PA Psychiatrist July 2019 by TEAM

PENNSYLVANIA

P SYC H I AT R I ST NEWSLETTER OF THE PENNSYLVANIA PSYCHIATRIC SOCIETY

PRESIDENT’S MESSAGE

by Keith Stowell, MD, DFAPA PaPS President

I hope you are all having a great start to the summer. I look forward to working with you, our Council, and Society staff during the upcoming year. We recently had our installation of new Pennsylvania Psychiatric Society officers at our Annual Business Meeting in May. The Executive Leadership and Council are committed to continued focus on our Society’s mission – “fully representing Pennsylvania Psychiatrists in advocating for their profession and their patients, to assure access to psychiatric services of high quality, through activities in education, shaping of legislation, and upholding ethical standards.” There are many resources available to us in helping to achieve these goals. Most notably, your membership, combined with the skills of our staff and volunteer members, allows us to have a seat at the policymaking table. Having a lobbyist on our staff who regularly monitors legislation, has a keen awareness of issues impacting our profession and our patients, and interacts on a frequent basis with government officials and representatives is key. In addition, many of our members dedicate countless hours to legislation review, educational initiatives, and meetings with legislators and other stakeholders. However, this advocacy is not only reserved for our staff and select volunteers. We are happy to have your participation on committees relevant to your interests. Another less time intensive way to participate in advocacy work is a phone call or email to a legislator on important issues. Recent areas of particular relevance to our members and patients have been possible changes to consent to treatment regulations for children and adolescent patients, Extreme Risk Protection Orders, scope of practice expansion for certified registered nurse practitioners, and Assisted Outpatient Treatment. I will devote future columns to other membership benefits and ways in which your active participation in the Society has additional benefits. In the interim, I am readily available for questions, concerns, or any ideas you may have. Feel free to reach out to me at stowellkr@upmc.edu. I look forward to working with you as President over the upcoming year. Warmest Regards, Keith Stowell, MD, DFAPA

Don’t miss what PaPS is working on for you! Check out the Activity Update.

Stay connected with PaPS and follow us

@PA_PsychSociety on TWITTER!

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

MEET YOUR 2019 - 2020 EXECUTIVE COMMITTEE Keith R. Stowell, MD, DFAPA serves as president. Dr. Stowell, who is board certified in psychiatry, forensic psychiatry and geriatric psychiatry, is currently the associate chief of clinical services at Western Psychiatric Hospital, where he oversees psychiatric emergency services, crisis services and the network admissions office. He also serves as director of forensic psychiatry.

Richard R. Silbert, MD, DLFAPA is your president-elect. He is senior medical director at Community Care Behavioral Health Organization (CCBHO), Moosic and is an associate professor of psychiatry at The Commonwealth Medical College. Dr. Silbert has served as president of the Greater Northeast PA Chapter of the American Foundation for Suicide Prevention (AFSP) and co-chairs a treatment committee that is part of a stop heroin/opioid overdose coalition.

Dhanalakshmi Ramasamy, MD, FAPA serves as vice president of PaPS. Dr. Ramasamy is a child and adolescent psychiatrist at the Lehigh Valley Health Network, Pennsylvania and a clinical professor of psychiatry at University of South Florida. Dr. Ramasamy is a past president of Lehigh Valley Psychiatric Society and serves on the PaPS Education Committee.

Hope S. Selarnick, MD, DFAPA serves as treasurer. Dr. Selarnick is director of addiction services and medical director of the opioid treatment program at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia. She is a past president of the Philadelphia Psychiatric Society (PPS) where she is a former chair and member of the Womenâ&#x20AC;&#x2122;s Committee. Dr. Selarnick is also active on the PPS/PaPS Education Committees.

Kavita K. Fischer, MD, FAPA serves as secretary. Dr. Fischer is regional medical director at Community Care Behavioral Health Organization (CCBHO) in affiliation with University of Pittsburgh Medical Center. Her focus with Community Care is on quality assurance for members throughout different levels of care including drug and alcohol treatment with a focus on the Blair County region. She also participates in various teaching programs and CME activities throughout the organization and in the community.

2019 - 2020

New officers of the Pennsylvania Psychiatric Society (PaPS) were formally installed at the Annual Business Meeting on May 11.

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

EDITOR’S COLUMN by Edward C. Leonard, Jr., MD, DLFAPA

Life, Liberty, and the Pursuit of Mental Health Randolph M. Nesse, MD, helped create the field of evolutionary psychiatry to search for Good Reasons for Bad Feelings, the title of his new book. Nesse tries to understand how the ancestors of today’s mentally ill persons avoided death before procreation to pass on genes contributing to mental disorders. Unfortunately, little progress has been made in finding genes that match our current psychiatric diagnoses. Nevertheless, Nesse expects evolutionary psychiatry will someday elucidate a physiology of mental life so that we may use normal functioning as the foundation for understanding pathology, as other medical specialties do. He cautions us that simply viewing diseases as adaptations is an error because mental disorders are not heritable functions. We should not ask the purpose of schizophrenia or how anorexia nervosa is useful. Eating disorders, ADHD, and serious depression are not shaped by selection, but mechanisms that regulate eating during famine, attention, and capacities for normal low and high moods are. Could it be that Philadelphia Quakers, who in 1813 founded their “Asylum for the Relief of Persons Deprived of the Use of Their Reason,” identified a common (heritable?) defect in the seriously disturbed? They were seen as lacking the homeostatic mechanism of effective reason. Defective reasoning could not calm the excited or improve the memory of the confused. Some experienced limited ability to doubt, often leading to delusions, which today may be seen as part of schizophrenia and psychotic depression. The reasoning of those clinically depressed was distorted by expecting the worst, which impaired functioning, leading ultimately to hopelessness. Perhaps genes help with only one of our “inalienable rights” – life. Our species survives because genes were selected to encourage birth and rearing of children to sexual maturity. However, evolution has not yet protected liberty and the pursuit of happiness. What can evolutionary psychiatry do for us today, besides stimulate twists of thought? Nesse suggests we could encourage patients by explaining possible evolutionary origins for aspects of a few disorders. We might point out that panic disorder is too much of a good thing. In ancient deadly environments ancestors survived by jumping away from every hint of a predator, but distraction by noises in a peaceful setting limits function. If clinical depression helps a patient coast through periods where success is thwarted, ask “Is there something very important that you are trying to do that you can’t succeed at and can’t give up?” Reading this book will help you keep up with how evolutionary ideas impact our specialty and our patients.

RESIDENT UPDATE by Mandar Jadhav, MD General Psychiatry Resident 2016 to 2019 at Penn State Health Hershey Medical Center Child & Adolescent Psychiatry Fellow 2019 to 2021 at The Johns Hopkins Hospital Thank you for providing me the opportunity to represent your voice this past year in the Pennsylvania Psychiatric Society’s Council meetings and deliberations. It has been a year full of learning through collaboration, which has helped me grow as an advocate for our professional interests. The greatest challenge that both the Society and I have faced this year is trying to grow engagement with our membership. The primary obstacles have been learning how to effectively communicate using new media channels and bringing together the vastly different local geographies across the state. Throughout this process our guiding mission has been to help young and aspiring psychiatrists see the value of a professional statewide body that advocates on their behalf. This mission is rather a lofty one, so the ways in which we have tried to make it digestible is to provide bite sized snippets of information, and to facilitate networking opportunities at the personal level. Through the course of the year we have taken some initial steps towards achieving those goals but suffice it to say there is a lot more work to be done. While my personal career pathway has led me away from the state of Pennsylvania for now, I hope someday I will be able to invest my time and efforts back toward the state that has been my first professional home. For the immediate future, I will be available to your next statewide trainee representative for assistance whenever possible. If you find yourself headed next door to Maryland any time soon, please feel free to get in touch with me, as I intend to continue my advocacy efforts here too.

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

by Deborah Shoemaker, Executive Director and Lobbyist

ACTIVITY UPDATE

Dealing with what is thrown at you - unexpected or not Life is full of uncertainty. When you think you figure it out, and all is going as planned, life decides to throw you a curveball, or series of them. Or as my dad used to say, “when it rains it pours.” My downpours this year have included two lacrosse injuries and cancer. But dealing with unexpected events puts things in perspective. There is always someone worse off than you, always things to be grateful for along the way. The glass now is more than half full vs. half empty. Curveball Thrown: 2019-2020 State Budget Negotiations How Handled: Governor Wolf took one for the team for all citizens Being thrown curveballs or rolling with the punches is par for the course in politics and public policy, especially when it comes to this time of year. Determining if you jump over the tall waves or dive through them during state budget negotiations is tricky if you do not know the path of the storm. Although this year’s budget was finished prior to the June 30th constitutional deadline, there were rough waves to navigate with at least one casualty: the loss of the General Assistance Program for the second time. A contentious battle between Lieutenant Governor John Fetterman (also the President of the Senate) and Senate Majority Leader Jake Corman made national news over Fetterman’s violation of chamber rules when he allowed Senator Katie Muth to share a constituent’s (a former homeless man) reliance on the General Assistance Program to keep him off the streets. In the end, the governor had to enact a 20192020 budget that went against his principles but was in the best interest of all citizens. Curveball Thrown: Proposed Amendments to Minor Consent Act (Act 147 of 2004) How Handled: Engaging our Medical Society Colleagues and Grassroots Advocacy Over the past few legislative sessions, members of the state legislature have begun to explore ways in which to clarify Act 147 or amend the current Act to allow parents and/or guardians more control over their children’s mental health and substance use treatment and their medical records. The Society has been vigilant over the past few legislative sessions in monitoring proposed legislation and working closely with the PA Department of Human Services’ Office of Mental Health and Substance Use Services (DHS-OMHSAS) to provide clinical guidance on the issue. We have been successful so far in opposing amendments to Act 147, largely based on our stellar reputation in the state legislature of clinical expertise and integrity. Representative Jason Ortitay (R- Allegheny/Washington) has introduced a Minor’s Consent Act amendment bill over the last two legislative sessions to force DHS and the PA Department of Health to clarify the current Act and provide additional protections for parents and guardians. The Society has been working closely with the House Human Service Committee executive director (and concurrently with

the office of the sponsor) to express our opposition to House Bill 672 (the current proposed legislation) in its current form. A copy of letter and documentation is enclosed here for your review. Although the bill passed the House prior to the legislative summer recess, we have engaged our colleagues at the PA Medical Society, who are prepared to sign onto a joint letter with us if the bill starts moving in the Senate. Stay tuned! Curveball Thrown: Support for Positive Gun Control (Extreme Risk Protection Orders- ERPOs) How Handled: Engaging our Medical Society Colleagues and our Mental Health Colleagues House Bill 1075 (proposed legislation to create Extreme Risk Protection Orders [ERPOs]) was finally reintroduced this past spring. Attached is a link to the legislation: hb 1075. PaPS has been a lead proponent of the bill, engaging hand in hand with Representative Stephens to get additional stakeholders not previously engaged to get involved in some fashion to support the bill. With the focus on public health/ reduction of suicide, the Pennsylvania Psychiatric Leadership Council, the Pennsylvania Medical Society and other key medical specialty colleagues have written letters of support or have expressed their support. Although the National Rifle Association (NRA) is still expressing concerns with the bill, delicate grassroots lobbying is being done to get them to neutral. Our revised letter is being drafted as we speak. For more information or to get engaged, please contact me. Curveball Thrown: Limiting Substance Use Proposed Legislation that Creates Barrier to Care How Handled: Engaging Medical Society Colleagues/Working in Coalitions and Grassroots Advocacy If you think that the world of Minor’s Consent is a free-for-all, just imagine how a conservative state legislature with a limited understanding of substance use treatment introduces proposed legislation to address their constituent concerns. As you would guess, although well-intentioned, most proposed legislation fails to consider evidence-based practice, instead relying on public opinion on what is in the best interest for citizens who have overdosed or are in active addiction from legal and illegal controlled substances. This session, proposed legislation ranges from amending current law to expand the current opioid prescribing guidelines from just minors to all individuals (Senate Bill 112, Printer’s Number 1017), to reverting back to the PA Client Placement Criteria (PCPC) from the current ASAM placement criteria [House Bill 386, Printer’s Number 370], to introducing legislation requiring certification of buprenorphine office-based prescribers by the PA Department of Drug and Alcohol Programs (Senate Bill 675, Printer’s Number 820). As you would guess, we oppose pretty much every piece of legislation. Although the sponsors think they are doing what is best, their knowledge of substance use treatment is often based on anti-Medication Assisted Treatment (MAT) and without any clinical knowledge. Although the Society supports all treatment options in an individual’s recovery from substance use challenges, these pieces of legislation limit access to evidence-based treatment. P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

On our end, we have been vigilant in fighting vs. these injustices for our patients and their families. We have banded with our medical specialty colleagues in emergency medicine, PAMED, the American Medical Association, the American Psychiatric Association, and the national and local Societies of Addiction Medicine (ASAM/PSAM) in opposing these pieces of proposed legislation. If you would like copies of our joint letters, let me know.

I anticipate that life will continue to challenge us at every turn. Regardless of what is thrown at us, we must decide what is important to us, how we will react and how to prioritize what is worth falling on our swords and what to let go. In my life, I have decided to fight for what is important to me: my family, all of you, and for our patients and their families who rarely will speak for themselves. Curveballs exist everywhere, and you can choose to dodge them or catch them. If you want to catch them with me, contact me via email dshoemaker@pamedsoc.org or via phone at 1.800.422.2900.

e-Prescribing: Get the Skinny on the New PA Law by Deborah Shoemaker, Executive Director

At the end of last year, Governor Wolf signed Act 96 of 2018 (Act). Provisions within the Act amended the Controlled Substances Act to require electronic prescribing for all Schedule II through V prescription medications [except when dispensed or administered directly to a patient by a health care practitioner and/or authorized agent (not a pharmacist) to an ultimate user]. The Act replaces the traditional “paper prescription pad” prescribing of controlled substances to patients.

Penalties: A healthcare practitioner who violates the Act is subject to the following administrative penalties: 1) first – tenth violations: $100 per violation; and 2) eleventh – subsequent violations: $250 per violation. The maximum cumulative fines in any calendar year cannot exceed $5,000. Hardship Exemption: Any health care practitioner can apply for a hardship exemption if there is an economic hardship, technical limitation(s) or exceptional circumstances. This exemption must be applied for annually. DOH has recently published an online hardship exemption form at the below link: https://appengine.egov.com/apps/pa/doh/ act96of2018temporaryexemptionform

Exceptions to Act 96 of 2018 Electronic prescribing is not mandatory for prescriptions issued under twelve exceptions. Highlights include: 1) under circumstances when an electronic prescription is not available to be issued due to a temporary technological/electrical failure; 2) by health care practitioner and dispensed by a pharmacy outside of the commonwealth; 3) by a health care practitioner and/or health care facility that does not have either Internet access or an electronic health record system; 4) by a practitioner treating a patient in an emergency department or health care facility under circumstances when a practitioner determines that electronically prescribing a controlled substance would be impractical…or would cause an untimely delay resulting in an adverse impact on the patient’s medical condition; 5) for a patient enrolled in a hospice program or residing in a nursing home/residential health care facility; 6) under circumstances where the pharmacy that receives the prescription is not set up to process electronic prescriptions; 7) for controlled substances that are not required to be reported to the commonwealth’s Prescription Drug Monitoring Program (PDMP) administered by the PA Department of Health (DOH); and 8) any other situation as prescribed by the Secretary of Health by regulation.

To request a hard copy form, contact DOH at 844-377-7367 or via email at ra-dh-epcs@pa.gov.

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

NOTE: Practitioners who may be seeking a hardship exemption are encouraged to continue to plan for the e-prescribing requirement, as that requirement must be implemented unless an exception applies, or DOH grants a hardship exemption. This is a state law requiring this change and, at the current time, not having an EHR exempts you from having to apply for the hardship exemption. However, if federal law requires mandatory use of a EHR this issue will have to be revisited. Please contact Deborah Ann Shoemaker, PaPS Executive Director at dshoemaker@pamedsoc.org if you have any additional questions or need more information.

Welcome New Members We welcome the following new PaPS members and congratulate those Members-In-Training who have recently achieved General Member status (effective January 1 - May 31, 2019). CENTRAL

WESTERN

Members in Training Timothy Newell, DO Ryan Richards, MD Victoria Tyrell, DO

General Member Geoffrey Sinner, MD Life Member Hardish K. Singh, MD

General Members Barbara A. Beadles, MD Palav Mehta, MD Abhishek Ravindra Nitturkar, MD Qasim Raza, MBBS LEHIGH VALLEY General Member Farhad Sholevar, MD Life Member Eric David Becker, MD NORTHEASTERN Member in Training Marwa M. Salam, MD General Members P. Elisabeth Hager, MD Kathleen Richards, MD

PITTSBURGH Members in Training Rohan Das, DO Benjamen Gangewere, DO Shan Gao, MD Joshua Riley-Graham, MD Meredith Leigh Spada, MD James Scott Steele, MD, PhD General Members Sarah A. DeBrunner, MD Sheena Ann Dohar, MD Mindy Hutchinson, MD Cara Lynne McCandless, MD James D. Tew, Jr. MD Ryan J. Wakim, MD

PHILADELPHIA Members in Training Mark A. Baptiste, MD Azka Bilal, MD Leon Edward Cushenberry, Jr, MD Francesca Engel, MD Olivia Hurwitz, DO Maryem Hussein, MD Kiran Johal, DO Prasad R. Joshi, MD Thomas Knightly, MD Victoria Lollo, MD Allison Loudermilk, DO Justine H. Mann, MD Sheyda Moshiri, MD Margaret R. Puelle, MD Michael Maher Roman, MD Agin Thomas, MD Yi Wang, MD

Edwin Kim, MD Onyekachi Joseph Oyiriaru, MD John Reitano, MD Jillan C. Sackett, MD Jane Marans Summers, MD Gabriel M. Tobia, MD Frederick Villars, MD Tal Weinberger, MD Lan Chi (Krysti) Chi Vo, MD Fellow Member Sosunmolu O. Shoyinka, MD

General Members Andres Barrera, MD Ran Barzilay, MD Harold F. Cottman, III, MD Alexandre Geronian, MD

Save the Date!

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

Department of Corrections to Expand Medication-Assisted Treatment Program Harrisburg, PA -- Beginning June 1, 2019, the Department of Corrections will expand its Medication Assisted Treatment (MAT) Program to include new inmate receptions and parole violators returning to prison who already are on a verified MAT. “Anyone who is enrolled in a verified MAT Program, either in the community or in a county jail, will be continued on MAT upon reception to the DOC,” Corrections Secretary John Wetzel said. “Suboxone and oral naltrexone will be available immediately and also will be offered to those on methadone until it can be added at a later date.” Wetzel said that inmates entering the state prison system who are on an MAT that is not available or that do not meet criteria for continuing MAT will have their individual cases reviewed by the agency’s Bureau of Health Care Services to determine the best course of treatment. In January 2018, Gov. Tom Wolf declared that the opioid crisis in Pennsylvania as a disaster emergency and directed that MAT be provided within the DOC. MAT medications include methadone, naltrexone (Vivitrol and Revia) and buprenorphine (Suboxone, Subutex and Sublocade). “The opioid crisis impacts our prison system, and rather than have an individual suffer through detox upon entering our system, we are going to help them to remain sober and curb cravings for the drugs that, in most cases, are the reason they are in prison to begin with,” Wetzel said. This expansion now serves as an incentive to county prison wardens to continue MAT for those individuals they receive from the community who are on verified MAT programs. The DOC receives new commitments directly from county prisons. “What we are doing here is ensuring the continuity of care and encouraging the continued use of MAT in county prisons as well,” Wetzel said. “In order to make a dent in the opioid epidemic, we need to make sure MAT is not discontinued simply because someone is involved in the criminal justice system.” The Pennsylvania DOC began its MAT program at SCI Muncy in 2014 with a small group of inmates receiving Vivitrol (naltrexone) injections just prior to release and then monthly after release for up to one year to curb cravings and help them to focus on reentry. In March 2016, the DOC hired a full-time MAT statewide coordinator who is responsible for providing training and technical assistance to site coordinators and is the liaison with DOC and Parole Board officials as well as single county authorities and community-based treatment providers. By 2018, the Vivitrol program expanded to all 25 state prisons; and, in March 2018 the DOC converted six therapeutic communities to opiate-specific therapeutic communities (TCs). The agency’s work in this area continues by expanding the program to include oral naltrexone maintenance while inmates are in the specialized TCs (e.g., Albion, Cambridge Springs, Camp Hill, Chester, Laurel Highlands, and Quehanna Boot Camp), and then they are switched to Vivitrol prior to release from prison. In addition, on April 1, 2019, the DOC began a pilot project program offering Sublocade (buprenorphine extended-release) injections at SCI Muncy. Sublocade is the first and only once-monthly injectable buprenorphine formulation for the treatment of moderate to severe opioid use disorder. At Muncy, select parolees who are diverted to an SCI for a 14-day detox only placement are prescribed Suboxone induction and then a long-acting Sublocade injection prior to being continued on parole in an outpatient or inpatient treatment setting. Eventually, the DOC plans to gradually roll out this part of the MAT program to other state prisons. The DOC also provides methadone maintenance to pregnant inmates to protect their fetuses from withdrawal. Learn more about the DOC’s Medication Assisted Treatment Program at www.cor.pa.gov.

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

EARLY CAREER PSYCHIATRIST WELL -BEING By Hetty Eisenberg, MD, PaPS ECP Representative The culture of medicine and medical education has not always supported physicians’ healthy development. In recent years, awareness of the impact and widespread nature of physician burnout has grown. There is evidence that physician burnout has its roots in residency education. This has brought greater attention to the importance of well-being in physician populations, as well as in residency populations. However, there has been little focus on early career physicians. During this pivotal period in our careers, we have the opportunity to heal from the burnout we may have experienced in residency and/or fellowship training. We also have the opportunity to begin to lay the groundwork for rewarding careers, by factoring in an awareness of well-being into our career choices. What exactly is burnout, and what is well-being? As much as we might prefer to block it out, most of us probably remember feeling burned out in training. When we are burned out professionally, we may feel limited by physical or emotional exhaustion, disconnected from colleagues and loved ones, powerless over our circumstances, and hopeless about our work’s purpose. On the other hand, when we are experiencing well-being in our professional lives, we may enjoy our work, draw from empathy and a sense of connection, and feel supported by our workplace. These concepts are highly subjective, and fluid. Something that elicits burnout in one person could be a source of well-being for another; and we might flow from a sense of burnout to well-being in a matter of days depending on the challenges we face any given day. The topic of well-being and burnout is one that I am used to thinking about – during my residency at UCSF, I designed a well-being curriculum for the residency program. As I focused on developing

skills in trauma psychiatry during residency, I quickly learned that preventing burnout is a necessary antidote for vicarious trauma. However, as I graduated and became an early career psychiatrist, I found myself on a completely new playing field. Post-residency life has greater freedom, which equals greater capacity to support achieving well-being. I finally had more control of my work hours, my work population, and my work environment. However, there can also be less structure, less sense of community with colleagues, and greater demands from family life that stretch us thin. Early post-training, I reset myself by taking some time off between residency and starting my new job. I also chose my work environment based on the area of psychiatry that truly excites me and made the choice to work the fewest hours possible. I found that putting energy into developing new connections with colleagues while maintaining friendships with residency colleagues has helped me to maintain my sense of work community post-residency. Recently, as I begin to age out of my early career chapter, I find myself in the role of medical director of the PTSD clinical team at the Philadelphia VA. In this role so far, I have had the opportunity to incorporate some techniques for fostering well-being within our team – to begin to institutionalize some workplace practices that I have found valuable in the past. At the beginning of every weekly team meeting, we invite team members to share patient successes. At the end of every team meeting, we invite team members to express gratitude to each other. We also take the time to commemorate staff birthdays, go out to lunch together, and learn from each team member what can help bring them joy on a challenging day. Supporting my personal well-being is very different from supporting that of my colleagues, but I do find that I draw from my own experience to do what I can to create a healthy work environment. Well-being is very much a process of self-learning, one that takes different forms throughout a career.

Congratulations to the following members of the Pennsylvania Psychiatric Society who were nominated by colleagues and selected by a statewide committee of Pennsylvania Medical Society members as part of the 2019 Top Physicians Under 40. David Clements IV, MD Philadelphia Dr. Clements is a psychiatrist with Southeast Executive Health and the Malvern Institute. He is a fellowship trained in addiction psychiatry. Dr. Clements is recognized by colleagues for his compassionate care and his innovative approaches to addiction treatment. Dr. Clements is dedicated to battling Pennsylvania’s opioid epidemic and offers the latest evidence-based treatments to his patients. Jagdeep Kaur, MD Chambersburg Dr. Kaur, a psychiatrist with Keystone Health, is fellowship trained in addiction psychiatry. She serves as clinical director for medication-assisted treatment of opioid use disorder at Keystone Health. Dr. Kaur is actively involved with her community, including by participating in the Franklin County Drug Taskforce. Her colleagues note her compassionate patient care for mental health and substance use disorder.

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

CHAPTER HIGHLIGHTS

CENTRAL CHAPTER President Update | Ailyn D. Diaz, MD, President At the Central Pennsylvania Psychiatric Society, our mission this year is unity and engagement. Through our grassroots efforts, we are committed to engage psychiatrists at different levels of training and experience to participate in events in our area. On May 7, I assumed the presidency with a slate of officers including Dr. Irakli Mania as President-Elect, Dr. Indranil Chakrabarti as Secretary-Treasurer, Dr. Kawish Garg, MD as immediate Past President, Dr. Douglas Ockrymiek as Pennsylvania Psychiatric Society Delegate and Dr. Shiv Aggarwal, Dr. Kathleen Dougherty and Dr. Ahmad Hameed as Councilors. The 2019-2020 schedule of events include on August 22, 2019, a Resident’s Night at the Colonial Country Club in Linglestown. Two of our resident representatives are heading that event, Dr. Andreea Bucaloiu from Geisinger and Dr. Salima Jiwani from Penn State Health. We are planning a council meeting and dinner and a movie with CME credits in October and our annual Holiday Social/Awards Night in December. Guests and non-members are welcome to attend our events. Our efforts in advocacy continue as our members receive notifications of the latest bills to hit the Harrisburg and Washington DC Capitol buildings. We continue advocating for patient care, improvement to access and for psychiatric practice rights. Upcoming Event Thursday, August 22, 2019 - Residents’ Night and Poster Competition. Join us at the Colonial Country Club on Linglestown Road from 6:00 – 8:00 pm. This is an excellent opportunity to present your research, meet and network with residents from Central PA programs and colleagues from across the region. Register to attend and submit your poster here.

NORTHEASTERN CHAPTER President Update | Jane Jesse, MD, President My name is Jane Jesse, MD, and I am the current president of the Northeastern Chapter of the Pennsylvania Psychiatric Society. And, while there’s a learning curve, I am excited to accept this challenge. The first item on my agenda is to try and find all of you. I’ve already reached out via email to everyone currently listed as a member by the Pennsylvania Psychiatric Society. I am looking to find active and previously active members and learn what you want or need from the society. We are a diverse group and spread out over a wide area. If my email didn’t reach you, I encourage you to email me at sabarainwater@gmail.com so I can keep you abreast of any and all activities our chapter will be participating in. Thank you to everyone who has already gotten back to me. One of the biggest changes that has affected Pennsylvania as a state is the change in law allowing the medical marijuana dispensaries. Many patients come through my office with lots of questions and inquiries on medical marijuana and CBD based products. Our October 16th CME event is on Medical Marijuana. Watch your email for the time and location in the upcoming weeks. Lastly, a big welcome to the newest psychiatrist in our area - the psychiatry residents at The Wright Center located in Lackawanna County (residency director, Dr Chandrigiri). “We are what we repeatedly do. Excellence then, is not an act, but a habit.” - Aristotle

P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019

PITTSBURGH CHAPTER President Update | Maher Ayyash, MD, FAPA, FACLP The Pittsburgh Psychiatric Society makes every effort to achieve many goals including but not limited to: • Promoting mental health awareness in the community • Attracting more members to join the Society and participate in itsactivities • Supporting the psychiatry residents in our area • Acknowledging the services of the psychiatrists who have served our communities with excellence • Reaching out to a broader base in the community through different channels including radio shows and programs • Offering a variety of CME programs with different modalities • Providing support to the different sectors of our community in times of need and hardship October 27, 2019 will mark the anniversary of the deadliest attack on the Jewish community in the United States. Eleven people were killed and seven were injured. Our PPS chapter was there to support our community and condemn any assault on innocent people due to religious prejudices. Diversity of religion, ethnicity, and race throughout Pittsburgh is something we will continue to celebrate and protect. During my presidency, I am dedicated to promoting education, enhancing the quality of care, and supporting the members of the noble profession of psychiatry. Upcoming Event Monday, September 23, 2019 – Residents’ Research & Awards Night Residents, Medical Students and Psychiatric Nurse Practitioners Students are invited to participate in this annual event. Gain experience in presenting your research and meet and network with residents from Pittsburgh programs and colleagues from across the region. The abstract submission deadline is Friday, August 2, and is quickly approaching. Submit your abstract today!

PHILADELPHIA CHAPTER President Update | Pietro Miazzo, MD, President It is an honor to be president of the Philadelphia Psychiatric Society. At a time when change in mental health care is continuous and relentless, it is important that psychiatrists have an organized presence and a voice. The Philadelphia chapter is the largest in Pennsylvania, and we remain open to welcome residents and colleagues to join the Society. Multiple events are scheduled for the chapter including the Addiction Symposium on September 14, and the November 16th Benjamin Rush Gala to be held at the Chubb Hotel & Conference Center. The American Psychiatric Association (APA) 173rd Annual Meeting will be held in Philadelphia in April 2020. We are excited to be the host city for the APA meeting, and the chapter is gearing up for this event. Upcoming Events Wednesday, August 28, 2019 – Philadelphia Residents’ Night This years’ event will be held at La Peg, on North Columbus Blvd, Philadelphia from 7:00 – 9:00 pm. Join us for an evening of networking with fellow Philadelphia residents, and members of the Philadelphia Psychiatric Society Council. Click here to register today! Saturday, September 14, 2019 – 5th Annual Addictions Symposium This years’ event will be held at the Jefferson Alumni Hall at Thomas Jefferson Hospital. Plan to join us to hear talks on Addiction Medicine for both the Generalist and the Specialist. Registration will be available soon, watch your email and our website for more information. P E N N S Y L V A N I A P S Y C H I A T R I S T | J U L Y 2 019