also, the seats in the theater are wood, so seat cushions are advised. You can bring your own, or, there are a limited number of seat cushions and blankets for rent at the theater. If you bring your own seat cushions you might want to use them during the conference in the Armory, which has folding chairs.

Due to continued fiscal issues, council members discussed dues for the upcoming year. The new dues collection system from APA allows members to use payment plans, stretching out the cost of membership over a year. Council members voted to increase dues by $25.00 to continue providing services to members without further cost reductions for 2015. The increase will be evaluated after a year.

The OPPA’s Program Committee hopes this program catches your interest, and that this year’s Ashland program will once again be, well, enchanting! 4

Enchantment: Natural & Unnatural 27th Annual Continuing Medical Education Conference September 18-21, 2014 - Ashland, OR sponsored by REGISTER ONLINE at http://fall.oregonpsychiatric.org Thursday, September 18

1:30pm-5:30pm DSM-5: Updating from DSM-4 - David Conant-Norville, MD; Thomas Hansen, MD; Christopher Lockey, MD (Pre-Conference requires additional registration fee)

FACULTY

Optional Shakespeare Festival Plays (Tickets Required)

Candice Barr chief executive officer, Lane Co. Medical Society

8:00am-8:15am

Welcome and Announcements - Lee Shershow, MD

Cecile Bassen, MD clinical assistant professor University of Washington Dept. of Psychiatry

8:15am-9:15am

Plugged In: How Technology is Shaping Neurological, Relational, and Intra-Personal Functions - Doreen Dodgen-McGee, PsyD

8:00pm

Friday, September 19

9:15am-10:15am Image Rehearsal Therapy, Managing Trauma Related to Dreams - Jon Emens, MD 10:30am-11:30am

Emotional Atunement, Finding the Other - Henry Grass, MD

David Conant-Norville; MD child & family psychiatrist in private practice, Beaverton; affiliated clinical professor of psychiatry, Oregon Health & Science Univ. Doreen Dodgen-McGee, PsyD psychologist in private practice, Lake Oswego

11:30am-12:30pm How Not to Make a Hash Out of Cannabis Legalization - Mark Kleiman, PhD

Jon Emens, MD assistant professor, Oregon Health & Science University; staff physician, Portland Veteran Affairs Medical Center

2:00pm-3:00pm

Brian Buss Lecture - Tragedy Leads to Lane Countyâ&#x20AC;&#x2122;s Physician Wellness Program - Candice Barr; TomFauria, PhD

Tom Fauria, PhD principal clinician, Lane Co. Physician Wellness Program

3:00pm-4:00pm

Assessment of Malingered Amenesia - Charles Scott, MD

Henry Grass, MD psychiatrist, Providence St. Vincent Medical Center

4:00pm-5:00pm

Pre-Play Discussion: Richard III - Daniel Pollack-Pelzner, PhD

8:00pm

Play - Richard III (Tickets Required)

Saturday, September 20

8:00am-9:45am Face Time: Doing Therapy in an Age of Digital Attachment - Doreen Dod gen-McGee, PsyD 10:00am-12:00pm

Actors Panel: Richard III

12:00pm-1:30pm

Lunch on your own or OPPA Members Business Lunch (Tickets Required)

1:30pm-2:30pm

Thomas Hansen, MD associate professor of psychiatry at Oregon Health & Science Univ.; supervising psychiatrist, Oregon State Hospital Mark Kleiman, PhD professor of public policy, Univ. of California Los Angeles Luskin School of Public Affairs Christopher Lockey, MD assistant professor of psychiatry, Oregon Health & Science Univ.; supervising psychiatrist, Oregon State Hospital Jed Myers, MD clinical professor, University of Washington Dept. of Psychiatry

Tackling Insomnia - Jon Emens, MD

2:30pm-3:30pm Good Girls & Wicked Women: Iconic Images in Cinderella & Snow White - Cecile Bassen, MD 3:45pm-4:45pm Necessary Enchantments: Poetry & the Creative Process - Jed Myers, MD; Lily Myers 4:45pm-5:45pm

Pre-Play Discussion: Into the Woods - Daniel Pollack-Pelzner, PhD

8:00pm

Play - Into the Woods (Tickets Required)

Lily Myers writer; student, Wesleyan Univ. Daniel Pollack-Pelzner, PhD assistant professor of english, Linfield College Charles Scott, MD professor of clinical psychiatry, Univ. of California Davis Health System

Sunday, September 21 8:00am-9:45am

Treatment of Antisocial Personality Disorders & Psychopaths: Hopeful or Hopeless? - Charles Scott, MD

Full Conference Fees OPPA Members - $375 MD/PhD/Doctorate - $465 Masters/NP/PA - $375 Bachelors/Other - $290

10:00am-12:00pm

Actors Panel: Into the Woods

For play tickets, single-day pricing, and DSM-5 pre-conference, visit website. 5

Oregon Council of Child & Adolescent Psychiatry presents awards at 4th annual conference

Kyle Johnson, MD (right) was presented with the Child Psychiatrist of the Year Award at OCCAPâ&#x20AC;&#x2122;s 4th Annual Childrenâ&#x20AC;&#x2122;s Mental Health Conference in Portland. He is pictured with then-OCCAP President Grant Godbey, MD.

Stewart Newman, MD (right) was presented with an Access Award for his work on the suicide prevention checklist by then-OPA President David Conant-Norville, MD. 6

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OF THE OREGON PSYCHIATRIC PHYSICIANS ASSOCIATION SEPTEMBER 18-21, ASHLAND

Enchantment: Natural & Unnatural