February 2016 - Massachusetts Psychiatric Society
Transcription
February 2016 - Massachusetts Psychiatric Society
Committee for Women MASSACHUSETTS PSYCHIATRIC SOCIETY PO Box 549154 Waltham, MA 02454-9154 ADDRESS SERVICE REQUESTED Issue 139 November/December 2013 Issue 139 November/December 2013 Issue February 2016 Issue 139160 November/December 2013 www.psychiatry-mps.org FROM THE PRESIDENT Membership: Joining in! Membership: Joining Joining in! and Parity: Are We Getting Closer? Coverage in! Membership: What does a professional society provide to its overlapped. One of the more exciting develop- MPS Calendar of Events November 15, 2013 at 12:00 NOON at MPS Rohn S. Friedman, MD MPS Calendar of Events [email protected] SEMPS - Risk Management w/Jim Hilliard February 3, 2016 at 6:00 PM at Alberto’s, 360 Main Street, Hyannis MA [email protected] Chairs and Council February 9, 2016 at 6:30 PM at MMS - Berkshire 1st Floor [email protected] Awards Committee February 10, 2016 at 7:00 PM at MMS - Middlesex West 3st Floor [email protected] Healthcare Systems and Finance February 16, 2016 at 6:30 PM at MMS - Middlesex 2st Floor [email protected] WMPS - “Can Examination of (Haitian) Vodou in Different Light Open Doors of Potential Collaboration Long Closed in The Mental Health Field?” w/Jennifer Severe, MD February 17, 2016 at 6:00 PM at Delaney House, Holyoke MA [email protected] Executive Committee February 23, 2016 at 6:30 PM at MMS - Middlesex Central 2st Floor [email protected] Health Information Technology Committee February 25, 2016 at 6:30 PM at MMS - Room TBD [email protected] Council March 8, 2016 at 6:30 PM at MMS - Charles River 1st Floor [email protected] 2016 Risk Avoidance and Risk Management Update March 12, 2016 from 8:30 AM to 3:30 PM at MMS [email protected] Healthcare Systems and Finance March 15, 2016 at 6:30 PM at MMS - Middlesex 2st Floor [email protected] Public Sector Committee March 17, 2016 at 7:00 PM at MMS - Room TBD [email protected] Executive Committee March 22, 2016 at 6:30 PM at MMS - Middlesex Central 2st Floor [email protected] members? question seems onto the What does aour professional societysimple provide its One ofaThis major priorities at MPS has What does professional society provide to its surface, but in depth is complex. Among the members? This question seems simple on been improving access to simple necessary psymembers? This question seems on the many benefits ofdepth being ispart of a vibrant surface, but treatment. complex. Among the chiatric Insurance is organicentral surface, but inin depth is complex. Among the zation like the Massachusetts Psychiatric Society many benefits of being part of a vibrant organito benefits access. ofInbeing the past tooa many many part of vibrantindividuorganiand twotheChapters the Psychiatric opportunity to had be zation like Massachusetts Society alsitslike either had no is health insuranceSociety or zation the Massachusetts Psychiatric with colleagues with shared interest, to network, and its two Chapters is the opportunity to be that did is notthecover mental tohealth and policies its two Chapters opportunity be to mentor and/orwith beabuse mentored, and to to network, make a with colleagues shared interest, and substance (MHSA) or covered with colleagues with shared interest, to network, difference in ourseparate profession. All of these werea mentorwith and/or be mentored, mentored, and torestrictive make them and more toto mentor and/or be and to make a Chairs and Counevident at the September 10thmaximums, difference our profession. All of these were annual lifetime levels difference ininand our profession. th All of these were cil Meeting as Chairs of Groups and Chairs andCounCounevident at the September 10thInterest of copayment, maximum inpatient days Chairs and evident at the September 10 Committees and their Member-in-Training cil Meeting as Chairs of Interest Groups and outpatient visits, and prior authorizacil and Meeting as Chairs of Interest Groups and (MIT) met tothe give andtwo listen Committees and their theirOver Member-in-Training tionCo-Chairs/Leaders requirements. last deCommittees and Member-in-Training to the vastly variedtheand important work the (MIT) Co-Chairs/Leaders metand give andof listen cades at both state national level, (MIT) Co-Chairs/Leaders met totogive and listen MPS interest groups andimportant committees. addito the the vastly varied and important work of the there have beenand serious efforts toInaddress to vastly varied work of the tion, I had the honor of attending meetings of MPS interest groups and committees. In additheinterest absence andand disparities in In coverage MPS groups committees. addiour two Chapter, Southeastern Massachusetts tion, I had the honor of attending meetings of for mental health and substance abuse. tion, I had the honor of attending meetings of Chapter and Western Massachusetts Chapter our two two Chapter, Chapter, Southeastern Massachusetts our Southeastern Massachusetts where I was meet with leaders and memChapter andable Western Massachusetts Chapter Milestones intothe Battle Chapter and Western Massachusetts Chapter bers ofI the to learn ofleaders their interests. where wasChapters abletotomeet meet andmemmem-I Massachusetts was awith leader in and mandating where I was able with leaders will report to all members the vibrant and excit-as bers of the Chapters to learn of their interests. coverage as early berssome of themental Chaptershealth to learn of their interests. II ing opportunities for members to not and only pay will report to all members the vibrant excit2000 and in establishing universal healthwill report to all members the vibrant and excittheir dues, to join in. ingcare opportunities for members members to not not only envipay in but 2006, but most of to the current ing opportunities for only pay their dues, but to join in. ronment flows from federal legislation. their dues,Groups but to join Interest and in. most Committees are openIn 1996 the Mental Health Parity Act (MHPA) to all members. Going forward, we plan use Interest Groups and and most Committees areto open Interest Groups most Committees are open mandated that aggregate lifetime and annuour newsletter asGoing a forum for Interest Groups to all members. forward, we plan to use to all members. Going forward,health we plan tophysiuse alCommittees dollar limits forforum mental andGroups and the with our newsletter newsletter as astoaaprovide formembership Interest Groups our forum for Interest cal health not differ. Although the information andcould current events with all Chairs or andCommittees Committees provide themembership membership with and totoprovide the with MHPA writing did not cover many plans, did not a designee a brief annual column. These information and current events with all Chairs information and current events with allnot Chairs oror apply towriting substance abuse, did require new columns will agive the membership an opa designee brief annual column. These a designee writing amental brief annual column. These coverage health, and Interest did not portunity to for learn about our varied new columns columns will give give the membership membership an opopnew will the an address issues like authorization requireGroups meet their portunityand to Committees learn about about that our may varied Interest portunity to learn our varied Interest mentsor orspark copays, it wasand an will opening salvo interest curiosity complement Groups and Committees that may meet theirin Groups and Committees that may in meet their the effort to reduce disparities the coverthe list of meetingsand thatwill are complement on the back interest orongoing spark curiosity curiosity interest or spark and will complement age mental illness. page of of ourongoing newsletter. the list of meetings that are onthe theback back the list of ongoing meetings that are on pageof ofour ournewsletter. newsletter. page 1999 and President the FedTheInChairs CouncilClinton Meetingordered was a large and Employee Health Benefits (FEHB) interactive group with Chairs connecting with Theeral Chairs and Council Meeting wasaalarge large and The Chairs and Meeting was and Program toCouncil implement parity forinterests mental other Chairs noting where their interactive group with Chairs connecting with interactive group with Chairs connecting with other Chairs Chairs noting noting where where their their interests interests other professionally away from others in this small, yet vital work setting and for residents learn ments has theofrole of the MIT, an initiative professionally awayfrom from others thistosmall, small, overlapped. One themore more exciting develophealth andbeen substance abuse treatment, in- and the quantitative treatment limitations professionally away others ininthis overlapped. One of the exciting developabout working in college mental health. started under the Presidency of Marie Hobart. yet vital work setting and for residents to learn ments has been the role of the MIT, an initiative cluding andthetreatment limits, like burdened health yetvisit vitallimits work that setting and formental residents to learn ments has cost-sharing been the role of MIT, an initiative The MITunder program has for Marie more involveabout working incollege college mental health. started the Presidency Presidency of Hobart. over providing a model forallowed more of comprehensive physical illness, types of discriminaabout working in mental health. started under the Marie Hobart. ConsultationConsultation-Liaison Interest Group is involved ment ofand MIT, offered much mentoring and pro- tory TheMIT MIT program hasallowed allowed forcosts moredid involveparity demonstrating that not disparities that are straightforward and The program has for more involvein both educational and legislative activities. The Consultation-Liaison Interest Group involved Consultation fessional development, and is appreciated by the ConsultationConsultation -Liaison Interest Group isisinvolved ment of MIT, offered much mentoring and prorocket andoffered the sky did mentoring not fall. and pro- measurable. Current concerns have fo-interment of up MIT, much Group leaders continue to work with an in both educational and legislative activities. The Chairs have a MIT Co-Chair/Leader to cused fessionalwho development, andisis appreciatedby bythe the in both and legislative activities. The oneducational the more opaque nonquantitative fessional development, and appreciated disciplinary group of physicians to address the Group leaders continue to work with an interassist inwho developing programs. I will attempt to Group leaders continue to work with an interChairsMental have MIT Co-Chair/Leader Co-Chair/Leader The Health Parity and Addictions limitations (NQTL), including: Chairs who have aa MIT toto treatment ongoing problems patients boarded in the disciplinary group of physicians to address the give succinct summary of of the 2008 current activities group of physicians to address the assistainin developing programs. willattempt attempt Equity Act (MHPAEA) required assist developing programs. I Iwill toto disciplinary Emergency Departments across the Commonongoing problems of patients boarded in the of theaifsuccinct Committees and covered, Interest Groups. In an 1.ongoing problems of adequacy patients boarded in the give summary thecurrent current activities that MHSA were thereactivities could Disparate network (phantom give a succinct summary ofofthe wealth. Meetings gather C/L psychiatrists, PsyEmergency Departments across the CommonCommoneffort to conserve space and reading time, I will Emergency Departments across the of the Committees and Interest Groups. In an separate and deductibles and out-ofnetworks). Health plans must ofnot thebe Committees Interest Groups. In an chosomatic Medicine fellows, and provide residentsPsyto wealth. Meetings gather C/Lpsychiatrists, psychiatrists, list only the name of the group. Meetings gather C/L effort conserve space andreading reading time, will wealth. pocket and the plans had to comply patients a sufficient number ofPsy-to effort totolimits, conserve space and time, I Iwill network andwith to provide educational and profeschosomatic Medicine fellows, andresidents residents chosomatic Medicine fellows, and to list only the name of the group. with financial parity physicians in provide eachprograms. specialty; list only the name of the(equal group.copays, deductsional development Anetworks recent wellnetwork andtoto educational andprofesprofesSpecial Committees Interest network and provide educational and ibles) and treatmentand parity (bothGroups quantitamust development be comparable onmedical the Amed-surg attended program discussed marijuana. sional programs. recent wellSpecial Committees and Interest Groups Alcoholism and the Addictions Interest Group is sional programs. A have recent all welltively measurable limitations and development the MHSA sides. medical We Special Committeestreatment and Interest Groupslike attended program discussed marijuana. amaximum longstanding active group with meetAlcoholism and theAddictions Addictions Interest Group discussed medical marijuana. Disaster Readiness Committee is a ofwellnumber of visits or5 dinner maximum heardprogram from patients their experience Alcoholism and the Interest Group isis attended ings a year, each withgroup an educational program a longstanding active with 5 dinner meetorganized group that was vital in responding to Disaster Readiness Committee wellnumber of inpatient days and nonquantitagetting a provider list and then a longstanding active group with 5 dinner meetDisaster Readiness Committee isis maka a welland for networking and support. ingsopportunities a year, year, each each with an educational educational program the needs ofgroup ourofmembership and the community organized that was vital in responding tive limitations especially man-It organized ing dozens phone calls, only to find ings atreatment with an program group that was vital in responding toto is attended by, with good authorization, involvement andwell opportunities fornetworking networking andsupport. support.of, in the immediate aftermath of the the incorMarathon thethat needs ofcontact ourmembership membership and community aged care techniques of prior the information and opportunities for and ItIt the needs of our and theiscommunity and medical students. is well well attended by, withgood goodand involvement of, bombing thispsychiatrist past spring. in the immediate aftermath of the Marathon medical necessity criteria, formulary rect, the is not actually in isMIT attended by, with involvement of, in the immediate aftermath of the Marathon MITand andmedical medicalstudents. students. bombing thispast past spring. design). the network, the provider is not taking MIT bombing this spring. Child and Adolescent Psychiatry Interest Group Forensics Interest Group (formerly the Commitnew patients, the available aptee on Psychiatry and thenext Law) meetsthe periodicalForensics Interestor Group (formerly Commitis reorganizing and getting restarted with an Forensics Child andAdolescent Adolescent Psychiatry Interest Group (formerly the CommitInterest Group Child and Psychiatry Interest Group The Affordable Care Act (ACA) in 2010 pointment is in 6 weeks. Low rates of the ly toonaddress timely issues thatmeets may periodicalaffect teeon Psychiatry andthe theLaw) Law) increased interestand from MIT restarted and earlywith career is reorganizing reorganizing getting an tee Psychiatry and meets periodicalisextended and getting restartedtowith an theThis parity requirements more not covering membership. One including recent issue dealt with lyreimbursement, to address timely issues that may affect the psychiatrists. group has many projects in ly increased interest from MIT and early career to address timely issues thatare may affect the increased interestbut from MITimportantly, and early career health plans, more theall certain E&M codes which proposed legislation about the covered process for membership. One recent issue dealt with development with planned meetings open to psychiatrists. This group has many projects in membership. Oneservices recent or issue dealtforwith psychiatrists. This has many projects in ACA aimed at group providing near-universal for med-surg paying involuntary hospitalization. note, the MIT proposed legislation aboutOf the process for members withwith interests in Child and Adolescent development planned meetings opentotoall all proposed legislation about the process for development withincluded planned meetings open coverage and mental health and those codes at a lower rate, as as MIT co-leader is ahospitalization. lawyer who adds to well the the group’s involuntary Of note, Psychiatry. members with interests in Child and Adolescent hospitalization. Of note, theareMIT members with interests in Child and Adolescent involuntary substance onerousis requirements discussion ofpaperwork co-leader aforensic lawyerissues. who addstotothe thegroup’s group’s Psychiatry. abuse coverage as one of the co-leader is a lawyer who adds Psychiatry. ten essential health benefits for individual among the reasons that mental health College Mental Health Interest Group is in its discussion of forensic issues. of forensic issues. Geriatrics Committee meets everyWhereas other month and small group plans as well as plans purnetworks are inadequate. third yearMental and isHealth focused on issues about the College its discussion Interest Group College isis inin its Mental Health Interest Group with one of its core activities being CME educaGeriatrics Committee meets every other month chased on the Marketplaces created under primary care doctors can refer their mental health of students in colleges and third year year andneeds focused on issues issues about the the Geriatrics Committee meets every other month third and isis focused on about tional presentations. The group deals with any with one of its core activities being CME educaObamacare. patients to colleagues with confidence universities. At present, psychiatrists constitute mental health needs of students in colleges and with one of its core activities being CME educamental health needs of students in colleges and issues that may affect the practice of geriatric tional presentations. The group deals with any that they are in the patient’s network, 5% of collegeAtcounseling center leadership. This tional presentations. The group deals with any universities. present, psychiatrists psychiatrists constitute universities. At present, constitute psychiatry and has been very busy of late with issues that may affect the practice of geriatric Progress and Remaining Disparities with the much narrower MHSA netgroup meets regularly tocenter provide educational 5% of college counseling leadership. This that may affect the practice of geriatric 5% of college counseling centerand leadership. This issues several the legislature thatlate would psychiatry has been verybusy busyprimary with These milestone legislative works,bills itandbefore ishas impossible for programs of topics relevant to this regulatory work setting psychiatry group meets meets regularly to provide provide educational and been very ofoflate with group regularly to educational require undue burden to provide any necessary several bills before the legislature that would actions have encouraged substantially all care offices to refer patients reliably to and age group, such as social media, ADHD, programsofoftopics topicsrelevant relevanttotothis thiswork worksetting setting several bills before the legislature that would programs psychiatric medication for a geriatric patient require undue burden provide anyavailnecessary health tosuch cover mental health and someone who is intoto network and and other mental health also is aADHD, forum ageplans group, astopics. socialItmedia, media, require undue burden provide any necessary and age group, such as social ADHD, in any setting (e.g., hospital, nursing facility, psychiatric medication for a geriatric patient substance abuse and have largely elimiable in a clinically appropriate time for mutual support for topics. psychiatrists who often psychiatric medication for a geriatric patient andother othermental mental health alsois isaaforum forum and health topics.and ItItalso assisted living inframe. any setting setting (e.g., hospital, hospital, nursing facility, nated thesettings different copays deductibles Thisfacility). forces patientsnursing to fendfacility, for work in that are geographically and in for mutual support for psychiatrists who often any (e.g., for mutual support for psychiatrists who often (Continued on page 3) assistedliving livingfacility). facility). work inin settings settings that that are are geographically geographically and and assisted work (Continued on3) page 3) (continued on page (Continued on page 3) From the President ............................................................... 1 Fromthe thePresident President............................................................... ............................................................... 11 From MIT Corner ............................................................................. From the President ...............................................................1 2 MIT Corner ............................................................................. 2 MIT CornerCare ............................................................................. Managed Update .......................................................... Resident Fellow Corner .......................................................224 ManagedCare CareUpdate Update.......................................................... .......................................................... 4 Managed MPSC/L New Members.............................................................3 MPS Committee Meeting Update ................................. 45 MPSC/L C/LCommittee CommitteeMeeting MeetingUpdate Update................................. ................................. 55 MPS from HIT Committee...............................................5 InUpdate Transitional Space ............................................................ 6 InTransitional TransitionalSpace Space............................................................ ............................................................ 66 In MPS Veterans Resources Committee Meeting Update ...... 7 MPSVeterans VeteransResources ResourcesCommittee CommitteeMeeting MeetingUpdate Update...... ...... 77 MPS MPS Classifieds 9 Ask PHS - Steve .................................................................... Adelman, MD...........................................7 MPS Classifieds .................................................................... MPS .................................................................... 99 MPS New Members .............................................................. 14 MPSClassifieds News............................................................................8 MPS NewMembers Members.............................................................. .............................................................. 14 MPS MPSNew Classifieds..................................................................10 MPS Calendar .......................................................................14 16 MPS Calendar ....................................................................... 16 MPS MPSCalendar Calendar....................................................................... ....................................................................1616 www.psychiatry-mps.org15 MPS Bulletin - February 2016 PO Box 549154 Waltham, MA 02454-9154 Phone: 781-237-8100 Fax: 781-464-4896 www.psychiatry-mps.org RESIDENT FELLOW MEMBER CORNER Rebecca Mae Allen, M.D., MPH Rohn S. Friedman, M.D. President Mark J. Hauser, M.D. President-Elect Gregory G. Harris, M.D., MPH Immediate Past-President Siu Ping Chin Feman, M.D. Secretary Bruce Black, M.D. Treasurer Gary Chinman, M.D. Sr. APA Representative 2015-2016 Patrick Aquino, M.D. APA Representative 2015-2016 John Bradley, M.D. APA Representative 2015-2016 Michelle Durham, M.D., MPH APA Representative 2015-2017 Marshall Forstein, M.D. APA Representative 2014-2017 Siu Ping Chin Feman, M.D. 2015-2018 Astrid Derosiers, M.D. 2014—2017 David Gitlin, M.D. 2014-2017 Eran D. Metzger, M.D. 2015-2018 Arthur Papas, M.D. 2013-2016 Pedro Politzer, M.D. 2014-2016 RESIDENT FELLOW MEMBERS Rebecca Mae Allen, M.D., MPH 2015-2017 Marc A. Whaley, M.D. President Donald A. Smith, M.D. President M. Cornelia Cremens, M.D., MPH Lynda Layer, CAE Administrative Director Mayuri Patel Coordinator, Member Relations Julie Kealey Continuing Medical Education Coordinator Complimenting the Alternatives (or, Think- also a reality of the world in which we practice. ing Differently About Supplements) An early experience in my pre-medical years hit this point home. I visited a clinic in Ecuador As long as we choose treatments with good which was lauded at the time as a successful inscientific evidence, it is illogical and does our tegrative medical setting. It was largely funded patients a disservice to limit our recommenda- by US money. The menu – and yes, it was a tions based on preconceived notions of what is menu, on a board with names of treatments and a drug. But, I have approached the subject of prices – was divided into two halves: Western dietary supplements warily. and traditional. The halves were equal in length with similar prices, most set at around a week’s To start, I must admit that I am not a fan of the wages for a typical lower middle class resident labels “integrative,” “alternative,” or “compli- of the region. I sat in on two traditional medimentary” medicine. These terms imply one of cine sessions. The first was fairly benign. The two things: (1) there is not enough evidence to practitioner had a dimly lit small office filled support the use of the treatment in mainstream with herbs, some of which she chewed in a medicine, or (2) medical doctors are too closed- complicated procedure involving chanting and, minded to use the treatment despite strong evi- as a finale, she sprayed a fine mist of herbaldence of efficacy, necessitating naturopathic ized spittle at the patient. The second was, to and other “alternative” practitioners to pick me, horrifying. A middle aged woman came in up the slack. Both implications are equally with her family, and the practitioner sat her on a problematic. I do not want to be prescribing a chair in the center of a large, sparse room with medication that has not been adequately stud- a tile floor. He took a live guinea pig, held it ied, and I also do not want to believe that a just under its head, and began walking around well-supported treatment would be rejected by the woman in the chair, shaking the guinea pig “Western medicine” just because it is perceived vigorously while intoning words. The guinea to be from a certain category (natural? herbal?). pig squealed in terror, but in a minute its neck Of course, like all medical traditions, “Western snapped, at which point the practitioner pulled medicine” has a long history of using remedies over a utilitarian plastic bucket and began cutfrom plants. I’m sure everyone reading this ting the skin off the guinea pig, making a show will be able to think of an example, but here are of examining the animal’s body carefully while two: aspirin is an archetypal tree-based medi- asking the patient a very normal set of questions cine, originally used in ancient Egypt and now to get a history of presenting illness. He later solidly in the realm of the mainstream, and opi- explained to me that he used the blood clotting um is from poppies, first cultivated in ancient in the corpse as clues to the location of the paMesopotamia. Likewise, I think it is a problem tient’s malady. He told her she had a liver probof lack of education and misleading marketing lem and sent her for a blood draw. Naturally, I when certain chemicals are labeled as “natural,” did not leave that clinic with a very positive imwith the implication that they are somehow in- pression of alternative treatments. The kicker? trinsically safe (especially with rounded green Every practitioner in that clinic, Western or trafont and leaf-shapes slipped into the lettering). ditional in label, wore thigh-length white coats. Again, examples abound of dangerous “natural” chemicals, but I think about the “natural” I am honestly not sure, these days, where the poisons arsenic, cyanide, and botulism toxin. I line is drawn between complimentary/alternacringe at the word “natural” when considering tive and traditional/Western. Diet advice from the history of medicine, particularly the “natu- MD’s (Mediterranean, plant-based, etc) and ral” rate of death from childbirth and the “natu- referrals to nutritionists are common. Vitamin ral” amount of pain people used to suffer from B12 levels are a standard part of a depression chronic, relatively minor injuries and illnesses, workup. Melatonin is utilized by primary care like infections and tooth decay. Historical lists physicians and sleep specialists alike (and I preof causes of death are morbidly fascinating scribe it often). It seems that more and more (see:http://thesocietypages.org/socimag- dietary supplements have made their way into es/2012/06/25/historical-changes-in-causes-of- standard, mainstream practice, with strong evideath/). dence behind them, like folic acid, omega-3 and -6 fatty acids, and DHA. In the meantime, the The division between Western/mainstream/ law has not caught up. In theory, the FDA monstandard and complimentary/alternative is arbi- itors the safety and labeling accuracy of dietary trary, and in my opinion highly faulty, but it is supplements, and the US Federal Trade Com- Lahey Health Behavioral Services | Lahey Hospital & Medical Center Exciting Opportunities For Psychiatrists Lahey Health Behavioral Services provides comprehensive mental health services in more than 30 locations throughout Eastern Massachusetts. Our behavioral health model promotes the delivery of care in the community setting, closely integrating behavioral health with services provided throughout the Lahey Health system, which includes a tertiary hospital and medical center, multiple community hospitals, and vast networks of primary, senior and home care services. With a broad range of programs, including inpatient and outpatient services, we have opportunities that match your professional interests and offer room for growth. Join our team and be a part of a new model of behavioral health care in Massachusetts! Opportunities Full-time and Part-time Psychiatrists, Adult Outpatient and Addiction Services We are seeking BE/BC psychiatrists interested in joining our team of fulland part-time providers. Providers in outpatient settings provide individual assessments, family interventions and individual/group psychopharmacological treatment. They consult with PCPs, pediatricians, schools and other behavioral health and human services providers, as well as provide supervision to nurse practitioners. Opportunities also exist for psychiatrists with addiction treatment expertise to provide direct patient care in both inpatient and outpatient addiction treatment settings. Ideal candidates will be fellowship trained in addiction psychiatry, but other medical specialties with addictions experience will be considered. Full-time Psychiatrist, Adult Inpatient BayRidge Hospital; Lynn, Massachusetts We are seeking a full-time BE/BC psychiatrist for the admission unit who will primarily work up newly admitted patients with no responsibility for ongoing patient care. This Monday-Friday position offers predictable hours and no required night call. Full-time Psychiatrists, Adult Outpatient Lahey Hospital & Medical Center; Burlington, Massachusetts We are seeking candidates for our outpatient adult practice, with consultation-liaison service responsibilities as well. The Department of Psychiatry includes a strong multi-disciplinary team of psychiatrists, clinical psychologists, clinical nurse specialists and licensed clinical social workers. Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Beverly Hospital; Beverly Massachusetts We are seeking candidates for Medical Director of our Beverly Hospital site, which includes an 18-bed medically oriented inpatient unit, consultation liaison service and a partial hospital program at a 200+-bed hospital that is ranked among the top 100 hospitals by Truven Health. Clinical duties will be primarily on consultation liaison service. Candidates must be board certified with more than five years’ experience. Consultative liaison fellowship training is a plus. Moonlighting Opportunities Lucrative night and weekend psychiatric call opportunities are available at BayRidge, Beverly and Addison Gilbert Hospitals. For consideration or more information contact: Kate Schnabel, Senior Physician Recruiter, Lahey Health • 781.744.5193 • [email protected] Learn more at LaheyHealth.org/Careers (continued on page 4) 781-237-8100 Medical Director, Beverly Hospital Psychiatry 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org 14 www.psychiatry-mps.org3 MPS Bulletin - February 2016 BC/BE Child and Adult Psychiatrists Needed In Our Affiliated Community Mental Health Centers Both full- and part-time physician leadership and staff physician opportunities are currently available in our community mental health center in Central MA. Medical Director Job Summary: The Medical Director is responsible for overall management of all medical matters for the North Suffolk Mental Health Association. Ensures continuous Quality Improvement of all Medical matters and standards for the Agency. Reports to the Chief Executive Director (CEO). Works closely with the Chief Operating Officer (COO), Director of Compliance and Quality Improvement, all Senior Managers, the Department of Mental Health Medical Director and the Massachusetts General Hospital Department of Psychiatry. POSITION REQUIREMENTS: Education and Experience Required: Five years of professional experience, current and valid registration as a physician under the Massachusetts Board of Registration in Medicine. Board Certified by the American Board of Psychiatry. License to practice medicine in the Commonwealth of Massachusetts; five years of clinical experience and prior demonstrated competency in management and administrative roles. Board certification in Psychiatry. Addictions experience required. Experience in community and public sector mental health required. Buprenorphine waiver preferred. Please contact : Jason Romano Phone: 617.912.7917 - Fax: 617.912.7971 [email protected] Community Healthlink (CHL) is a dynamic, multi-service organization committed to establishing, maintaining and restoring the dignity, well being and overall mental health of individuals and families in Central MA. It provides a wide range of services to individuals suffering from mental illness, developmental disabilities and substance abuse issues, including youth and family services, residential services, adult outpatient services, and homeless and inpatient services. CHL is staffed by a mission oriented, multi-disciplinary team of psychiatrists, psychologists, nurses, social workers and other dedicated health care providers all committed to providing comprehensive, high quality care. Come join the dedicated team of professionals at CHL and help make a difference in the lives of some of Central Massachusetts’ most challenged individuals and families. CHL psychiatrists receive competitive salaries and comprehensive benefits packages. Faculty appointments, commensurate with training and experience, are available as well, as is the opportunity to teach UMass Medical Students, Residents and Fellows. For additional information about CHL, please visit our website: www.communityhealthlink.org. Interested candidates (J-1 and H-1B candidates are welcome to apply) are encouraged to submit their CVs and letters of interest to: Kathy Anderson at: [email protected]. Arbour Hospital, Arbour-Fuller Hospital, and Pembroke Hospital have outstanding opportunities for (continued from page 1) themselves and often forego treatment or go out of network. 2. Disparate rates of denial. NAMI reports that mental health and substance abuse treatment is denied at twice the rate of medical and surgical treatments. The criteria for medical necessity are often arbitrary and opaque. Prior authorization is required for admission and treatment for mental health and substance abuse in ways without parallel in the medical and surgical realms. 3. Disparate pharmacy benefit management. Narrow formularies, in particular restricting antipsychotics, are combined with fail first or step therapy requirements and tier 3 copays to make it difficult or impossible for patients to receive essential psychiatric medications in a timely and affordable manner. The Problem of Enforcement Parity legislation has created a regulatory framework that is highly complex and requires heavy-duty data analysis. For MHPAEA a parity analysis involves six classifications (inpatient in network, inpatient out of network, outpatient in network, outpatient out of network, emergency care, and prescription drugs). Any type of financial or treatment limitation for mental health must apply to substantially all (defined as 2/3) medical and surgical benefits in that classification, and the level of the limitation can be no more restrictive than the predominant level (that applying to half or more of the medical and surgical benefits) in that classification. It is not feasible for a patient or provider to obtain and parse the data essential for a parity analysis. There has also been a fragmentation of responsibility for parity enforcement. If a parity complaint involves a fully insured group plan or an individual policy, patients or providers would go to the Massachusetts Department of Insurance; for MassHealth they would go to the MassHealth Customer Service; for a self-insured employer plan they would go to the United States Department of Labor. The US Department of Health and Human Services also has a share of the enforcement responsibility. To this end, MPS has been meeting with state and federal officials to raise our concerns and advocate more assertive and coordinated enforcement of parity. We have filed legislation to require transparency and establish a data clearinghouse. We have joined with other professional and consumer organizations in the Mental Health Parity Coalition to promote parity. We ask you to report to us specifics of disparities we can use to make the case with legislators and officials. Parity is closer, but we have work to do. In the face of such complexity and fragmentation, we need 1. disclosure and transparency of health Rohn S. Friedman, MD plan policies and decision-making, President, including clear descriptions of ben- Massachusetts Psychiatric Society efits, medical necessity criteria, prior authorization policies, and reasons for denials 2. public reporting of data, making information such as the number of physicians in each specialty in a plan’s network, the number of claims filed by each, the rates of denial and of outof-network claims for med-surg and MHSA services, and medical necessity criteria readily available 3. a central clearinghouse which can collect this data, have the expertise to do the necessary data analysis, and unite or coordinate the fragmented enforcers Inpatient Psychiatrists Arbour Health System provides a continuum of care that includes evaluation, crisis stabilization and treatment for children, adolescents and adults with mental illness, dual diagnosis and/or addiction disorders. All hospitals are accredited by The Joint Commission and licensed by the Massachusetts Department of Mental Health. www.arbourhealth.com Enjoy highly competitive compensation and benefits, a schedule that allows for work-life balance, and the stability of working for the largest private mental health system in Massachusetts. • Reasonable caseload • Weekday schedule with no call or weekend work required • Paid moonlighting available for additional compensation • A benefits package that includes: health and dental insurance, retirement savings with company match, paid time off including CME allowance Arbour Hospital is a 136-bed psychiatric hospital in the Jamaica Plain section of Boston. The hospital has inpatient units for adolescents and adults including a dedicated unit for substance abuse/dual diagnosis and a high intensity unit. The Quincy Center, a satellite of Arbour Hospital, has an adult psychiatric unit. The hospital also offers partial hospitalization programs, outpatient and community-based services. Arbour-Fuller Hospital is a 103-bed hospital in South Attleboro, Massachusetts. Inpatient units treat adolescents and adults. The hospital also has an adult inpatient intellectual disabilities specialty unit as well as an adult acute residential treatment program. The hospital also offers an adult partial hospitalization program and community-based services. Pembroke Hospital in Pembroke, Massachusetts, is a 120-bed psychiatric hospital with services include adolescent, adult and older adult inpatient as well as partial hospitalization programs for adolescents and adults. Inpatient and outpatient electro-convulsive therapy services are available. The hospital is currently recruiting for adult psychiatrists including those with addictions or geropsychiatry specialties. MPS IS PLEASED TO WELCOME THE FOLLOWING NEW MEMBERS General Member: Bibi Alamiri, MD Jon Wesley Boyd, MD David John Dybdal, MD David Fish, MD Uma Naidoo, MD James Mathew Recht, MD Steven Schlozman, MD Resident Fellow Member: Mitchell Crawford, MD David Sturman, MD Anna Weissman, MD Transfer In: Yadira Alonso, MD Teresita G. Balderas, MD Kara Brown, MD Michelle Chaney, MD Amber Frank, MD Stephanie Hernandez, DO Marcela V. Horvitz-Lennon, MD For more information on these or other openings, contact the Office of Physician Recruitment by phone: 617-390-1224, or e-mail: [email protected] 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org MPS Bulletin - February 2016 4 www.psychiatry-mps.org 13 (continued from page 2) mission oversees truthfulness in advertising. The legal category of “dietary supplement” is defined in the Dietary Supplement Health and Education Act of 1994 as “a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary ingredients: (A) a vitamin; (B) a mineral; (C) an herb or other botanical; (D) an amino acid; (E) a dietary substance for use by man to supplement the diet by increasing the total dietary intake; or (F) a concentrate, metabolite, constituent, extract, or combination of any ingredient described in clause (A), (B), (C), (D), or (E).” (https://ods.od.nih.gov/About/DSHEA_Wording.aspx). By law, supplement labeling “may not claim to diagnose, mitigate, treat, cure, or prevent a specific disease or class of diseases,” but a stroll through any natural food store or GMC will illustrate how intelligently manufacturers have dealt with this limitation. – German Commission E ( http://cms.herbalgram.org/ commissione/index.html) – American Herbal Pharmacopoeia ( http://www.herbal- ahp.org/order_online.htm) – American Botanical Council ( http://abc.herbalgram. org/site/PageServer) –ConsumerLab.com Liability also might be a concern when going off-book with treatment recommendations. In a nutshell, the liability issues are almost exactly the same for dietary supplements as for regular drugs. There must be a thorough diagnostic evaluation; there must be evidence behind the treatment recommendations; there must not be neglect of standard treatments; and there must be careful and well documented informed consent. The 1994 law was written to bring supplement regulation more in line with the standard for food than for drugs. But what happens when a “mineral,” “herb,” or “botanical” is actually as effective, or as dangerous, as a prescription drug? Not much. Like food, dietary supplements do not have to demonstrate any efficacy or safety prior to marketing, and can only be removed from the market if the FDA shoulders the burden of proof that the supplement is harmful. Ingredient amount and quality is not monitored as closely as with drugs, and dietary supplement manufacturers are allowed to keep the exact amounts of each ingredient in their preparations as proprietary information. Thus, we have a market where some plant-based medicines are regulated as food, and some as drugs. What supplements to recommend is in many ways beyond the scope of a short newsletter column. I will end, however, with a few suggestions, compliments of Dr. Barry Fogel: 1. Give huperzine A (200 micrograms QD or BID) to mitigate anticholinergic side effects of various prescription psychotropics. 2. Give methylfolate supplementation to people on lamotrigine, to mitigate executive dysfunction related to central effects of inhibited folate metabolism. 3. Give curcumin to people with atypical depression with somatic symptoms suggesting chronic inflammation – either alone or to augment SSRIs. Dr. Fogel sent me six articles on curcumin, and the evidence is indeed strong. Nevertheless – I have come to think that we should consider dietary supplements as part of our psychiatric tool kit. Although I have only been a doctor for 4.5 years and my board certification is as new as it gets, I have already experienced the intense frustration and helplessness of treating patients who just do not get better. This year, I have a supervisor, Dr. Barry Fogel, who is a bit of a Renaissance man. If I were to try to summarize his curriculum vitae, I would not do it justice, so I will simply state that he is a Harvard and Brigham affiliated neurologist and psychiatrist who teaches, does clinical work, writes books, and has started a few companies. Along with Dr. Donna Greenberg, he edited an enormous book published last year called “Psychiatric Care of the Medical Patient.” Kindle informs me that the typical time to read this 1,812 page book is 119 hours and 57 minutes. Needless to say, it is quite thorough, and it is extremely high quality writing. In supervision the past six months, Dr. Fogel has regularly been encouraging me to push boundaries in considering how to help patients. For instance, on his advice I ordered psychotropic pharmacogenomic testing for two of my patients, and it was surprisingly helpful. In sum, it seems that complimentary/alternative and traditional/ Western remedies are divided more by culture than science, and the division is getting outdated. I have come around from a rather anti-alternative medicine stance to carefully adding dietary supplements to the list of treatments I have to offer patients, and I have so far been pleasantly surprised at the amount and quality of research available to support some non-prescription remedies. If this article has piqued your interest in the topic of supplements, I recommend this chapter in Dr. Fogel’s book: Gerbarg, Patricia L. & Brown, Richard P. (2015). Therapeutic Nutrients, Herbs, and Hormones. In Fogel, Barry & Greenberg, Donna (Eds.), Psychiatric Care of the Medical Patient (chapter 28).. New York, NY: Oxford University Press. Dr. Fogel has opened my mind to the use of dietary supplements in psychiatry. However, safety has been my biggest concern in recommending any dietary supplements to my patients, even vitamins. Despite the limitations of government regulation in the United States, which is paltry compared to, say, Germany or Canada, there are several reliable resources for checking on the safety of specific supplements: – FDA website (www.fda.gov/Food/Dietary Supplements/ Alerts) – “Alerts and Advisories” section of the National Center for Complementary and Alternative medicine (www.nc cam.nih.gov/news/alerts) – Dietary Supplement Labels Database at The National Institute of Health National Library of Medicine (www. dietarysupplements.nlm.nih.gov/dietary) 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Boston University School of Medicine/Boston Medical Center Department of Psychiatry The Boston University School of Medicine/Boston Medical Center Department of Psychiatry seeking Child Adolescent Psychiatrist Child/Adolescent Psychiatrist: Full or part-time position for a dynamic program in the Division of Child and Adolescent Psychiatry. Responsibilities include patient care in the outpatient setting, clinical consultation to the pediatric emergency department and pediatric units, and teaching of residents, medical students and trainees in psychiatry, psychology, social work and mental health counseling. Opportunities are also available for research. This position could include leadership activities for the qualified applicant. The successful applicant will wish to participate in the shaping of a child-centered, family-focused, culturally competent, community-linked child psychiatry program targeted at the needs of Boston’s most vulnerable children. Applicants must be board eligible or certified in child and adolescent psychiatry. Boston Medical Center is a private, not-for-profit, 482 bed academic medical center serving a diverse, multicultural patient population. Boston Medical Center is the largest safety net hospital in New England and is dedicated to providing accessible health care. As the main teaching affiliate of Boston University School of Medicine, Boston Medical Center is devoted to training future generations of health care professionals. Interested applicants should send a letter detailing relevant experience and a current CV to Lisa Fortuna, MD, Medical Director, Child and Adolescent Psychiatry, c/o BU Psychiatry, 85 E. Newton Street, Suite 802, Boston, MA 02118 or by email to [email protected] Academic appointment is commensurate with experience. Salary is competitive and benefits are excellent. Boston University School of Medicine/Boston Medical Center is an equal opportunity/affirmative action employer. The Boston University Medical Center Community Psychiatry Fellowship The Boston University Medical Center Community Psychiatry Fellowship is a half-time clinical training experience to expand a fellow’s knowledge base of community psychiatry. The fellowship may be combined with a Master of Public Health from Boston University School of Public Health with tuition support. The program is designed with the interest of the fellow with rotations in many areas of public psychiatry including the Boston Emergency Service Team (urgent care, community based assessment, jail diversion, emergency psychiatry at Boston Medical Center), outpatient community services, intermediate care, policy development through DMH Central Office, and an elective. The goal of the fellowship is to develop leaders in community and public psychiatry. Eligibility Graduates or PGY4 residents from an ACGME accredited psychiatry residency program are eligible to apply to the fellowship. Applicants must possess a full or limited Massachusetts Medical License by the time the program commences in July. Application Process Please send a CV and cover letter addressed to David Henderson MD, Interim Program Director, Community Psychiatry Fellowship and Chair, Department of Psychiatry, c/o Joan Taglieri, 85 East Newton Street, Suite 802, Boston, MA 02118 or email to [email protected]. Boston University School of Medicine/Boston Medical Center is an equal opportunity/affirmative action employer. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org 12 www.psychiatry-mps.org5 MPS Bulletin - February 2016 DEPARTMENT OF PSYCHIATRY – MASSACHUSETTS GENERAL HOSPITAL – HARVARD MEDICAL SCHOOL Health Information Technology (HIT) is a broad term that has a slightly different meaning for each MPS member. At this January’s inaugural meeting of the MPS HIT Committee, members each discussed what areas at the intersection of psychiatry and technology most interested them. The diversity of responses ranging from encrypted text messages to telepsychiatry, smartphone apps to electronic medical records, social media guidelines to sharing medical records was impressive. Such diversity points towards the challenges of HIT, but also the opportunity for MPS to provide members a forum to share, support, and learn about these various digital tools. ATTENDING POSITIONS AND HOSPITALIST/ BEHAVIORAL HEALTH INTEGRATION DEVELOPMENT PROGRAM The MGH Department of Psychiatry has outstanding attending opportunities in Emergency, Outpatient (General and Specialty), Addictions, ConsultLiaison, and Inpatient Psychiatry. In addition the department is pleased to announce a new Hospitalist/ Behavioral Health Integration Development Program preparing candidates for leadership roles in inpatient psychiatry and collaborative care in academic and community settings. Rated among the leading psychiatry departments by US News and World Report, the Department is committed to excellence in patient care, education, research and community service. Candidates should be: board certified/board eligible in Psychiatry and qualified for an academic appointment at Harvard Medical School at the rank of Instructor or above. Fellowship training in relevant areas including addiction, consult-liaison, neuropsychiatry, or geriatric psychiatry and a record of scholarly productivity are highly desirable. Interested individuals should apply to Jonathan E. Alpert MD PhD, Associate Chief of Psychiatry (jalpert@mgh. harvard.edu). The Massachusetts General Hospital is an affirmative action/equal opportunity employer. Minorities and women are strongly urged to apply. Update from the Health Information Technology Committee BAY COVE Human Services, Inc in Boston is looking for a Community Psychiatrist. The Community Psychiatrist will serve a diverse population of individuals in various community settings including the Michael J. Gill Mental Health and Wellness Clinic, Center House Day Treatment, and the Community Flexible Support (CBFS) system of care which serves Department of Mental Health (DMH) clients with serious mental illness. Qualified applicants may become Tufts faculty for the teaching of PGY III Tufts residents who rotate through Bay Cove for their Community Psychiatry rotation. 1520 hours; no call. For more information about this job opening, visit Baycove.org. Just as HIT covers many different areas of technology, it also connects many areas of healthcare and psychiatry. At our meeting questions arose about using electronic medical records for psychotherapy, smartphone apps in substance abuse, and telepsychiatry to consult with new patients. While a list of HIT tools and resources for psychiatry would be pages long, simply understanding that all these various technologies serve a common purpose of improving care is more important. In order to better learn what HIT means to MPS members, one initial role of the committee will be to conduct a survey of the membership. Surveying MPS members about use, concerns, and questions regarding technology will ensure that this new committee can be responsive and best help members. And in order to be most responsive, we will begin to fully utilize the MPS website, www.psychiatry-mps.org, and make it your destination for resources and answers. Another early project of the committee will be to develop guidelines to help in the evaluation of smartphone apps. While it may be currently impossible to create a rating scale that is guaranteed to always find the best app, following the right guidelines can help you avoid downloading digital snake oil. If there are any apps that you particularly like and find helpful, we would love to hear from you as we begin identify the common elements of good apps. Our next, and second, meeting will be on Thursday, February 25th. As always, we encourage all MPS members to attend regardless of experience with technology. In the meantime, be sure to visit the MPS website frequently for updates and the latest information. PSYCHIATRY POSITIONS Beth Israel Deaconess Medical Center in Boston, a 500+ bed tertiary care teaching hospital of Harvard Medical School, is recruiting staff psychiatrists for positions on the Consultation-Liaison Service and Inpatient Service. In addition, moonlighting opportunities are available on both services. The Department of Psychiatry is a major teaching site for Harvard Medical School and the Harvard Longwood Psychiatry Residency Training Program; positions will include opportunities for teaching medical students and residents. Underrepresented minorities are encouraged to apply. Harvard Medical School appointment at an appropriate rank is available. 1. STAFF PSYCHIATRIST ON THE INPATIENT PSYCHIATRY UNIT. This is a full-time position within the Department of Psychiatry that includes clinical care, teaching, and supervision on an active 25 bed inpatient teaching unit. 2. STAFF PSYCHIATRIST ON THE PSYCHIATRIC CONSULTATION SERVICE. This is a half-time position within the Department of Psychiatry that includes clinical care, teaching, and supervision on a busy service that sees 2200 Emergency Department and 1000 Inpatient Medical-Surgical consultations annually. Certification (or eligibility) in Psychosomatic Medicine is desirable. 3. ATTENDING PSYCHIATRISTS FOR WEEKEND AND HOLIDAY COVERAGE OF THE INPATIENT PSYCHIATRY UNIT AND THE PSYCHIATRIC CONSULTATION SERVICE. Must have a full license and be board-certified. Coverage includes morning rounds onsite and off-site telephone backup to the resident. Please send a letter of interest and CV to William Greenberg, MD, Chief of Psychiatry, by email: [email protected]. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Public Sector Inpatient Psychiatrist Unique opportunity at the Lemuel Shattuck Hospital for a full time inpatient psychiatrist to provide continuing care to Boston Metropolitan Area DMH patients within an urban public health general teaching hospital. Join an expert, collegial group of colleagues. Teaching and mentoring opportunities and academic appointment at Tufts potentially available. No weekend or night call. This is a State Block, union position. Contact Audrey GrahamSmith by fax 617-971-3195 to apply or Dr. Amy Lisser, Chief of Psychiatry Shattuck Hospital for further information 617-971-3177. An Equal Opportunity/Affirmative Action Employer. Females, minorities, veterans and persons with disabilities are strongly encouraged to apply. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org MPS Bulletin - February 2016 6 American Professional Agency, Inc. Leaders In Professional Liability / Malpractice Insurance Where Superior Protection Meets Exceptional Service Join your colleagues who have chosen to be represented by our professional team, which is endorsed by the two most prominent associations in your profession - the American Psychiatric Association and American Academy of Child and Adolescent Psychiatry. Superior protection provided by Allied World Assurance Company rated “A” by A.M. Best Co. Access to a Risk Management Team during business hours and a 24/7 emergency hotline Telepsychiatry, ECT coverage and Forensic Psychiatric Services are included Fire Damage Legal Liability and Medical Payment coverage included Interest-Free Quarterly Payments / Credit Cards accepted American Academy of Child Adolescent Psychiatry 1-877-740-1777 www.APAmalpractice.com www.psychiatry-mps.org Worcester, MA seeks a BC/BE Psychiatrist for its University Hospital Outpatient Clinic. Candidates should have strong academic credentials and sound clinical skills, and interest in pursuing academic opportunities in either training or research. An academic appointment, commensurate with experience, is available. Interested applicants (J-1 and H-1B candidates are welcome to apply) are encouraged to submit CVs and letters of interest to: [email protected] The Department of Psychiatry at UMass Memorial Health Care is currently seeking a full time BC/BE Attending Psychiatrist to join the team on the 27 bed adult inpatient unit at UMass Memorial Medical Center, the academic teaching hospital and clinical partner of the University of Massachusetts Medical School. Primary duties involve direct clinical care and support of the academic mission of the Department and the Medical Center including educational responsibilities and the opportunity to participate in research. The position provides the opportunity for involvement in a full range of clinical and academic pursuits. A faculty appointment, commensurate with experience, is also available. Come join Dr. Alan Brown, Vice Chairman of Clinical Services, Dr. Douglas Ziedonis, Department Chair, and other prominent members of the Psychiatry Department in their ongoing pursuit of clinical and academic excellence. Interested candidates (J-1 and H-1B candidates are welcome to apply) should submit CVs and Letter of Intent to [email protected], Attention: Kathleen Anderson. Candidates are also encouraged to visit the Psychiatry Department’s website at: www.umassmed. edu/psychiatry. Behavioral Health Clinic Available Clinic consultant for hire to establish outpatient Behavioral health practice or clinic for 11 Children, Adolescents, Adults. Experienced with all clinic regs, Licensure, Joint Commission, BCBS, etc. Available To set up entire practice with systems, from policies And procedures to billing and accounting. Please call Business Behavioral Health Network at 781-762-1419 Exciting opportunity for part-time substance abuse/mental health practice in NORTH CONWAY, NH. Skiing, hiking, biking, nature’s playground. Flexible schedule, $140/hr. with guarantee of 6 hours/day. Will need Suboxone certification. Also could have FULL-TIME private practice in same office to do general mental health. Currently 2-3 month waiting list for adult and child psychiatry services so market is wide open. PathwaysforBetterLiving.com, 603-356-3400. Family and Community Resources, Inc. FCR seeks licensed, board certified psychiatrist Family and Community Resources, Inc., a small non-profit trauma and domestic violence focused mental health center is in need of a P/T Psychiatrist/Medical Director for 8 hrs/week. Responsible for providing patient diagnostics, medication management, staff training as well as clinic coordination in conjunction with the clinic director. Day(s) and hours flexible. Qualifications: Medical degree from an accredited school of medicine Licensed in psychiatry in the state of Massachusetts Board certified in Adult Psychiatry; Child Psychiatry a plus Location: Brockton, MA Please send CVs to: [email protected] w w w . A A C A P . O R G Boston Area Psychiatrist Reviewer – Consultant Come join a well-established and outstanding group of psychiatrists providing utilization management and case consultation in the Health and Medical Management division of Blue Cross Blue Shield of Massachusetts. Our model of utilization management is one of collegial, respectful and consultative interactions with psychiatrists, psychologists, social workers and other providers for promoting the efficient use of evidence-based practices. Blue Cross Blue Shield of Massachusetts is a highly successful HMO with a commitment to placing our members’ health first. With our coverage reaching over 2.7 million members and an increasing behavioral health concentration, we are seeking a physician reviewer to work part-time. We offer flexible hours and will consider individuals with post-training clinical experience and Board Certification in general psychiatry. Additional expertise and certification in addictions and or child/adolescent psychiatry are highly desirable. Interested parties are encouraged to apply on our website at: www.bluecrossma.com/careers or contact Heather Franey at: [email protected] Our commitment to building a diverse workplace is without question. We are an Equal Opportunity Employer. 781-237-8100 Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Child Psychiatrist Opportunity, Near Boston, MA North Shore Medical Center (NSMC) has an exciting opportunity for a child psychiatrist to join a thriving and growing psychiatric service in Salem, MA about 15 miles north of Boston. NSMC is part of the prestigious Partners HealthCare System, and the Department of Psychiatry is closely aligned with the Massachusetts General Hospital (MGH). The department provides a full spectrum of care, including adult inpatient psychiatry, an older adult inpatient unit, a child inpatient unit, a partial hospitalization program, and several outpatient clinics. Our department is also a hub for the Massachusetts Child Psychiatry Access Project (MCPAP), a grant supported outpatient consultation service for area pediatricians. We have a vibrant educational program, and teaching opportunities are available. Physicians in the department enjoy a collegial and supportive practice environment. Our department is presently engaged in creating a 120 bed “Center for Excellence” in collaboration with the MGH Department of Psychiatry, which will include an expansion of outpatient services as well. Physicians in the department can expect to be engaged and have input into the creation and design of this exciting new program. At present we have an opportunity for a Child Psychiatrist to join our group. There are opportunities for this to be an inpatient or outpatient position, depending on the appropriate candidate’s interest and experience, and matching this with Department needs. The call schedule is very reasonable and requires no in-house coverage. A clinical appointment at MGH and the potential for a Harvard Medical School appointment are available for the qualified candidate. Interested candidates should forward their CV to Louis Caligiuri, Director of Physician Services at [email protected]. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org www.psychiatry-mps.org MPS Bulletin - February 2016 10 BUSINESS SERVICES BUSINESS SERVICES Hea SPECIALIZED CREDENTIALING SERVICES MEDICAL CREDENTIALING SPECIALISTS LEGAL ADVICE FOR PSYCHIATRISTS Milton L. Kerstein, Esq. Andrew L. Hyams, Esq. Mr. Hyams, former General Counsel to the Bd. of Reg. in Medicine, and Mr. Kerstein provide legal services to psychiatrists and other health professionals in the following areas: • Licensing Board Complaints and Applications • Medicare/Medicaid Audits • Patient Confidentiality • Provider and Employer Contracts • Civil/Criminal Litigation As a service to Bulletin readers, we offer one free 15-minute consultation to discuss any general legal concerns. Kerstein, Coren & Lichtenstein, LLP 60 Walnut Street, Wellesley, MA 02481 www.KCLwww.KCL-law.com 969--7139 (617) 969 SPECIALIZED BILLING SERVICES PSYCHIATRIC BILLING SPECIALISTS ♦ EXCELLENT COLLECTION RATES ♦ UNDERSTANDABLE REPORTING AND MANAGEMENT TOOLS ♦ STATE-OF-THE ART BILLING SOFTWARE ♦ BANKING SERVICES ♦ CREDENTIALING CONSULTATION AND ASSISTANCE ♦ CUSTOMER SERVICE, CUSTOMER SERVICE, CUSTOMER SERVICE !! Practice Medicine and We’ll Do the Rest. Call us for more information at (617) 244-3322 Ask about our discount program www.specializedbillingservices.com THE DEADLINE FOR THE DEADLINE FORTHE THE JANUARY 2014 MPS NEWSLETTER IS MARCH 2016 MPS NEWSLETTER IS DECEMBER 15, 2013. FEBRUARY 15,ADVERTISING 2016. FOR FOR ADDITIONAL ADDITIONAL ADVERTISING INFORMATION, PLEASE CONTACT THE INFORMATION, PLEASE CONTACT MPS OFFICE AT: (781) 237-8100 THE MPS OFFICE AT (781) 237-8100 OR OR [email protected] [email protected] • PROVIDER CREDENTIALING • APPLICATION PROCESS Billing Specialists, AND Inc. • Healthcare HEALTH PLAN ENROLLMENT LINKAGE Providing Billing Services to the Mental Health Community • NPI AND PROVIDER NUMBERS • NATIONAL AND MULTI-STATE Billing. . . SERVICES • CAQH REGISTRY It’s what MAINTENANCE we do. • STATE OF THE ART SOFTWARE Every mental health professional needs Please call us to discuss feea great arrangements. Credentialing Services are priced billing service. For over 15either by application or on a monthly flat fee basis Billing dependingyears, on the Healthcare scope of services requested. Specialists has been IN ADDITION TO OUR CREDENTIALING exceptional SERVICES,providing WE OFFER MEDICAL BILLING SERVICES TO to PHYSICIANS, HOSPITALS, service over 100 practices GROUP PRACTICES, CLINICS, ETC. in Massachusetts. FOR CLIENTS WHO PURCHASE OUR MEDICAL BILLING SERVICES, WE OFFER CREDENTIALING AS PART OF Contact us for more information! THAT PACKAGE. Office: (781) 784-4123 (781) 784-0996 PRACTICE Fax: MEDICINE, WE DO THE REST. Email: [email protected] CALL US FOR MORE INFORMATION Web: www.hcbilling.com AT (617) 244-3322 SPECIALIZED CREDENTIALING SERVICES www.sbscincorporated.com/ MEDICAL CREDENTIALING SPECIALISTS ♦ PROVIDER CREDENTIALING OFFICE SPACE ♦ APPLICATION PROCESS ♦ HEALTH PLAN ENROLLMENT AND Boston,LINKAGE Back Bay. Several offices for sublet in prestigious psych/med building on ♦ NPI AND PROVIDER NUMBERS Marlborough Street near Public Gardens. ♦ NATIONAL AND MULTI-STATE Whole and half days. All with beautiful SERVICES detailing, fireplaces and high ceilings. Col♦ atmosphere. CAQH REGISTRY MAINTENANCE legial $300-350/day/month. Contact: [email protected] ♦ STATE OF THE ART SOFTWARE Please call us to discuss fee arrangements. Credentialing Services are priced either by application PSYCHIATRIST or on a monthly flat fee basis depending on the scope of services requested. IN ADDITION TO OUR CREDENTIALING Cambridge Psychiatric Services SERVICES, WE OFFER MEDICALin BILLING PSYCHIATRISTS: Interested flexible SERVICES TO PHYSICIANS, hours, competitive pay rates, andHOSPITALS, a schedule GROUP PRACTICES, CLINICS, ETC. FOR that fits your needs? CLIENTS WHO PURCHASE OUR MEDICAL Qualified psychiatristsWEneeded provide BILLING SERVICES, OFFERtoCREDENovernight, weekend, holiday moonlightTIALING AS PART OFand THAT PACKAGE. ing coverage at area hospitals, clinics, and othMEDICINE, THEinformation REST. erPRACTICE psychiatric facilities.WE ForDO more please call Jessica D’Angio at (617)864-7452 US FOR MORE INFORMATION AT orCALL at [email protected] (617) 244244-3322 STAFFwww.sbscincorporated.com/ PSYCHIATRIST POSTIONS. Full and part-time positions are available for ADULT PSYCHIATRISTS in our outpatient OF clinicsFI in Framingham, Marlboro C E SPACE and satellites. Advocates is a full-service, non-profit system serving individuals with Brookline: and developmental disabilities psychiatric Attractive, comfortable, reasonably priced and other challenges in quiet, a strength-based, 3 suite office nearand Coolidge Corner has opening person-centered multi-disciplinary for a fullExcellent time or physicians two 1/2 time setting. areclinicians honored, as of January 2014.a warm, Street friendly parking practice and nearenT. Call and we offer Jim Harburger MD, is617-232-3822 vironment. Compensation competitive or email [email protected] and benefits are available for 30 hours +. Contact in confidence Chris Gordon, MD, Medical Director at 508.628.6652 or at [email protected] PSYCHIATRISTS ATTENDING PSYCHIATRIST Tewksbury Hospital is looking for a full time Tewksbury Hospital The is a Joint Commisinpatient psychiatrist. position is on a DMH sion accredited Department of Public intermediate care unit working with a wide varieHealth hospital located 23 milesmental ty of patients with severe about and persistent north Boston, MA near the intersecillness.ofNo managed care or after-hours on-call. tion of Interstates 495 and 93. Median LOS about 200 days. Competitive com- pensation. WorkChoices with an excellent and personaTwo Life Style ble group of psychiatrists. 1. Salary: $210,000 base for board cerFor information contact: tified psychiatrist with 1-2 overnight call shifts per month. Anthony Vagnucci, MD Recent salary increases, generousTewksbury signing bonus, Chief of Psychiatry, Hospitalexcellent fringe x2863 benefits, generous allow978-851-7321 ance for license and board certification [email protected] fees, CME fees and 6 weeks leave time for full or part time psychiatrists. You STAFF PSYCHIATRIST POSTIONS. Full will work on a DMH intermediate care and part-time positions are available ADULT unit where you can treat people for with PSYCHIATRISTS in our outpatient clinics chronic persistent mental illness with in Framingham, satellites. Advocates both therapy Marlboro as well asand medication due Incthe is median a full-service, non-profit system to 200 days LOS. Work withserving individuals andgroup developmental an excellentwith andpsychiatric personable of disabilities and other challenges in a strengthpsychiatrists. based, person-centered and multi-disciplinary 2. Salary: $185,350 same as withand we setting. Excellent physicians areabove honored, no overnight/weekend call. environment. offer a warm, friendlyonpractice Fax: 781-464-4896 7 ASK PHS - A Doctor I Am Treating Cannot Stop Drinking Steve Adelman, MD – PHS Director Question from a Central Massachusetts Psychiatrist: I’m a general psychiatrist (not an addiction psychiatrist) and I am concerned about a physician patient of mine who has a serious drinking problem. I’d like to refer him to PHS for an assessment. I think that he needs to connect up with other doctors in recovery and he would probably benefit from a long-term monitoring program. We have been working together for several years (weekly psychodynamic psychotherapy plus meds for dysthymia) and I am worried that a referral to PHS would somehow rupture our longstanding, positive therapeutic relationship because I am not an addiction psychiatrist and PHS has reputation for referring its clients to experts. I am also worried about jeopardizing this physician’s medical license. Help! The purpose of our recommendations is to help the physician overcome his or her challenges in an enduring and lasting fashion, such that a substance use disorder or other significant health challenge does not jeopardize the health and well-being of both the physician and his or her patients. Although PHS sometimes (but not always) recommends specialized treatment programs and providers, we are very respectful of a physician’s longstanding treatment relationships, and we always do everything possible to strengthen and sustain ongoing treatment relationships in a collaborative fashion. The best way to learn about PHS is to contact us whenever you have relevant questions and concerns. Please feel free to draw on our specialized experience and knowledge whenever you are Answer: When physicians with serious drinking problems cannot treating physicians with challenges that have the potential to sidestop drinking either on their own, or with the help of an outpatient line them and sabotage their careers. psychiatrist, it is typically only a matter of time before the drinking progresses to the point where it begins to interfere with the doctor’s ability to practice medicine. It is of critical importance to I invite you to email me your questions about PHS. Please do the physician, as well as to his patients, colleagues and loved ones, not send me any information about an identifiable physician colthat he stop drinking before alcohol begins impeding his ability to league or patient. If your question is of general interest, we may deliver good medical care. Once active substance mis-use inter- answer it here in this column. Otherwise, I will respond to your feres with a doctor’s performance at work, a cascade of adverse email individually. I can be reached at [email protected] or at events may be set in motion, jeopardizing patient safety as well as 781-434-7404. the physician’s professional viability. -----------------------------------------------------------------------------This situation furnishes you with an opportunity to assist your doctor-patient by collaborating with PHS. The first step is to con- Physician Health Services (PHS) is a nonprofit corporation of the tact PHS to describe the situation at hand. At the time of that Massachusetts Medical Society, that provides a safe, confidential phone call, we will tell you about our referral, intake and assess- environment designed to help identify, refer to treatment, guide ment processes. There is no need for you to identify the physician and monitor the recovery of physicians and medical students with at the time of this initial phone call. The goal of the phone call is health concerns. acquaint you with what we do, and to help you assist your patient by making the case that specialized help is available for him or her at Physician Health Services. What kind of help is available to this physician at PHS? A Compensation is competitive and benefits Contact Anthony Vagnucci, MD, are range of possibilities exists, and PHS will work with this phyavailable of for 20Psychiatry, hours +. Chief Tewksbury sician, should he or she choose to make use of our services, to Hospital, 978-851-7321 x2863, explore a variety of options. At the very least, the physician may Are you Contact in confidence Chris Gordon, MD, Medi [email protected] contact PHS anonymously and hear directly about our confidencal Director at 508.628.6652 or at eligible tial physician support groups. We will also describe what might [email protected]. Tewksbury Hospital unfold at PHS should he or she choose to come in for an intake and interested appointment. at the Delaney House in Holyoke, Dr. Ben Liptzin will present Half-time Psychiatrist (20 hours per Cambridge Psychiatric Services week) in applying for PSYCHIATRISTS: Excellent salary and fringe benefits, We This talk discussdesires the potential will schedule an intake appointment if thewill physician signing bonus and generous leave time an in-person and is willing to identify himself or herself. roles for psychiatrists asmeeting Accountable Care Organizations develop as a result of Fellow Interested in flexible hours, competitive pay for half-time psychiatrists. Positions Knowing the name of the doctor simply helpscare us keep trackallofover the rates, and a schedule that fits your needs? the Accountable Care Act which is stimulating health reform available on a DMH intermediate or things. Once the physician has identified himself or herself,risk PHSby caring organizations will be expected to take on financial care unit psychiatrists working with a wide variety over- country. These Qualified needed to provide works for and with the physician. Nothing about this physician with a fixedoutward, amountwithout of money. It is expected that psychiatric of patients with persistentcover- for a population Distinguished night, weekend, andsevere holidayand moonlighting is communicated the express written consent of mental illness areclinics, available. bephysician. integratedA common into primary care using a variety of organizational age at area hospitals, and other No psychiat- services willthe misconception is that PHS is an arm of Fellow Status? managed care or after hours on-call. ric facilities. models. This willThis describe ways forWe practicing psychiatrists to learn more thetalk BRM. is not the case. are a confidential, peer review Median LOS about 200 days. Work programinand we local aim to assist physicians before they come to the about these models their service area. For more information call group with an excellent and please personable attention of the BRM. Jessica D’Angio at 617-864-7452 of psychiatrists. Contact Anthony We will host a reception starting at 6 with dinner being served at 6:30PM. The Contact the MPS Office. or at [email protected] Vagnucci, MD, Chief of Psychiatry, program will If start 7:30 PM. The comes Massachusetts Society designates youratphysician-patient to PHS forPsychiatric an intake appointment, Tewksbury Hospital, 978-851-7321 we will written communicate you. TM When Category with 1 Credit . Physicians for arequest maximum ofconsent 1 AMAtoPRA Adult psychiatrist for part or full time. Private this live activity x2863, [email protected] provide us with consentwith to check in withofclinicians and only the credit commensurate the extent their participation in Group Practice of MD’s & PhD’s. CBT exclu- should claimphysicians We would be glad to assist you others who may provide us with information that helps usbytothe detersively. Services needed include diagnostics and the activity. The BC/BE Psychiatrist for University Massachusetts Psychiatric Society is accredited Massachu mine the nature and severity of the problem, we use this additional Hospital Outpatient Clinic med management. in completing your application. setts Medicalinformation Society to provide continuing medical education physicians. to formulate recommendations that are for intended to UMass Medical Contact: Memorial Peter W. Moran, Ph.D.Center/ Cornerstone assist thefor physician in overcoming the challenges at hand. With pay by University of Massachusetts the meal and the CME credits. You can either Behavioral Health, 469 Chandler Medical St., Worcester, The cost is $25.00 the physician’s permission, we will share our recommendations School Department of Psychiatry in MA 01602 or [email protected] check, cash or credit card on Wednesday night. with you. Massachusetts Psychiatric Society ♦ 40 Washington Street, Suite 201 ♦ Wellesley, MASociety 02481-1802 Massachusetts Psychiatric PO Box 549154 781-237-8100 ♦ Fax: 781-237-7625 ♦ Email: [email protected] ♦ [email protected] 781-237-8100 www.psychiatry-mps.org 9 Email: [email protected] Waltham, MA 02454-9154 www.psychiatry-mps.org 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org MPS Bulletin - February 2016 8 www.psychiatry-mps.org 9 MPS News SAVE THE DATES SATURDAY, MARCH 12, 2016 2016 Risk Avoidance and Risk Management Update Massachusetts Medical Society, Waltham, MA A postcard announcement with conference details will be mailed soon SATURDAY, JUNE 11, 2016 Annual Psychotherapy Conference Massachusetts Medical Society, Waltham, MA SAVE THE DATE MPS Annual Meeting & Dinner April 26, 2016 Please save the date for the MPS Annual Meeting & Dinner scheduled for Tuesday, April 26, 2016 at the Massachusetts Medical Society, the new home of the Massachusetts Psychiatric Society. The cocktail reception will start at 5:30pm and dinner will begin promptly at 6:30pm. A detailed postcard announcement will be mailed soon. We look forward to welcoming the membership to our new office space. MPS Member Elected President of APA’s Women’s Caucus Maureen Sayres Van Niel, MD, a member of MPS, was recently elected president of the National Women’s Caucus of the American Psychiatric Association for a two-year term. The caucus is a division of the APA Assembly and it represents the interests of the more than 13,000 women members of the APA. The caucus aims to address issues relevant to women members, including providing ideas to those at district branches who would like to offer special services for women members. If you have questions or ideas for national or local women’s programs, please contact Dr. Van Niel at [email protected] or the MPS CME Coordinator, Julie Kealey at [email protected]. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org SAVE ON YOUR APA/DB MEMBERSHIP DUES Looking for Ways to Save Time and Money on Your Membership Dues? Check Out These Ways to Save: Lump Sum Dues—Pay a one-time amount for APA national dues for your lifetime. Never worry about annual renewal increases or invoices again. DB/SA dues continue to be billed annually. Scheduled Payment Plan—Have your APA and District Branch dues automatically charged to your credit card in monthly, quarterly, biannual, or annual installments. No interest or service fees. Couples Discount—If you are married to another APA member (or live in the same household), share your print copy of AJP and you’ll each get a 15% discount on your APA national dues. Ready to Start Saving? Contact APA Member Services for more information and to sign up. 781-237-8100 Call: 703-907-7300; 888-35-PSYCH Email: [email protected] Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org MPS Bulletin - February 2016 8 www.psychiatry-mps.org 9 MPS News SAVE THE DATES SATURDAY, MARCH 12, 2016 2016 Risk Avoidance and Risk Management Update Massachusetts Medical Society, Waltham, MA A postcard announcement with conference details will be mailed soon SATURDAY, JUNE 11, 2016 Annual Psychotherapy Conference Massachusetts Medical Society, Waltham, MA SAVE THE DATE MPS Annual Meeting & Dinner April 26, 2016 Please save the date for the MPS Annual Meeting & Dinner scheduled for Tuesday, April 26, 2016 at the Massachusetts Medical Society, the new home of the Massachusetts Psychiatric Society. The cocktail reception will start at 5:30pm and dinner will begin promptly at 6:30pm. A detailed postcard announcement will be mailed soon. We look forward to welcoming the membership to our new office space. MPS Member Elected President of APA’s Women’s Caucus Maureen Sayres Van Niel, MD, a member of MPS, was recently elected president of the National Women’s Caucus of the American Psychiatric Association for a two-year term. The caucus is a division of the APA Assembly and it represents the interests of the more than 13,000 women members of the APA. The caucus aims to address issues relevant to women members, including providing ideas to those at district branches who would like to offer special services for women members. If you have questions or ideas for national or local women’s programs, please contact Dr. Van Niel at [email protected] or the MPS CME Coordinator, Julie Kealey at [email protected]. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org SAVE ON YOUR APA/DB MEMBERSHIP DUES Looking for Ways to Save Time and Money on Your Membership Dues? Check Out These Ways to Save: Lump Sum Dues—Pay a one-time amount for APA national dues for your lifetime. Never worry about annual renewal increases or invoices again. DB/SA dues continue to be billed annually. Scheduled Payment Plan—Have your APA and District Branch dues automatically charged to your credit card in monthly, quarterly, biannual, or annual installments. No interest or service fees. Couples Discount—If you are married to another APA member (or live in the same household), share your print copy of AJP and you’ll each get a 15% discount on your APA national dues. Ready to Start Saving? Contact APA Member Services for more information and to sign up. 781-237-8100 Call: 703-907-7300; 888-35-PSYCH Email: [email protected] Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org www.psychiatry-mps.org MPS Bulletin - February 2016 10 BUSINESS SERVICES BUSINESS SERVICES Hea SPECIALIZED CREDENTIALING SERVICES MEDICAL CREDENTIALING SPECIALISTS LEGAL ADVICE FOR PSYCHIATRISTS Milton L. Kerstein, Esq. Andrew L. Hyams, Esq. Mr. Hyams, former General Counsel to the Bd. of Reg. in Medicine, and Mr. Kerstein provide legal services to psychiatrists and other health professionals in the following areas: • Licensing Board Complaints and Applications • Medicare/Medicaid Audits • Patient Confidentiality • Provider and Employer Contracts • Civil/Criminal Litigation As a service to Bulletin readers, we offer one free 15-minute consultation to discuss any general legal concerns. Kerstein, Coren & Lichtenstein, LLP 60 Walnut Street, Wellesley, MA 02481 www.KCLwww.KCL-law.com 969--7139 (617) 969 SPECIALIZED BILLING SERVICES PSYCHIATRIC BILLING SPECIALISTS ♦ EXCELLENT COLLECTION RATES ♦ UNDERSTANDABLE REPORTING AND MANAGEMENT TOOLS ♦ STATE-OF-THE ART BILLING SOFTWARE ♦ BANKING SERVICES ♦ CREDENTIALING CONSULTATION AND ASSISTANCE ♦ CUSTOMER SERVICE, CUSTOMER SERVICE, CUSTOMER SERVICE !! Practice Medicine and We’ll Do the Rest. Call us for more information at (617) 244-3322 Ask about our discount program www.specializedbillingservices.com THE DEADLINE FOR THE DEADLINE FORTHE THE JANUARY 2014 MPS NEWSLETTER IS MARCH 2016 MPS NEWSLETTER IS DECEMBER 15, 2013. FEBRUARY 15,ADVERTISING 2016. FOR FOR ADDITIONAL ADDITIONAL ADVERTISING INFORMATION, PLEASE CONTACT THE INFORMATION, PLEASE CONTACT MPS OFFICE AT: (781) 237-8100 THE MPS OFFICE AT (781) 237-8100 OR OR [email protected] [email protected] • PROVIDER CREDENTIALING • APPLICATION PROCESS Billing Specialists, AND Inc. • Healthcare HEALTH PLAN ENROLLMENT LINKAGE Providing Billing Services to the Mental Health Community • NPI AND PROVIDER NUMBERS • NATIONAL AND MULTI-STATE Billing. . . SERVICES • CAQH REGISTRY It’s what MAINTENANCE we do. • STATE OF THE ART SOFTWARE Every mental health professional needs Please call us to discuss feea great arrangements. Credentialing Services are priced billing service. For over 15either by application or on a monthly flat fee basis Billing dependingyears, on the Healthcare scope of services requested. Specialists has been IN ADDITION TO OUR CREDENTIALING exceptional SERVICES,providing WE OFFER MEDICAL BILLING SERVICES TO to PHYSICIANS, HOSPITALS, service over 100 practices GROUP PRACTICES, CLINICS, ETC. in Massachusetts. FOR CLIENTS WHO PURCHASE OUR MEDICAL BILLING SERVICES, WE OFFER CREDENTIALING AS PART OF Contact us for more information! THAT PACKAGE. Office: (781) 784-4123 (781) 784-0996 PRACTICE Fax: MEDICINE, WE DO THE REST. Email: [email protected] CALL US FOR MORE INFORMATION Web: www.hcbilling.com AT (617) 244-3322 SPECIALIZED CREDENTIALING SERVICES www.sbscincorporated.com/ MEDICAL CREDENTIALING SPECIALISTS ♦ PROVIDER CREDENTIALING OFFICE SPACE ♦ APPLICATION PROCESS ♦ HEALTH PLAN ENROLLMENT AND Boston,LINKAGE Back Bay. Several offices for sublet in prestigious psych/med building on ♦ NPI AND PROVIDER NUMBERS Marlborough Street near Public Gardens. ♦ NATIONAL AND MULTI-STATE Whole and half days. All with beautiful SERVICES detailing, fireplaces and high ceilings. Col♦ atmosphere. CAQH REGISTRY MAINTENANCE legial $300-350/day/month. Contact: [email protected] ♦ STATE OF THE ART SOFTWARE Please call us to discuss fee arrangements. Credentialing Services are priced either by application PSYCHIATRIST or on a monthly flat fee basis depending on the scope of services requested. IN ADDITION TO OUR CREDENTIALING Cambridge Psychiatric Services SERVICES, WE OFFER MEDICALin BILLING PSYCHIATRISTS: Interested flexible SERVICES TO PHYSICIANS, hours, competitive pay rates, andHOSPITALS, a schedule GROUP PRACTICES, CLINICS, ETC. FOR that fits your needs? CLIENTS WHO PURCHASE OUR MEDICAL Qualified psychiatristsWEneeded provide BILLING SERVICES, OFFERtoCREDENovernight, weekend, holiday moonlightTIALING AS PART OFand THAT PACKAGE. ing coverage at area hospitals, clinics, and othMEDICINE, THEinformation REST. erPRACTICE psychiatric facilities.WE ForDO more please call Jessica D’Angio at (617)864-7452 US FOR MORE INFORMATION AT orCALL at [email protected] (617) 244244-3322 STAFFwww.sbscincorporated.com/ PSYCHIATRIST POSTIONS. Full and part-time positions are available for ADULT PSYCHIATRISTS in our outpatient OF clinicsFI in Framingham, Marlboro C E SPACE and satellites. Advocates is a full-service, non-profit system serving individuals with Brookline: and developmental disabilities psychiatric Attractive, comfortable, reasonably priced and other challenges in quiet, a strength-based, 3 suite office nearand Coolidge Corner has opening person-centered multi-disciplinary for a fullExcellent time or physicians two 1/2 time setting. areclinicians honored, as of January 2014.a warm, Street friendly parking practice and nearenT. Call and we offer Jim Harburger MD, is617-232-3822 vironment. Compensation competitive or email [email protected] and benefits are available for 30 hours +. Contact in confidence Chris Gordon, MD, Medical Director at 508.628.6652 or at [email protected] PSYCHIATRISTS ATTENDING PSYCHIATRIST Tewksbury Hospital is looking for a full time Tewksbury Hospital The is a Joint Commisinpatient psychiatrist. position is on a DMH sion accredited Department of Public intermediate care unit working with a wide varieHealth hospital located 23 milesmental ty of patients with severe about and persistent north Boston, MA near the intersecillness.ofNo managed care or after-hours on-call. tion of Interstates 495 and 93. Median LOS about 200 days. Competitive com- pensation. WorkChoices with an excellent and personaTwo Life Style ble group of psychiatrists. 1. Salary: $210,000 base for board cerFor information contact: tified psychiatrist with 1-2 overnight call shifts per month. Anthony Vagnucci, MD Recent salary increases, generousTewksbury signing bonus, Chief of Psychiatry, Hospitalexcellent fringe x2863 benefits, generous allow978-851-7321 ance for license and board certification [email protected] fees, CME fees and 6 weeks leave time for full or part time psychiatrists. You STAFF PSYCHIATRIST POSTIONS. Full will work on a DMH intermediate care and part-time positions are available ADULT unit where you can treat people for with PSYCHIATRISTS in our outpatient clinics chronic persistent mental illness with in Framingham, satellites. Advocates both therapy Marlboro as well asand medication due Incthe is median a full-service, non-profit system to 200 days LOS. Work withserving individuals andgroup developmental an excellentwith andpsychiatric personable of disabilities and other challenges in a strengthpsychiatrists. based, person-centered and multi-disciplinary 2. Salary: $185,350 same as withand we setting. Excellent physicians areabove honored, no overnight/weekend call. environment. offer a warm, friendlyonpractice Fax: 781-464-4896 7 ASK PHS - A Doctor I Am Treating Cannot Stop Drinking Steve Adelman, MD – PHS Director Question from a Central Massachusetts Psychiatrist: I’m a general psychiatrist (not an addiction psychiatrist) and I am concerned about a physician patient of mine who has a serious drinking problem. I’d like to refer him to PHS for an assessment. I think that he needs to connect up with other doctors in recovery and he would probably benefit from a long-term monitoring program. We have been working together for several years (weekly psychodynamic psychotherapy plus meds for dysthymia) and I am worried that a referral to PHS would somehow rupture our longstanding, positive therapeutic relationship because I am not an addiction psychiatrist and PHS has reputation for referring its clients to experts. I am also worried about jeopardizing this physician’s medical license. Help! The purpose of our recommendations is to help the physician overcome his or her challenges in an enduring and lasting fashion, such that a substance use disorder or other significant health challenge does not jeopardize the health and well-being of both the physician and his or her patients. Although PHS sometimes (but not always) recommends specialized treatment programs and providers, we are very respectful of a physician’s longstanding treatment relationships, and we always do everything possible to strengthen and sustain ongoing treatment relationships in a collaborative fashion. The best way to learn about PHS is to contact us whenever you have relevant questions and concerns. Please feel free to draw on our specialized experience and knowledge whenever you are Answer: When physicians with serious drinking problems cannot treating physicians with challenges that have the potential to sidestop drinking either on their own, or with the help of an outpatient line them and sabotage their careers. psychiatrist, it is typically only a matter of time before the drinking progresses to the point where it begins to interfere with the doctor’s ability to practice medicine. It is of critical importance to I invite you to email me your questions about PHS. Please do the physician, as well as to his patients, colleagues and loved ones, not send me any information about an identifiable physician colthat he stop drinking before alcohol begins impeding his ability to league or patient. If your question is of general interest, we may deliver good medical care. Once active substance mis-use inter- answer it here in this column. Otherwise, I will respond to your feres with a doctor’s performance at work, a cascade of adverse email individually. I can be reached at [email protected] or at events may be set in motion, jeopardizing patient safety as well as 781-434-7404. the physician’s professional viability. -----------------------------------------------------------------------------This situation furnishes you with an opportunity to assist your doctor-patient by collaborating with PHS. The first step is to con- Physician Health Services (PHS) is a nonprofit corporation of the tact PHS to describe the situation at hand. At the time of that Massachusetts Medical Society, that provides a safe, confidential phone call, we will tell you about our referral, intake and assess- environment designed to help identify, refer to treatment, guide ment processes. There is no need for you to identify the physician and monitor the recovery of physicians and medical students with at the time of this initial phone call. The goal of the phone call is health concerns. acquaint you with what we do, and to help you assist your patient by making the case that specialized help is available for him or her at Physician Health Services. What kind of help is available to this physician at PHS? A Compensation is competitive and benefits Contact Anthony Vagnucci, MD, are range of possibilities exists, and PHS will work with this phyavailable of for 20Psychiatry, hours +. Chief Tewksbury sician, should he or she choose to make use of our services, to Hospital, 978-851-7321 x2863, explore a variety of options. At the very least, the physician may Are you Contact in confidence Chris Gordon, MD, Medi [email protected] contact PHS anonymously and hear directly about our confidencal Director at 508.628.6652 or at eligible tial physician support groups. We will also describe what might [email protected]. Tewksbury Hospital unfold at PHS should he or she choose to come in for an intake and interested appointment. at the Delaney House in Holyoke, Dr. Ben Liptzin will present Half-time Psychiatrist (20 hours per Cambridge Psychiatric Services week) in applying for PSYCHIATRISTS: Excellent salary and fringe benefits, We This talk discussdesires the potential will schedule an intake appointment if thewill physician signing bonus and generous leave time an in-person and is willing to identify himself or herself. roles for psychiatrists asmeeting Accountable Care Organizations develop as a result of Fellow Interested in flexible hours, competitive pay for half-time psychiatrists. Positions Knowing the name of the doctor simply helpscare us keep trackallofover the rates, and a schedule that fits your needs? the Accountable Care Act which is stimulating health reform available on a DMH intermediate or things. Once the physician has identified himself or herself,risk PHSby caring organizations will be expected to take on financial care unit psychiatrists working with a wide variety over- country. These Qualified needed to provide works for and with the physician. Nothing about this physician with a fixedoutward, amountwithout of money. It is expected that psychiatric of patients with persistentcover- for a population Distinguished night, weekend, andsevere holidayand moonlighting is communicated the express written consent of mental illness areclinics, available. bephysician. integratedA common into primary care using a variety of organizational age at area hospitals, and other No psychiat- services willthe misconception is that PHS is an arm of Fellow Status? managed care or after hours on-call. ric facilities. models. This willThis describe ways forWe practicing psychiatrists to learn more thetalk BRM. is not the case. are a confidential, peer review Median LOS about 200 days. Work programinand we local aim to assist physicians before they come to the about these models their service area. For more information call group with an excellent and please personable attention of the BRM. Jessica D’Angio at 617-864-7452 of psychiatrists. Contact Anthony We will host a reception starting at 6 with dinner being served at 6:30PM. The Contact the MPS Office. or at [email protected] Vagnucci, MD, Chief of Psychiatry, program will If start 7:30 PM. The comes Massachusetts Society designates youratphysician-patient to PHS forPsychiatric an intake appointment, Tewksbury Hospital, 978-851-7321 we will written communicate you. TM When Category with 1 Credit . Physicians for arequest maximum ofconsent 1 AMAtoPRA Adult psychiatrist for part or full time. Private this live activity x2863, [email protected] provide us with consentwith to check in withofclinicians and only the credit commensurate the extent their participation in Group Practice of MD’s & PhD’s. CBT exclu- should claimphysicians We would be glad to assist you others who may provide us with information that helps usbytothe detersively. Services needed include diagnostics and the activity. The BC/BE Psychiatrist for University Massachusetts Psychiatric Society is accredited Massachu mine the nature and severity of the problem, we use this additional Hospital Outpatient Clinic med management. in completing your application. setts Medicalinformation Society to provide continuing medical education physicians. to formulate recommendations that are for intended to UMass Medical Contact: Memorial Peter W. Moran, Ph.D.Center/ Cornerstone assist thefor physician in overcoming the challenges at hand. With pay by University of Massachusetts the meal and the CME credits. You can either Behavioral Health, 469 Chandler Medical St., Worcester, The cost is $25.00 the physician’s permission, we will share our recommendations School Department of Psychiatry in MA 01602 or [email protected] check, cash or credit card on Wednesday night. with you. Massachusetts Psychiatric Society ♦ 40 Washington Street, Suite 201 ♦ Wellesley, MASociety 02481-1802 Massachusetts Psychiatric PO Box 549154 781-237-8100 ♦ Fax: 781-237-7625 ♦ Email: [email protected] ♦ [email protected] 781-237-8100 www.psychiatry-mps.org 9 Email: [email protected] Waltham, MA 02454-9154 www.psychiatry-mps.org 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org MPS Bulletin - February 2016 6 American Professional Agency, Inc. 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Candidates should have strong academic credentials and sound clinical skills, and interest in pursuing academic opportunities in either training or research. An academic appointment, commensurate with experience, is available. Interested applicants (J-1 and H-1B candidates are welcome to apply) are encouraged to submit CVs and letters of interest to: [email protected] The Department of Psychiatry at UMass Memorial Health Care is currently seeking a full time BC/BE Attending Psychiatrist to join the team on the 27 bed adult inpatient unit at UMass Memorial Medical Center, the academic teaching hospital and clinical partner of the University of Massachusetts Medical School. Primary duties involve direct clinical care and support of the academic mission of the Department and the Medical Center including educational responsibilities and the opportunity to participate in research. The position provides the opportunity for involvement in a full range of clinical and academic pursuits. A faculty appointment, commensurate with experience, is also available. Come join Dr. Alan Brown, Vice Chairman of Clinical Services, Dr. Douglas Ziedonis, Department Chair, and other prominent members of the Psychiatry Department in their ongoing pursuit of clinical and academic excellence. Interested candidates (J-1 and H-1B candidates are welcome to apply) should submit CVs and Letter of Intent to [email protected], Attention: Kathleen Anderson. Candidates are also encouraged to visit the Psychiatry Department’s website at: www.umassmed. edu/psychiatry. Behavioral Health Clinic Available Clinic consultant for hire to establish outpatient Behavioral health practice or clinic for 11 Children, Adolescents, Adults. Experienced with all clinic regs, Licensure, Joint Commission, BCBS, etc. Available To set up entire practice with systems, from policies And procedures to billing and accounting. Please call Business Behavioral Health Network at 781-762-1419 Exciting opportunity for part-time substance abuse/mental health practice in NORTH CONWAY, NH. Skiing, hiking, biking, nature’s playground. Flexible schedule, $140/hr. with guarantee of 6 hours/day. Will need Suboxone certification. Also could have FULL-TIME private practice in same office to do general mental health. Currently 2-3 month waiting list for adult and child psychiatry services so market is wide open. PathwaysforBetterLiving.com, 603-356-3400. Family and Community Resources, Inc. FCR seeks licensed, board certified psychiatrist Family and Community Resources, Inc., a small non-profit trauma and domestic violence focused mental health center is in need of a P/T Psychiatrist/Medical Director for 8 hrs/week. Responsible for providing patient diagnostics, medication management, staff training as well as clinic coordination in conjunction with the clinic director. Day(s) and hours flexible. Qualifications: Medical degree from an accredited school of medicine Licensed in psychiatry in the state of Massachusetts Board certified in Adult Psychiatry; Child Psychiatry a plus Location: Brockton, MA Please send CVs to: [email protected] w w w . A A C A P . O R G Boston Area Psychiatrist Reviewer – Consultant Come join a well-established and outstanding group of psychiatrists providing utilization management and case consultation in the Health and Medical Management division of Blue Cross Blue Shield of Massachusetts. Our model of utilization management is one of collegial, respectful and consultative interactions with psychiatrists, psychologists, social workers and other providers for promoting the efficient use of evidence-based practices. Blue Cross Blue Shield of Massachusetts is a highly successful HMO with a commitment to placing our members’ health first. With our coverage reaching over 2.7 million members and an increasing behavioral health concentration, we are seeking a physician reviewer to work part-time. We offer flexible hours and will consider individuals with post-training clinical experience and Board Certification in general psychiatry. Additional expertise and certification in addictions and or child/adolescent psychiatry are highly desirable. Interested parties are encouraged to apply on our website at: www.bluecrossma.com/careers or contact Heather Franey at: [email protected] Our commitment to building a diverse workplace is without question. We are an Equal Opportunity Employer. 781-237-8100 Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Child Psychiatrist Opportunity, Near Boston, MA North Shore Medical Center (NSMC) has an exciting opportunity for a child psychiatrist to join a thriving and growing psychiatric service in Salem, MA about 15 miles north of Boston. NSMC is part of the prestigious Partners HealthCare System, and the Department of Psychiatry is closely aligned with the Massachusetts General Hospital (MGH). The department provides a full spectrum of care, including adult inpatient psychiatry, an older adult inpatient unit, a child inpatient unit, a partial hospitalization program, and several outpatient clinics. Our department is also a hub for the Massachusetts Child Psychiatry Access Project (MCPAP), a grant supported outpatient consultation service for area pediatricians. We have a vibrant educational program, and teaching opportunities are available. Physicians in the department enjoy a collegial and supportive practice environment. Our department is presently engaged in creating a 120 bed “Center for Excellence” in collaboration with the MGH Department of Psychiatry, which will include an expansion of outpatient services as well. Physicians in the department can expect to be engaged and have input into the creation and design of this exciting new program. At present we have an opportunity for a Child Psychiatrist to join our group. There are opportunities for this to be an inpatient or outpatient position, depending on the appropriate candidate’s interest and experience, and matching this with Department needs. The call schedule is very reasonable and requires no in-house coverage. A clinical appointment at MGH and the potential for a Harvard Medical School appointment are available for the qualified candidate. Interested candidates should forward their CV to Louis Caligiuri, Director of Physician Services at [email protected]. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org 12 www.psychiatry-mps.org5 MPS Bulletin - February 2016 DEPARTMENT OF PSYCHIATRY – MASSACHUSETTS GENERAL HOSPITAL – HARVARD MEDICAL SCHOOL Health Information Technology (HIT) is a broad term that has a slightly different meaning for each MPS member. At this January’s inaugural meeting of the MPS HIT Committee, members each discussed what areas at the intersection of psychiatry and technology most interested them. The diversity of responses ranging from encrypted text messages to telepsychiatry, smartphone apps to electronic medical records, social media guidelines to sharing medical records was impressive. Such diversity points towards the challenges of HIT, but also the opportunity for MPS to provide members a forum to share, support, and learn about these various digital tools. ATTENDING POSITIONS AND HOSPITALIST/ BEHAVIORAL HEALTH INTEGRATION DEVELOPMENT PROGRAM The MGH Department of Psychiatry has outstanding attending opportunities in Emergency, Outpatient (General and Specialty), Addictions, ConsultLiaison, and Inpatient Psychiatry. In addition the department is pleased to announce a new Hospitalist/ Behavioral Health Integration Development Program preparing candidates for leadership roles in inpatient psychiatry and collaborative care in academic and community settings. Rated among the leading psychiatry departments by US News and World Report, the Department is committed to excellence in patient care, education, research and community service. Candidates should be: board certified/board eligible in Psychiatry and qualified for an academic appointment at Harvard Medical School at the rank of Instructor or above. Fellowship training in relevant areas including addiction, consult-liaison, neuropsychiatry, or geriatric psychiatry and a record of scholarly productivity are highly desirable. Interested individuals should apply to Jonathan E. Alpert MD PhD, Associate Chief of Psychiatry (jalpert@mgh. harvard.edu). The Massachusetts General Hospital is an affirmative action/equal opportunity employer. Minorities and women are strongly urged to apply. Update from the Health Information Technology Committee BAY COVE Human Services, Inc in Boston is looking for a Community Psychiatrist. The Community Psychiatrist will serve a diverse population of individuals in various community settings including the Michael J. Gill Mental Health and Wellness Clinic, Center House Day Treatment, and the Community Flexible Support (CBFS) system of care which serves Department of Mental Health (DMH) clients with serious mental illness. Qualified applicants may become Tufts faculty for the teaching of PGY III Tufts residents who rotate through Bay Cove for their Community Psychiatry rotation. 1520 hours; no call. For more information about this job opening, visit Baycove.org. Just as HIT covers many different areas of technology, it also connects many areas of healthcare and psychiatry. At our meeting questions arose about using electronic medical records for psychotherapy, smartphone apps in substance abuse, and telepsychiatry to consult with new patients. While a list of HIT tools and resources for psychiatry would be pages long, simply understanding that all these various technologies serve a common purpose of improving care is more important. In order to better learn what HIT means to MPS members, one initial role of the committee will be to conduct a survey of the membership. Surveying MPS members about use, concerns, and questions regarding technology will ensure that this new committee can be responsive and best help members. And in order to be most responsive, we will begin to fully utilize the MPS website, www.psychiatry-mps.org, and make it your destination for resources and answers. Another early project of the committee will be to develop guidelines to help in the evaluation of smartphone apps. While it may be currently impossible to create a rating scale that is guaranteed to always find the best app, following the right guidelines can help you avoid downloading digital snake oil. If there are any apps that you particularly like and find helpful, we would love to hear from you as we begin identify the common elements of good apps. Our next, and second, meeting will be on Thursday, February 25th. As always, we encourage all MPS members to attend regardless of experience with technology. In the meantime, be sure to visit the MPS website frequently for updates and the latest information. PSYCHIATRY POSITIONS Beth Israel Deaconess Medical Center in Boston, a 500+ bed tertiary care teaching hospital of Harvard Medical School, is recruiting staff psychiatrists for positions on the Consultation-Liaison Service and Inpatient Service. In addition, moonlighting opportunities are available on both services. The Department of Psychiatry is a major teaching site for Harvard Medical School and the Harvard Longwood Psychiatry Residency Training Program; positions will include opportunities for teaching medical students and residents. Underrepresented minorities are encouraged to apply. Harvard Medical School appointment at an appropriate rank is available. 1. STAFF PSYCHIATRIST ON THE INPATIENT PSYCHIATRY UNIT. This is a full-time position within the Department of Psychiatry that includes clinical care, teaching, and supervision on an active 25 bed inpatient teaching unit. 2. STAFF PSYCHIATRIST ON THE PSYCHIATRIC CONSULTATION SERVICE. This is a half-time position within the Department of Psychiatry that includes clinical care, teaching, and supervision on a busy service that sees 2200 Emergency Department and 1000 Inpatient Medical-Surgical consultations annually. Certification (or eligibility) in Psychosomatic Medicine is desirable. 3. ATTENDING PSYCHIATRISTS FOR WEEKEND AND HOLIDAY COVERAGE OF THE INPATIENT PSYCHIATRY UNIT AND THE PSYCHIATRIC CONSULTATION SERVICE. Must have a full license and be board-certified. Coverage includes morning rounds onsite and off-site telephone backup to the resident. Please send a letter of interest and CV to William Greenberg, MD, Chief of Psychiatry, by email: [email protected]. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Public Sector Inpatient Psychiatrist Unique opportunity at the Lemuel Shattuck Hospital for a full time inpatient psychiatrist to provide continuing care to Boston Metropolitan Area DMH patients within an urban public health general teaching hospital. Join an expert, collegial group of colleagues. Teaching and mentoring opportunities and academic appointment at Tufts potentially available. No weekend or night call. This is a State Block, union position. Contact Audrey GrahamSmith by fax 617-971-3195 to apply or Dr. Amy Lisser, Chief of Psychiatry Shattuck Hospital for further information 617-971-3177. An Equal Opportunity/Affirmative Action Employer. Females, minorities, veterans and persons with disabilities are strongly encouraged to apply. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org MPS Bulletin - February 2016 4 www.psychiatry-mps.org 13 (continued from page 2) mission oversees truthfulness in advertising. The legal category of “dietary supplement” is defined in the Dietary Supplement Health and Education Act of 1994 as “a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary ingredients: (A) a vitamin; (B) a mineral; (C) an herb or other botanical; (D) an amino acid; (E) a dietary substance for use by man to supplement the diet by increasing the total dietary intake; or (F) a concentrate, metabolite, constituent, extract, or combination of any ingredient described in clause (A), (B), (C), (D), or (E).” (https://ods.od.nih.gov/About/DSHEA_Wording.aspx). By law, supplement labeling “may not claim to diagnose, mitigate, treat, cure, or prevent a specific disease or class of diseases,” but a stroll through any natural food store or GMC will illustrate how intelligently manufacturers have dealt with this limitation. – German Commission E ( http://cms.herbalgram.org/ commissione/index.html) – American Herbal Pharmacopoeia ( http://www.herbal- ahp.org/order_online.htm) – American Botanical Council ( http://abc.herbalgram. org/site/PageServer) –ConsumerLab.com Liability also might be a concern when going off-book with treatment recommendations. In a nutshell, the liability issues are almost exactly the same for dietary supplements as for regular drugs. There must be a thorough diagnostic evaluation; there must be evidence behind the treatment recommendations; there must not be neglect of standard treatments; and there must be careful and well documented informed consent. The 1994 law was written to bring supplement regulation more in line with the standard for food than for drugs. But what happens when a “mineral,” “herb,” or “botanical” is actually as effective, or as dangerous, as a prescription drug? Not much. Like food, dietary supplements do not have to demonstrate any efficacy or safety prior to marketing, and can only be removed from the market if the FDA shoulders the burden of proof that the supplement is harmful. Ingredient amount and quality is not monitored as closely as with drugs, and dietary supplement manufacturers are allowed to keep the exact amounts of each ingredient in their preparations as proprietary information. Thus, we have a market where some plant-based medicines are regulated as food, and some as drugs. What supplements to recommend is in many ways beyond the scope of a short newsletter column. I will end, however, with a few suggestions, compliments of Dr. Barry Fogel: 1. Give huperzine A (200 micrograms QD or BID) to mitigate anticholinergic side effects of various prescription psychotropics. 2. Give methylfolate supplementation to people on lamotrigine, to mitigate executive dysfunction related to central effects of inhibited folate metabolism. 3. Give curcumin to people with atypical depression with somatic symptoms suggesting chronic inflammation – either alone or to augment SSRIs. Dr. Fogel sent me six articles on curcumin, and the evidence is indeed strong. Nevertheless – I have come to think that we should consider dietary supplements as part of our psychiatric tool kit. Although I have only been a doctor for 4.5 years and my board certification is as new as it gets, I have already experienced the intense frustration and helplessness of treating patients who just do not get better. This year, I have a supervisor, Dr. Barry Fogel, who is a bit of a Renaissance man. If I were to try to summarize his curriculum vitae, I would not do it justice, so I will simply state that he is a Harvard and Brigham affiliated neurologist and psychiatrist who teaches, does clinical work, writes books, and has started a few companies. Along with Dr. Donna Greenberg, he edited an enormous book published last year called “Psychiatric Care of the Medical Patient.” Kindle informs me that the typical time to read this 1,812 page book is 119 hours and 57 minutes. Needless to say, it is quite thorough, and it is extremely high quality writing. In supervision the past six months, Dr. Fogel has regularly been encouraging me to push boundaries in considering how to help patients. For instance, on his advice I ordered psychotropic pharmacogenomic testing for two of my patients, and it was surprisingly helpful. In sum, it seems that complimentary/alternative and traditional/ Western remedies are divided more by culture than science, and the division is getting outdated. I have come around from a rather anti-alternative medicine stance to carefully adding dietary supplements to the list of treatments I have to offer patients, and I have so far been pleasantly surprised at the amount and quality of research available to support some non-prescription remedies. If this article has piqued your interest in the topic of supplements, I recommend this chapter in Dr. Fogel’s book: Gerbarg, Patricia L. & Brown, Richard P. (2015). Therapeutic Nutrients, Herbs, and Hormones. In Fogel, Barry & Greenberg, Donna (Eds.), Psychiatric Care of the Medical Patient (chapter 28).. New York, NY: Oxford University Press. Dr. Fogel has opened my mind to the use of dietary supplements in psychiatry. However, safety has been my biggest concern in recommending any dietary supplements to my patients, even vitamins. Despite the limitations of government regulation in the United States, which is paltry compared to, say, Germany or Canada, there are several reliable resources for checking on the safety of specific supplements: – FDA website (www.fda.gov/Food/Dietary Supplements/ Alerts) – “Alerts and Advisories” section of the National Center for Complementary and Alternative medicine (www.nc cam.nih.gov/news/alerts) – Dietary Supplement Labels Database at The National Institute of Health National Library of Medicine (www. dietarysupplements.nlm.nih.gov/dietary) 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Boston University School of Medicine/Boston Medical Center Department of Psychiatry The Boston University School of Medicine/Boston Medical Center Department of Psychiatry seeking Child Adolescent Psychiatrist Child/Adolescent Psychiatrist: Full or part-time position for a dynamic program in the Division of Child and Adolescent Psychiatry. Responsibilities include patient care in the outpatient setting, clinical consultation to the pediatric emergency department and pediatric units, and teaching of residents, medical students and trainees in psychiatry, psychology, social work and mental health counseling. Opportunities are also available for research. This position could include leadership activities for the qualified applicant. The successful applicant will wish to participate in the shaping of a child-centered, family-focused, culturally competent, community-linked child psychiatry program targeted at the needs of Boston’s most vulnerable children. Applicants must be board eligible or certified in child and adolescent psychiatry. Boston Medical Center is a private, not-for-profit, 482 bed academic medical center serving a diverse, multicultural patient population. Boston Medical Center is the largest safety net hospital in New England and is dedicated to providing accessible health care. As the main teaching affiliate of Boston University School of Medicine, Boston Medical Center is devoted to training future generations of health care professionals. Interested applicants should send a letter detailing relevant experience and a current CV to Lisa Fortuna, MD, Medical Director, Child and Adolescent Psychiatry, c/o BU Psychiatry, 85 E. Newton Street, Suite 802, Boston, MA 02118 or by email to [email protected] Academic appointment is commensurate with experience. Salary is competitive and benefits are excellent. Boston University School of Medicine/Boston Medical Center is an equal opportunity/affirmative action employer. The Boston University Medical Center Community Psychiatry Fellowship The Boston University Medical Center Community Psychiatry Fellowship is a half-time clinical training experience to expand a fellow’s knowledge base of community psychiatry. The fellowship may be combined with a Master of Public Health from Boston University School of Public Health with tuition support. The program is designed with the interest of the fellow with rotations in many areas of public psychiatry including the Boston Emergency Service Team (urgent care, community based assessment, jail diversion, emergency psychiatry at Boston Medical Center), outpatient community services, intermediate care, policy development through DMH Central Office, and an elective. The goal of the fellowship is to develop leaders in community and public psychiatry. Eligibility Graduates or PGY4 residents from an ACGME accredited psychiatry residency program are eligible to apply to the fellowship. Applicants must possess a full or limited Massachusetts Medical License by the time the program commences in July. Application Process Please send a CV and cover letter addressed to David Henderson MD, Interim Program Director, Community Psychiatry Fellowship and Chair, Department of Psychiatry, c/o Joan Taglieri, 85 East Newton Street, Suite 802, Boston, MA 02118 or email to [email protected]. Boston University School of Medicine/Boston Medical Center is an equal opportunity/affirmative action employer. 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org 14 www.psychiatry-mps.org3 MPS Bulletin - February 2016 BC/BE Child and Adult Psychiatrists Needed In Our Affiliated Community Mental Health Centers Both full- and part-time physician leadership and staff physician opportunities are currently available in our community mental health center in Central MA. Medical Director Job Summary: The Medical Director is responsible for overall management of all medical matters for the North Suffolk Mental Health Association. Ensures continuous Quality Improvement of all Medical matters and standards for the Agency. Reports to the Chief Executive Director (CEO). Works closely with the Chief Operating Officer (COO), Director of Compliance and Quality Improvement, all Senior Managers, the Department of Mental Health Medical Director and the Massachusetts General Hospital Department of Psychiatry. POSITION REQUIREMENTS: Education and Experience Required: Five years of professional experience, current and valid registration as a physician under the Massachusetts Board of Registration in Medicine. Board Certified by the American Board of Psychiatry. License to practice medicine in the Commonwealth of Massachusetts; five years of clinical experience and prior demonstrated competency in management and administrative roles. Board certification in Psychiatry. Addictions experience required. Experience in community and public sector mental health required. Buprenorphine waiver preferred. Please contact : Jason Romano Phone: 617.912.7917 - Fax: 617.912.7971 [email protected] Community Healthlink (CHL) is a dynamic, multi-service organization committed to establishing, maintaining and restoring the dignity, well being and overall mental health of individuals and families in Central MA. It provides a wide range of services to individuals suffering from mental illness, developmental disabilities and substance abuse issues, including youth and family services, residential services, adult outpatient services, and homeless and inpatient services. CHL is staffed by a mission oriented, multi-disciplinary team of psychiatrists, psychologists, nurses, social workers and other dedicated health care providers all committed to providing comprehensive, high quality care. Come join the dedicated team of professionals at CHL and help make a difference in the lives of some of Central Massachusetts’ most challenged individuals and families. CHL psychiatrists receive competitive salaries and comprehensive benefits packages. Faculty appointments, commensurate with training and experience, are available as well, as is the opportunity to teach UMass Medical Students, Residents and Fellows. For additional information about CHL, please visit our website: www.communityhealthlink.org. Interested candidates (J-1 and H-1B candidates are welcome to apply) are encouraged to submit their CVs and letters of interest to: Kathy Anderson at: [email protected]. Arbour Hospital, Arbour-Fuller Hospital, and Pembroke Hospital have outstanding opportunities for (continued from page 1) themselves and often forego treatment or go out of network. 2. Disparate rates of denial. NAMI reports that mental health and substance abuse treatment is denied at twice the rate of medical and surgical treatments. The criteria for medical necessity are often arbitrary and opaque. Prior authorization is required for admission and treatment for mental health and substance abuse in ways without parallel in the medical and surgical realms. 3. Disparate pharmacy benefit management. Narrow formularies, in particular restricting antipsychotics, are combined with fail first or step therapy requirements and tier 3 copays to make it difficult or impossible for patients to receive essential psychiatric medications in a timely and affordable manner. The Problem of Enforcement Parity legislation has created a regulatory framework that is highly complex and requires heavy-duty data analysis. For MHPAEA a parity analysis involves six classifications (inpatient in network, inpatient out of network, outpatient in network, outpatient out of network, emergency care, and prescription drugs). Any type of financial or treatment limitation for mental health must apply to substantially all (defined as 2/3) medical and surgical benefits in that classification, and the level of the limitation can be no more restrictive than the predominant level (that applying to half or more of the medical and surgical benefits) in that classification. It is not feasible for a patient or provider to obtain and parse the data essential for a parity analysis. There has also been a fragmentation of responsibility for parity enforcement. If a parity complaint involves a fully insured group plan or an individual policy, patients or providers would go to the Massachusetts Department of Insurance; for MassHealth they would go to the MassHealth Customer Service; for a self-insured employer plan they would go to the United States Department of Labor. The US Department of Health and Human Services also has a share of the enforcement responsibility. To this end, MPS has been meeting with state and federal officials to raise our concerns and advocate more assertive and coordinated enforcement of parity. We have filed legislation to require transparency and establish a data clearinghouse. We have joined with other professional and consumer organizations in the Mental Health Parity Coalition to promote parity. We ask you to report to us specifics of disparities we can use to make the case with legislators and officials. Parity is closer, but we have work to do. In the face of such complexity and fragmentation, we need 1. disclosure and transparency of health Rohn S. Friedman, MD plan policies and decision-making, President, including clear descriptions of ben- Massachusetts Psychiatric Society efits, medical necessity criteria, prior authorization policies, and reasons for denials 2. public reporting of data, making information such as the number of physicians in each specialty in a plan’s network, the number of claims filed by each, the rates of denial and of outof-network claims for med-surg and MHSA services, and medical necessity criteria readily available 3. a central clearinghouse which can collect this data, have the expertise to do the necessary data analysis, and unite or coordinate the fragmented enforcers Inpatient Psychiatrists Arbour Health System provides a continuum of care that includes evaluation, crisis stabilization and treatment for children, adolescents and adults with mental illness, dual diagnosis and/or addiction disorders. All hospitals are accredited by The Joint Commission and licensed by the Massachusetts Department of Mental Health. www.arbourhealth.com Enjoy highly competitive compensation and benefits, a schedule that allows for work-life balance, and the stability of working for the largest private mental health system in Massachusetts. • Reasonable caseload • Weekday schedule with no call or weekend work required • Paid moonlighting available for additional compensation • A benefits package that includes: health and dental insurance, retirement savings with company match, paid time off including CME allowance Arbour Hospital is a 136-bed psychiatric hospital in the Jamaica Plain section of Boston. The hospital has inpatient units for adolescents and adults including a dedicated unit for substance abuse/dual diagnosis and a high intensity unit. The Quincy Center, a satellite of Arbour Hospital, has an adult psychiatric unit. The hospital also offers partial hospitalization programs, outpatient and community-based services. Arbour-Fuller Hospital is a 103-bed hospital in South Attleboro, Massachusetts. Inpatient units treat adolescents and adults. The hospital also has an adult inpatient intellectual disabilities specialty unit as well as an adult acute residential treatment program. The hospital also offers an adult partial hospitalization program and community-based services. Pembroke Hospital in Pembroke, Massachusetts, is a 120-bed psychiatric hospital with services include adolescent, adult and older adult inpatient as well as partial hospitalization programs for adolescents and adults. Inpatient and outpatient electro-convulsive therapy services are available. The hospital is currently recruiting for adult psychiatrists including those with addictions or geropsychiatry specialties. MPS IS PLEASED TO WELCOME THE FOLLOWING NEW MEMBERS General Member: Bibi Alamiri, MD Jon Wesley Boyd, MD David John Dybdal, MD David Fish, MD Uma Naidoo, MD James Mathew Recht, MD Steven Schlozman, MD Resident Fellow Member: Mitchell Crawford, MD David Sturman, MD Anna Weissman, MD Transfer In: Yadira Alonso, MD Teresita G. Balderas, MD Kara Brown, MD Michelle Chaney, MD Amber Frank, MD Stephanie Hernandez, DO Marcela V. Horvitz-Lennon, MD For more information on these or other openings, contact the Office of Physician Recruitment by phone: 617-390-1224, or e-mail: [email protected] 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org www.psychiatry-mps.org15 MPS Bulletin - February 2016 PO Box 549154 Waltham, MA 02454-9154 Phone: 781-237-8100 Fax: 781-464-4896 www.psychiatry-mps.org RESIDENT FELLOW MEMBER CORNER Rebecca Mae Allen, M.D., MPH Rohn S. Friedman, M.D. President Mark J. Hauser, M.D. President-Elect Gregory G. Harris, M.D., MPH Immediate Past-President Siu Ping Chin Feman, M.D. Secretary Bruce Black, M.D. Treasurer Gary Chinman, M.D. Sr. APA Representative 2015-2016 Patrick Aquino, M.D. APA Representative 2015-2016 John Bradley, M.D. APA Representative 2015-2016 Michelle Durham, M.D., MPH APA Representative 2015-2017 Marshall Forstein, M.D. APA Representative 2014-2017 Siu Ping Chin Feman, M.D. 2015-2018 Astrid Derosiers, M.D. 2014—2017 David Gitlin, M.D. 2014-2017 Eran D. Metzger, M.D. 2015-2018 Arthur Papas, M.D. 2013-2016 Pedro Politzer, M.D. 2014-2016 RESIDENT FELLOW MEMBERS Rebecca Mae Allen, M.D., MPH 2015-2017 Marc A. Whaley, M.D. President Donald A. Smith, M.D. President M. Cornelia Cremens, M.D., MPH Lynda Layer, CAE Administrative Director Mayuri Patel Coordinator, Member Relations Julie Kealey Continuing Medical Education Coordinator Complimenting the Alternatives (or, Think- also a reality of the world in which we practice. ing Differently About Supplements) An early experience in my pre-medical years hit this point home. I visited a clinic in Ecuador As long as we choose treatments with good which was lauded at the time as a successful inscientific evidence, it is illogical and does our tegrative medical setting. It was largely funded patients a disservice to limit our recommenda- by US money. The menu – and yes, it was a tions based on preconceived notions of what is menu, on a board with names of treatments and a drug. But, I have approached the subject of prices – was divided into two halves: Western dietary supplements warily. and traditional. The halves were equal in length with similar prices, most set at around a week’s To start, I must admit that I am not a fan of the wages for a typical lower middle class resident labels “integrative,” “alternative,” or “compli- of the region. I sat in on two traditional medimentary” medicine. These terms imply one of cine sessions. The first was fairly benign. The two things: (1) there is not enough evidence to practitioner had a dimly lit small office filled support the use of the treatment in mainstream with herbs, some of which she chewed in a medicine, or (2) medical doctors are too closed- complicated procedure involving chanting and, minded to use the treatment despite strong evi- as a finale, she sprayed a fine mist of herbaldence of efficacy, necessitating naturopathic ized spittle at the patient. The second was, to and other “alternative” practitioners to pick me, horrifying. A middle aged woman came in up the slack. Both implications are equally with her family, and the practitioner sat her on a problematic. I do not want to be prescribing a chair in the center of a large, sparse room with medication that has not been adequately stud- a tile floor. He took a live guinea pig, held it ied, and I also do not want to believe that a just under its head, and began walking around well-supported treatment would be rejected by the woman in the chair, shaking the guinea pig “Western medicine” just because it is perceived vigorously while intoning words. The guinea to be from a certain category (natural? herbal?). pig squealed in terror, but in a minute its neck Of course, like all medical traditions, “Western snapped, at which point the practitioner pulled medicine” has a long history of using remedies over a utilitarian plastic bucket and began cutfrom plants. I’m sure everyone reading this ting the skin off the guinea pig, making a show will be able to think of an example, but here are of examining the animal’s body carefully while two: aspirin is an archetypal tree-based medi- asking the patient a very normal set of questions cine, originally used in ancient Egypt and now to get a history of presenting illness. He later solidly in the realm of the mainstream, and opi- explained to me that he used the blood clotting um is from poppies, first cultivated in ancient in the corpse as clues to the location of the paMesopotamia. Likewise, I think it is a problem tient’s malady. He told her she had a liver probof lack of education and misleading marketing lem and sent her for a blood draw. Naturally, I when certain chemicals are labeled as “natural,” did not leave that clinic with a very positive imwith the implication that they are somehow in- pression of alternative treatments. The kicker? trinsically safe (especially with rounded green Every practitioner in that clinic, Western or trafont and leaf-shapes slipped into the lettering). ditional in label, wore thigh-length white coats. Again, examples abound of dangerous “natural” chemicals, but I think about the “natural” I am honestly not sure, these days, where the poisons arsenic, cyanide, and botulism toxin. I line is drawn between complimentary/alternacringe at the word “natural” when considering tive and traditional/Western. Diet advice from the history of medicine, particularly the “natu- MD’s (Mediterranean, plant-based, etc) and ral” rate of death from childbirth and the “natu- referrals to nutritionists are common. Vitamin ral” amount of pain people used to suffer from B12 levels are a standard part of a depression chronic, relatively minor injuries and illnesses, workup. Melatonin is utilized by primary care like infections and tooth decay. Historical lists physicians and sleep specialists alike (and I preof causes of death are morbidly fascinating scribe it often). It seems that more and more (see:http://thesocietypages.org/socimag- dietary supplements have made their way into es/2012/06/25/historical-changes-in-causes-of- standard, mainstream practice, with strong evideath/). dence behind them, like folic acid, omega-3 and -6 fatty acids, and DHA. In the meantime, the The division between Western/mainstream/ law has not caught up. In theory, the FDA monstandard and complimentary/alternative is arbi- itors the safety and labeling accuracy of dietary trary, and in my opinion highly faulty, but it is supplements, and the US Federal Trade Com- Lahey Health Behavioral Services | Lahey Hospital & Medical Center Exciting Opportunities For Psychiatrists Lahey Health Behavioral Services provides comprehensive mental health services in more than 30 locations throughout Eastern Massachusetts. Our behavioral health model promotes the delivery of care in the community setting, closely integrating behavioral health with services provided throughout the Lahey Health system, which includes a tertiary hospital and medical center, multiple community hospitals, and vast networks of primary, senior and home care services. With a broad range of programs, including inpatient and outpatient services, we have opportunities that match your professional interests and offer room for growth. Join our team and be a part of a new model of behavioral health care in Massachusetts! Opportunities Full-time and Part-time Psychiatrists, Adult Outpatient and Addiction Services We are seeking BE/BC psychiatrists interested in joining our team of fulland part-time providers. Providers in outpatient settings provide individual assessments, family interventions and individual/group psychopharmacological treatment. They consult with PCPs, pediatricians, schools and other behavioral health and human services providers, as well as provide supervision to nurse practitioners. Opportunities also exist for psychiatrists with addiction treatment expertise to provide direct patient care in both inpatient and outpatient addiction treatment settings. Ideal candidates will be fellowship trained in addiction psychiatry, but other medical specialties with addictions experience will be considered. Full-time Psychiatrist, Adult Inpatient BayRidge Hospital; Lynn, Massachusetts We are seeking a full-time BE/BC psychiatrist for the admission unit who will primarily work up newly admitted patients with no responsibility for ongoing patient care. This Monday-Friday position offers predictable hours and no required night call. Full-time Psychiatrists, Adult Outpatient Lahey Hospital & Medical Center; Burlington, Massachusetts We are seeking candidates for our outpatient adult practice, with consultation-liaison service responsibilities as well. The Department of Psychiatry includes a strong multi-disciplinary team of psychiatrists, clinical psychologists, clinical nurse specialists and licensed clinical social workers. Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Beverly Hospital; Beverly Massachusetts We are seeking candidates for Medical Director of our Beverly Hospital site, which includes an 18-bed medically oriented inpatient unit, consultation liaison service and a partial hospital program at a 200+-bed hospital that is ranked among the top 100 hospitals by Truven Health. Clinical duties will be primarily on consultation liaison service. Candidates must be board certified with more than five years’ experience. Consultative liaison fellowship training is a plus. Moonlighting Opportunities Lucrative night and weekend psychiatric call opportunities are available at BayRidge, Beverly and Addison Gilbert Hospitals. For consideration or more information contact: Kate Schnabel, Senior Physician Recruiter, Lahey Health • 781.744.5193 • [email protected] Learn more at LaheyHealth.org/Careers (continued on page 4) 781-237-8100 Medical Director, Beverly Hospital Psychiatry 781-237-8100 Massachusetts Psychiatric Society PO Box 549154 Waltham, MA 02454-9154 Fax: 781-464-4896 Email: [email protected] www.psychiatry-mps.org Committee for Women MASSACHUSETTS PSYCHIATRIC SOCIETY PO Box 549154 Waltham, MA 02454-9154 ADDRESS SERVICE REQUESTED Issue 139 November/December 2013 Issue 139 November/December 2013 Issue February 2016 Issue 139160 November/December 2013 www.psychiatry-mps.org FROM THE PRESIDENT Membership: Joining in! Membership: Joining Joining in! and Parity: Are We Getting Closer? Coverage in! Membership: What does a professional society provide to its overlapped. One of the more exciting develop- MPS Calendar of Events November 15, 2013 at 12:00 NOON at MPS Rohn S. Friedman, MD MPS Calendar of Events [email protected] SEMPS - Risk Management w/Jim Hilliard February 3, 2016 at 6:00 PM at Alberto’s, 360 Main Street, Hyannis MA [email protected] Chairs and Council February 9, 2016 at 6:30 PM at MMS - Berkshire 1st Floor [email protected] Awards Committee February 10, 2016 at 7:00 PM at MMS - Middlesex West 3st Floor [email protected] Healthcare Systems and Finance February 16, 2016 at 6:30 PM at MMS - Middlesex 2st Floor [email protected] WMPS - “Can Examination of (Haitian) Vodou in Different Light Open Doors of Potential Collaboration Long Closed in The Mental Health Field?” w/Jennifer Severe, MD February 17, 2016 at 6:00 PM at Delaney House, Holyoke MA [email protected] Executive Committee February 23, 2016 at 6:30 PM at MMS - Middlesex Central 2st Floor [email protected] Health Information Technology Committee February 25, 2016 at 6:30 PM at MMS - Room TBD [email protected] Council March 8, 2016 at 6:30 PM at MMS - Charles River 1st Floor [email protected] 2016 Risk Avoidance and Risk Management Update March 12, 2016 from 8:30 AM to 3:30 PM at MMS [email protected] Healthcare Systems and Finance March 15, 2016 at 6:30 PM at MMS - Middlesex 2st Floor [email protected] Public Sector Committee March 17, 2016 at 7:00 PM at MMS - Room TBD [email protected] Executive Committee March 22, 2016 at 6:30 PM at MMS - Middlesex Central 2st Floor [email protected] members? question seems onto the What does aour professional societysimple provide its One ofaThis major priorities at MPS has What does professional society provide to its surface, but in depth is complex. Among the members? This question seems simple on been improving access to simple necessary psymembers? This question seems on the many benefits ofdepth being ispart of a vibrant surface, but treatment. complex. Among the chiatric Insurance is organicentral surface, but inin depth is complex. Among the zation like the Massachusetts Psychiatric Society many benefits of being part of a vibrant organito benefits access. ofInbeing the past tooa many many part of vibrantindividuorganiand twotheChapters the Psychiatric opportunity to had be zation like Massachusetts Society alsitslike either had no is health insuranceSociety or zation the Massachusetts Psychiatric with colleagues with shared interest, to network, and its two Chapters is the opportunity to be that did is notthecover mental tohealth and policies its two Chapters opportunity be to mentor and/orwith beabuse mentored, and to to network, make a with colleagues shared interest, and substance (MHSA) or covered with colleagues with shared interest, to network, difference in ourseparate profession. All of these werea mentorwith and/or be mentored, mentored, and torestrictive make them and more toto mentor and/or be and to make a Chairs and Counevident at the September 10thmaximums, difference our profession. All of these were annual lifetime levels difference ininand our profession. th All of these were cil Meeting as Chairs of Groups and Chairs andCounCounevident at the September 10thInterest of copayment, maximum inpatient days Chairs and evident at the September 10 Committees and their Member-in-Training cil Meeting as Chairs of Interest Groups and outpatient visits, and prior authorizacil and Meeting as Chairs of Interest Groups and (MIT) met tothe give andtwo listen Committees and their theirOver Member-in-Training tionCo-Chairs/Leaders requirements. last deCommittees and Member-in-Training to the vastly variedtheand important work the (MIT) Co-Chairs/Leaders metand give andof listen cades at both state national level, (MIT) Co-Chairs/Leaders met totogive and listen MPS interest groups andimportant committees. addito the the vastly varied and important work of the there have beenand serious efforts toInaddress to vastly varied work of the tion, I had the honor of attending meetings of MPS interest groups and committees. In additheinterest absence andand disparities in In coverage MPS groups committees. addiour two Chapter, Southeastern Massachusetts tion, I had the honor of attending meetings of for mental health and substance abuse. tion, I had the honor of attending meetings of Chapter and Western Massachusetts Chapter our two two Chapter, Chapter, Southeastern Massachusetts our Southeastern Massachusetts where I was meet with leaders and memChapter andable Western Massachusetts Chapter Milestones intothe Battle Chapter and Western Massachusetts Chapter bers ofI the to learn ofleaders their interests. where wasChapters abletotomeet meet andmemmem-I Massachusetts was awith leader in and mandating where I was able with leaders will report to all members the vibrant and excit-as bers of the Chapters to learn of their interests. coverage as early berssome of themental Chaptershealth to learn of their interests. II ing opportunities for members to not and only pay will report to all members the vibrant excit2000 and in establishing universal healthwill report to all members the vibrant and excittheir dues, to join in. ingcare opportunities for members members to not not only envipay in but 2006, but most of to the current ing opportunities for only pay their dues, but to join in. ronment flows from federal legislation. their dues,Groups but to join Interest and in. most Committees are openIn 1996 the Mental Health Parity Act (MHPA) to all members. Going forward, we plan use Interest Groups and and most Committees areto open Interest Groups most Committees are open mandated that aggregate lifetime and annuour newsletter asGoing a forum for Interest Groups to all members. forward, we plan to use to all members. Going forward,health we plan tophysiuse alCommittees dollar limits forforum mental andGroups and the with our newsletter newsletter as astoaaprovide formembership Interest Groups our forum for Interest cal health not differ. Although the information andcould current events with all Chairs or andCommittees Committees provide themembership membership with and totoprovide the with MHPA writing did not cover many plans, did not a designee a brief annual column. These information and current events with all Chairs information and current events with allnot Chairs oror apply towriting substance abuse, did require new columns will agive the membership an opa designee brief annual column. These a designee writing amental brief annual column. These coverage health, and Interest did not portunity to for learn about our varied new columns columns will give give the membership membership an opopnew will the an address issues like authorization requireGroups meet their portunityand to Committees learn about about that our may varied Interest portunity to learn our varied Interest mentsor orspark copays, it wasand an will opening salvo interest curiosity complement Groups and Committees that may meet theirin Groups and Committees that may in meet their the effort to reduce disparities the coverthe list of meetingsand thatwill are complement on the back interest orongoing spark curiosity curiosity interest or spark and will complement age mental illness. page of of ourongoing newsletter. the list of meetings that are onthe theback back the list of ongoing meetings that are on pageof ofour ournewsletter. newsletter. page 1999 and President the FedTheInChairs CouncilClinton Meetingordered was a large and Employee Health Benefits (FEHB) interactive group with Chairs connecting with Theeral Chairs and Council Meeting wasaalarge large and The Chairs and Meeting was and Program toCouncil implement parity forinterests mental other Chairs noting where their interactive group with Chairs connecting with interactive group with Chairs connecting with other Chairs Chairs noting noting where where their their interests interests other professionally away from others in this small, yet vital work setting and for residents learn ments has theofrole of the MIT, an initiative professionally awayfrom from others thistosmall, small, overlapped. One themore more exciting develophealth andbeen substance abuse treatment, in- and the quantitative treatment limitations professionally away others ininthis overlapped. One of the exciting developabout working in college mental health. started under the Presidency of Marie Hobart. yet vital work setting and for residents to learn ments has been the role of the MIT, an initiative cluding andthetreatment limits, like burdened health yetvisit vitallimits work that setting and formental residents to learn ments has cost-sharing been the role of MIT, an initiative The MITunder program has for Marie more involveabout working incollege college mental health. started the Presidency Presidency of Hobart. over providing a model forallowed more of comprehensive physical illness, types of discriminaabout working in mental health. started under the Marie Hobart. ConsultationConsultation-Liaison Interest Group is involved ment ofand MIT, offered much mentoring and pro- tory TheMIT MIT program hasallowed allowed forcosts moredid involveparity demonstrating that not disparities that are straightforward and The program has for more involvein both educational and legislative activities. The Consultation-Liaison Interest Group involved Consultation fessional development, and is appreciated by the ConsultationConsultation -Liaison Interest Group isisinvolved ment of MIT, offered much mentoring and prorocket andoffered the sky did mentoring not fall. and pro- measurable. Current concerns have fo-interment of up MIT, much Group leaders continue to work with an in both educational and legislative activities. The Chairs have a MIT Co-Chair/Leader to cused fessionalwho development, andisis appreciatedby bythe the in both and legislative activities. The oneducational the more opaque nonquantitative fessional development, and appreciated disciplinary group of physicians to address the Group leaders continue to work with an interassist inwho developing programs. I will attempt to Group leaders continue to work with an interChairsMental have MIT Co-Chair/Leader Co-Chair/Leader The Health Parity and Addictions limitations (NQTL), including: Chairs who have aa MIT toto treatment ongoing problems patients boarded in the disciplinary group of physicians to address the give succinct summary of of the 2008 current activities group of physicians to address the assistainin developing programs. willattempt attempt Equity Act (MHPAEA) required assist developing programs. I Iwill toto disciplinary Emergency Departments across the Commonongoing problems of patients boarded in the of theaifsuccinct Committees and covered, Interest Groups. In an 1.ongoing problems of adequacy patients boarded in the give summary thecurrent current activities that MHSA were thereactivities could Disparate network (phantom give a succinct summary ofofthe wealth. Meetings gather C/L psychiatrists, PsyEmergency Departments across the CommonCommoneffort to conserve space and reading time, I will Emergency Departments across the of the Committees and Interest Groups. In an separate and deductibles and out-ofnetworks). Health plans must ofnot thebe Committees Interest Groups. In an chosomatic Medicine fellows, and provide residentsPsyto wealth. Meetings gather C/Lpsychiatrists, psychiatrists, list only the name of the group. Meetings gather C/L effort conserve space andreading reading time, will wealth. pocket and the plans had to comply patients a sufficient number ofPsy-to effort totolimits, conserve space and time, I Iwill network andwith to provide educational and profeschosomatic Medicine fellows, andresidents residents chosomatic Medicine fellows, and to list only the name of the group. with financial parity physicians in provide eachprograms. specialty; list only the name of the(equal group.copays, deductsional development Anetworks recent wellnetwork andtoto educational andprofesprofesSpecial Committees Interest network and provide educational and ibles) and treatmentand parity (bothGroups quantitamust development be comparable onmedical the Amed-surg attended program discussed marijuana. sional programs. recent wellSpecial Committees and Interest Groups Alcoholism and the Addictions Interest Group is sional programs. A have recent all welltively measurable limitations and development the MHSA sides. medical We Special Committeestreatment and Interest Groupslike attended program discussed marijuana. amaximum longstanding active group with meetAlcoholism and theAddictions Addictions Interest Group discussed medical marijuana. Disaster Readiness Committee is a ofwellnumber of visits or5 dinner maximum heardprogram from patients their experience Alcoholism and the Interest Group isis attended ings a year, each withgroup an educational program a longstanding active with 5 dinner meetorganized group that was vital in responding to Disaster Readiness Committee wellnumber of inpatient days and nonquantitagetting a provider list and then a longstanding active group with 5 dinner meetDisaster Readiness Committee isis maka a welland for networking and support. ingsopportunities a year, year, each each with an educational educational program the needs ofgroup ourofmembership and the community organized that was vital in responding tive limitations especially man-It organized ing dozens phone calls, only to find ings atreatment with an program group that was vital in responding toto is attended by, with good authorization, involvement andwell opportunities fornetworking networking andsupport. support.of, in the immediate aftermath of the the incorMarathon thethat needs ofcontact ourmembership membership and community aged care techniques of prior the information and opportunities for and ItIt the needs of our and theiscommunity and medical students. is well well attended by, withgood goodand involvement of, bombing thispsychiatrist past spring. in the immediate aftermath of the Marathon medical necessity criteria, formulary rect, the is not actually in isMIT attended by, with involvement of, in the immediate aftermath of the Marathon MITand andmedical medicalstudents. students. bombing thispast past spring. design). the network, the provider is not taking MIT bombing this spring. Child and Adolescent Psychiatry Interest Group Forensics Interest Group (formerly the Commitnew patients, the available aptee on Psychiatry and thenext Law) meetsthe periodicalForensics Interestor Group (formerly Commitis reorganizing and getting restarted with an Forensics Child andAdolescent Adolescent Psychiatry Interest Group (formerly the CommitInterest Group Child and Psychiatry Interest Group The Affordable Care Act (ACA) in 2010 pointment is in 6 weeks. Low rates of the ly toonaddress timely issues thatmeets may periodicalaffect teeon Psychiatry andthe theLaw) Law) increased interestand from MIT restarted and earlywith career is reorganizing reorganizing getting an tee Psychiatry and meets periodicalisextended and getting restartedtowith an theThis parity requirements more not covering membership. One including recent issue dealt with lyreimbursement, to address timely issues that may affect the psychiatrists. group has many projects in ly increased interest from MIT and early career to address timely issues thatare may affect the increased interestbut from MITimportantly, and early career health plans, more theall certain E&M codes which proposed legislation about the covered process for membership. One recent issue dealt with development with planned meetings open to psychiatrists. This group has many projects in membership. Oneservices recent or issue dealtforwith psychiatrists. This has many projects in ACA aimed at group providing near-universal for med-surg paying involuntary hospitalization. note, the MIT proposed legislation aboutOf the process for members withwith interests in Child and Adolescent development planned meetings opentotoall all proposed legislation about the process for development withincluded planned meetings open coverage and mental health and those codes at a lower rate, as as MIT co-leader is ahospitalization. lawyer who adds to well the the group’s involuntary Of note, Psychiatry. members with interests in Child and Adolescent hospitalization. Of note, theareMIT members with interests in Child and Adolescent involuntary substance onerousis requirements discussion ofpaperwork co-leader aforensic lawyerissues. who addstotothe thegroup’s group’s Psychiatry. abuse coverage as one of the co-leader is a lawyer who adds Psychiatry. ten essential health benefits for individual among the reasons that mental health College Mental Health Interest Group is in its discussion of forensic issues. of forensic issues. Geriatrics Committee meets everyWhereas other month and small group plans as well as plans purnetworks are inadequate. third yearMental and isHealth focused on issues about the College its discussion Interest Group College isis inin its Mental Health Interest Group with one of its core activities being CME educaGeriatrics Committee meets every other month chased on the Marketplaces created under primary care doctors can refer their mental health of students in colleges and third year year andneeds focused on issues issues about the the Geriatrics Committee meets every other month third and isis focused on about tional presentations. The group deals with any with one of its core activities being CME educaObamacare. patients to colleagues with confidence universities. At present, psychiatrists constitute mental health needs of students in colleges and with one of its core activities being CME educamental health needs of students in colleges and issues that may affect the practice of geriatric tional presentations. The group deals with any that they are in the patient’s network, 5% of collegeAtcounseling center leadership. This tional presentations. The group deals with any universities. present, psychiatrists psychiatrists constitute universities. At present, constitute psychiatry and has been very busy of late with issues that may affect the practice of geriatric Progress and Remaining Disparities with the much narrower MHSA netgroup meets regularly tocenter provide educational 5% of college counseling leadership. This that may affect the practice of geriatric 5% of college counseling centerand leadership. This issues several the legislature thatlate would psychiatry has been verybusy busyprimary with These milestone legislative works,bills itandbefore ishas impossible for programs of topics relevant to this regulatory work setting psychiatry group meets meets regularly to provide provide educational and been very ofoflate with group regularly to educational require undue burden to provide any necessary several bills before the legislature that would actions have encouraged substantially all care offices to refer patients reliably to and age group, such as social media, ADHD, programsofoftopics topicsrelevant relevanttotothis thiswork worksetting setting several bills before the legislature that would programs psychiatric medication for a geriatric patient require undue burden provide anyavailnecessary health tosuch cover mental health and someone who is intoto network and and other mental health also is aADHD, forum ageplans group, astopics. socialItmedia, media, require undue burden provide any necessary and age group, such as social ADHD, in any setting (e.g., hospital, nursing facility, psychiatric medication for a geriatric patient substance abuse and have largely elimiable in a clinically appropriate time for mutual support for topics. psychiatrists who often psychiatric medication for a geriatric patient andother othermental mental health alsois isaaforum forum and health topics.and ItItalso assisted living inframe. any setting setting (e.g., hospital, hospital, nursing facility, nated thesettings different copays deductibles Thisfacility). forces patientsnursing to fendfacility, for work in that are geographically and in for mutual support for psychiatrists who often any (e.g., for mutual support for psychiatrists who often (Continued on page 3) assistedliving livingfacility). facility). work inin settings settings that that are are geographically geographically and and assisted work (Continued on3) page 3) (continued on page (Continued on page 3) From the President ............................................................... 1 Fromthe thePresident President............................................................... ............................................................... 11 From MIT Corner ............................................................................. From the President ...............................................................1 2 MIT Corner ............................................................................. 2 MIT CornerCare ............................................................................. Managed Update .......................................................... Resident Fellow Corner .......................................................224 ManagedCare CareUpdate Update.......................................................... .......................................................... 4 Managed MPSC/L New Members.............................................................3 MPS Committee Meeting Update ................................. 45 MPSC/L C/LCommittee CommitteeMeeting MeetingUpdate Update................................. ................................. 55 MPS from HIT Committee...............................................5 InUpdate Transitional Space ............................................................ 6 InTransitional TransitionalSpace Space............................................................ ............................................................ 66 In MPS Veterans Resources Committee Meeting Update ...... 7 MPSVeterans VeteransResources ResourcesCommittee CommitteeMeeting MeetingUpdate Update...... ...... 77 MPS MPS Classifieds 9 Ask PHS - Steve .................................................................... Adelman, MD...........................................7 MPS Classifieds .................................................................... MPS .................................................................... 99 MPS New Members .............................................................. 14 MPSClassifieds News............................................................................8 MPS NewMembers Members.............................................................. .............................................................. 14 MPS MPSNew Classifieds..................................................................10 MPS Calendar .......................................................................14 16 MPS Calendar ....................................................................... 16 MPS MPSCalendar Calendar....................................................................... ....................................................................1616