Assembly Looks to Health Reform, Honors Psychiatrist's Courage
Psychiatrist Blair Romer, M.D., didn't let the power of his bosses and other state officials scare him away from fighting the good fight on behalf of patients, who happened to be inmates in a California prison's forensic medical facility. Romer is a staff psychiatrist at the state prison at Vacaville who refused to stand by and let officials downgrade the quality of care these psychiatrically ill inmates received.
Romer's efforts won him the Profile of Courage Award from the APA Assembly at its meeting last month in Washington, D.C.
Blair Romer, M.D., shows off the APA Assembly's Profile of Courage Award, which he received in November for his efforts to fight state hospital officials whose plans for changes at the prison medical facility in Vacaville, Calif., would have threatened patient care. The award was presented by Area 6 Representative Marc Graff, M.D. (center), and Deputy Representative Barbara Yates, M.D.
Credit: Sylvia Johnson Photography 2008
Putting his career in jeopardy, Romer organized and led a protest against prison officials' plan to downgrade the prison hospital's medical license by eliminating the organized medical staff, shifting most mental health care from physicians to nonphysician health care professionals, reducing the nurse-patient ratio, and changing bylaws so that a psychologist could head the medical staff and credentials committee.
Romer enlisted support from the California Psychiatric Association and California Medical Association in his protest, which led to a halt in the imminent downgrade of his facility. His actions led to retaliatory steps by the hospital's executive director and eventually a reprimand, he told the Assembly. He countered with a “whistle-blower” complaint to the California Personnel Board, whose decision failed to back Romer's position.
Romer noted that several months ago the hospital administration indicated that it plans to dismantle the forensic psychiatry service, which he heads, and it has moved him to a tiny office where the furniture will not accommodate his 6-foot, 4-inch body. All this has worn him down, Romer said, and he will leave state service this January.
He emphasized that he was accepting the Assembly's award “for the everyday heroes in mental health,” only a few of whom get the recognition they deserve.
The Assembly also addressed several key issues and proposals at its November meeting, many of them affected by fiscal constraints facing APA in light of declining income and rising expenses. Among the issues decided, representatives voted to
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endorse an APA position statement titled “Principles for Health Care Reform for Psychiatry” that describes positions for which APA will advocate in discussions over reforming the nation's health care system. The principles focus on ways to increase access to mental health care, including that for substance abuse; describe key elements of quality care; and explain the need for strict confidentiality standards in electronic records systems. The statement also stresses the need to take action to stamp out mental illness stigma and for greater resources to be aimed at increasing the psychiatric workforce, especially in the area of child psychiatry.
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have APA urge President-elect Barack Obama to convene a health care reform planning advisory group that would include health care professionals “including APA and the AMA, and not only funders of health care.”
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“make available” an award that can go to a psychiatry resident from every U.S. and Canadian training program. The award will acknowledge residents who have demonstrated the values of “compassion, leadership, community service, or advocacy” for the benefit of their patients, professsion, or community. Each year APA will encourage training directors to submit the name of a resident worthy of the award, which will be in the form of a certificate. Residents do not have to be APA members to be eligible.
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try to retain medical students who join APA by having APA e-mail district branches the names of medical-student members in their area so the district branch can assign mentors and engage them in activities that could result in their pursuing psychiatry and remaining APA members.
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have the Steering Committee on Practice Guidelines explore the idea of “establishing evidence- and consensus-based practice guidelines on the treatment of psychiatric symptoms in the intellectually disabled.” Advocates of this proposal stated that“ unsubstantiated approaches sometimes used in the treatment of intellectually disabled patients with psychiatric symptoms can increase the risk of adverse consequences to this population.”
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have the APA Election Committee and appropriate staff apply the same conflict-of-interest disclosure standards to candidates for APA national office as used when evaluating candidates to be APA journal editors, component participants, and presenters at APA annual and CME meetings.
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revise the member referendum procedure in light of the fact that in recent years the percentage of members who vote in APA elections often flirts with the 40 percent minimum participation needed to pass a referendum. The Assembly backed a proposal to put referenda to votes by strength of the Assembly, with such referenda needing two-thirds of votes to pass, when the minimum percentage of ballots to constitute a “valid vote” is not achieved. The Board of Trustees will review this issue.
The Assembly Nominating Committee announced candidates for two offices. The election will take place next May (see Nominations Announced).
A summary of actions taken by the Assembly is posted APA Web site at<www.psych.org> in the Members Corner section under “Assembly.”▪
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Published online: 5 December 2008
Published in print: December 5, 2008
Notes
A psychiatrist who went into battle against the public system that employed him when it began taking steps he believed were lowering the quality of care wins an APA award for his efforts.
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