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

ISSUESPresident’s message 1

Legislative report 3

Executive Council highlights 4

Fall conference preview 4

Fall conference program 5

OCCAP Awards 6

Success!! (but possibly still confusing). Let me see if I can explain.

Your approach to maintenance of certification (MOC) in psychiatry likely falls into one of four categories: 1) Lifetime certification, not required to recertify, 2) 10-Year MOC Certification (MOC recertification candidates in 2015-2021), when you recertify you will enter the Continuous Pathway, 3) Continuous Pathway MOC Certification (certified on or after 2012), now paying annually to maintain certification, or 4) Not maintaining certification.

For those in the first three categories, there have been a number of recent changes to the American Board of Psychiatry and Neurology (ABPN) recertification process that you should know about. Importantly, these changes came about through feedback from APA members to the ABPN.

There are four components to maintaining certification: 1) Maintaining an active unrestricted medical license, 2) regular CME, 3) Self-Assessment CME (CME that gives you a report on how you compare to peers), and 4) a Performance in Practice (PIP) Unit – which used to include a chart review, peer feedback AND patient feedback.

In 2010 APA members started complaining that MOC was an onerous process, and in particular, the patient feedback requirement posed several problems for psychiatrists. One major problem with patient feedback was the ethical concern that the reason for asking the patient for feedback for MOC was a request by the psychiatrist to the patient with the goal of gratifying the needs of the psychiatrist. Another concern was that several subspecialties of psychiatry, for example some forensic practices, do not actually have doctor-patient relationships per se, so asking for patient feedback isn’t really applicable or appropriate in those relationships.

Since 2010 the APA had been addressing these and other issues with the ABPN. There has been an APA Ballot Measure, an APA Presidential Task Force, an APA Assembly Work Group, a MOC Caucus at the APA Annual Meeting, and several meetings of APA officers and administrators with the ABPN Director and Board. And success! … there have been some changes.

Diplomats in all categories no longer must complete patient surveys AND peer surveys to meet the feedback

module for Part IV of MOC (Performance in Practice, or PIP). For all those recertifying, the feedback part of the PIP can now include any ONE of the following options:

• Five patient surveys• Five peer evaluations of general

competencies• Five resident evaluations of

general competencies• 360-degree evaluation of

general competencies with five respondents

• Institutional peer review of general competencies with five respondents

• One supervisor evaluation of general competencies

The components of “general competencies” that get reviewed in peer, resident, 360-degree, institutional peer review, and/or supervisor evaluations are: Patient Care, Practice-Based Learning and Improvement, Professionalism, Medical Knowledge, Interpersonal and Communication Skills, and System Based Practice. Sample forms are available at the ABPN web site www.abpn.com.

For those of you in the 10-Year

by Annette Matthews, MD

PRESIDENT’S MESSAGE

(Continued on page 2)

Maintenance of Certification: less and less enigmatic

2

OPPA Executive CouncilPresident

Annette Matthews, MD

President–ElectCraig Zarling, MD

SecretaryDaniel Dick, MD

TreasurerApril Sweeney, MD

Past PresidentsDavid Conant-Norville, MD

Chris Lockey, MDSatya Chandragiri, MD

APA RepresentativeAnnette Matthews, MD

APA Deputy RepresentativeAmela Blekic, MD

CouncilorsStephanie Lopez, MD Neisha D’Souza, MD

Simrat Sethi, MD

At Large Councilors Denise Dion, MD

Norwood Knight-Richardson, MD

Child Psychiatry RepresentativeKirk Wolfe, MD

Newsletter EditorScott Reichlin, MD

Lane County Chapter PresidentVictor Richenstein, MD

Psychiatric Residents’ RepresentativeKelly Cleaves, DO

Committee ChairpersonsCME

Scott Reichlin, MD

EthicsVictor Richenstein, MD

LegislativeDaniel Dick, MD

Member Assistance ProgramHenry Grass, MD

MembershipGeorge Keepers, MD

ProgramLee Shershow, MD

Public Information & EducationDaniel Bristow, MD

OPPA StaffExecutive Director

Patrick Sieng

Government Relations DirectorAmy Goodall

Program Committee CoordinatorPatti Legarda

OPPA Contact:phone/fax: 503-406-2526

info@oregonpsychiatric.org

MOC Program, the requirements have also changed. ABPN was phasing in the requirements, which resulted in about 15 different sets of requirements for those recertifying between the years of 2015-2021. Vastly simplified and consolidated into one set of requirements, these are now the requirements for all participants in the 10-Year MOC Program:

• 300 Category-1 CME credits• 24 Category-1 CME credits from

Self-Assessment Activities (can count toward the 300 total CME credits)

• 1 PIP Unit (clinical module and feedback module)

If you are in this category, however, once you complete your next 10-Year MOC recertification, you will enter the Continuous Pathway.

For those of you who have Lifetime Certification, you should also know about a subtle but important change in the way your certification status is displayed in the publicly accessible ABPN certification status web page (verifyCERT: https://application.abpn.com/verifycert/verifycert.asp). The change is that the reporting of Lifetime Certificate holders includes “not required to participate in MOC” behind the statement that they are “not participating.” This helps prevent someone accessing the verifyCERT database from thinking that you are “not

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

Another important thing to know about the MOC process is that it is possible to combine general psychiatry and/or neurology and/or one or more subspecialty examinations (up to three modules). This will reduce cost and inconvenience, but you have to pass all the modules you take. For those who are “grandfathered” into the general boards but are on a 10-year cycle for subspecialty boards, you do not need to redo the general boards, only your subspecialty boards.

APA and the Oregon Psychiatric Physicians Association are both member driven organizations, so please speak up when you have an issue. As in the case of MOC, it can make a difference.

President’s message(Continued from page 1)

    

        

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3

President’s message(Continued from page 1) Struggles with parity

by Amy Goodall

The OPPA legislative committee has been active this quarter. Four legislators have attended committee meetings to discuss upcoming legislative issues with our members. The committee is preparing for the upcoming session by participating in ongoing legislative efforts, monitoring campaigns, preparing for potential issues of opposition, and laying the groundwork to introduce an OPPA sponsored bill.

The task force created to address the payment parity issues in primary care and mental health services that arose in the 2013 session has been meeting regularly. The bill requires insurance carriers to reimburse alternate providers such as nurse practitioners the same amount as physicians when providing the same service. The bill received much opposition, but an amended version passed that clarified that insurance companies cannot reduce physician payments, created a task force to discuss alternatives, and added a sunset in 2016.

Three OPPA members, David Conant-Norville, MD, Daniel Dick, MD, and Kathryn Flegel, MD, presented at one of the task force meetings, expressing our concerns with the bill and answering questions about mental health services from the task force members. The task force has created a draft report for the legislature and may be introducing legislation in 2015. The group accepted feedback on their proposal that our members provided in July. On August 15 the task force will be reviewing all of the feedback that they received and will vote in September on what the proposed legislation will look like. At this point, because there has not been a clear solution agreed upon for how to address the issue, OPPA has expressed concern regarding legislation that would remove the sunset. There are still many details that have not been addressed and because the legislature will meet in 2016, there is an additional year to find alternative solutions rather than merely removing the sunset and leaving the statute as HB2902 rewrote it indefinitely.

In September, when the task force agrees upon a bill, the legislative committee will determine how to proceed. The committee will also watch for other issues of concern that could arise, and continue working towards an OPPA sponsored bill. Several particularly relevant legislators will receive small PAC contributions throughout the campaign cycle as we continue to build stronger relationships with Senators and Representatives throughout the state.

LEGISLATIVE REPORT

At Northwest Permanente, P.C., we want every patient we see to receive the medical care they need to live long and thrive. We also offer NWP physicians the opportunity to pursue their personal and professional goals with equal passion through cross-specialty collaboration and work-life balance. We invite you to consider these opportunities with our physician-managed, multi-specialty group of 1,000 physicians who care for 479,000 members throughout Oregon and Southwest Washington.

OUTPATIENT, INPATIENT & GERIATRIC PSYCHIATRIST OPPORTUNITIESOur Department of Mental Health has a multi-disciplinary staff of over 130 mental health professionals and offers adult and child/adolescent outpatient treatment, intensive outpatient therapy and group therapies, as well as a 24-hour hospital-based crisis program and a residential treatment facility located at our Sunnyside Medical Center.

Full-time openings are available throughout the region for Adult Psychiatrists to provide direct clinical work with outpatients. Must have experience in medication consultations and crisis intervention.

We invite Residential Treatment Unit/Consultation Liaison Psychiatrists to join us at our new, state-of-the-art residential treatment unit specializing in trauma informed care. Our center features medical management services, skill building groups and individual therapy. Our Residential Unit Psychiatrists also provide consultation liaison services to Kaiser Permanente's Sunnyside Medical Center Emergency Room and inpatient units.

We offer a competitive salary and benefit package which includes a generous retirement program, professional liability coverage and more. To apply, please visit our Web site at: http://physiciancareers.kp.org/nw/ and click on Career Opportunities. You may also email your CV to Laura Russell, Sr. Recruiter: Laura.A.Russell@kp.org. For more information please call (800) 813-3762. No J1 opportunities. We are an equal opportunity employer and value diversity within our organization.

Northwest Permanente, P.C.,Physicians and Surgeons

Help Build a Gateway for Better Health

4

Executive Council HighlightsApril 17, 2014– Tualatin

The Executive Council met for the first time at its new location at Hayden’s Lakefront Grill in Tualatin. The move from the Oregon Medical Association event center was a cost-saving measure, expected to save the organization approximately $200 per meeting.

This was the last meeting for outgoing President David Conant-Norville, MD. He said he would continue to be involved in membership recruitment after his term.

The Council approved a new logo based on the recent name change to the Oregon Psychiatric Physicians Association. Daniel Bristow, MD, who formerly worked in the radio industry, was appointed as chair of the Public Information & Education Committee. He recently recorded several public service announcements about psychiatry and mental health that are airing in radio stations around the state.

July 24, 2014 – Tualatin Executive Council members did not meet in May because

of the national APA meeting in New York, New York. There was also no meeting in June due to schedule conflicts. The July meeting was the first meeting for new President Annette Matthews, MD.

The council discussed the recent APA meeting in New York where several members and executive director Patrick Sieng attended. APA covers most of the travel costs for state executive directors.

Daniel Dick, MD, was appointed as the council’s Secretary, filling the vacancy left by previous Secretary Mark Bradshaw, MD. Dick also serves as the chair of the legislative committee. He provided an update on recent meetings of the House Bill 2902 committee and work on a bill for the next legislative session.

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

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

Enchantment abounds in Ashlandby Lee Shershow, MD

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

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

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

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

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

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

5

27th Annual Continuing Medical Education ConferenceSeptember 18-21, 2014 - Ashland, OR

REGISTER ONLINE at http://fall.oregonpsychiatric.orgThursday, September 181:30pm-5:30pm DSM-5: Updating from DSM-4 - David Conant-Norville, MD; Thomas Hansen, MD; Christopher Lockey, MD (Pre-Conference requires additional registration fee)

8:00pm Optional Shakespeare Festival Plays (Tickets Required)

Friday, September 198:00am-8:15am Welcome and Announcements - Lee Shershow, MD

8:15am-9:15am Plugged In: How Technology is Shaping Neurological, Relational, and Intra-Personal Functions - Doreen Dodgen-McGee, PsyD

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

10:30am-11:30am Emotional Atunement, Finding the Other - Henry Grass, MD

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

2:00pm-3:00pm Brian Buss Lecture - Tragedy Leads to Lane County’s Physician Wellness Program - Candice Barr; TomFauria, PhD

3:00pm-4:00pm Assessment of Malingered Amenesia - Charles Scott, MD

4:00pm-5:00pm Pre-Play Discussion: Richard III - Daniel Pollack-Pelzner, PhD

8:00pm Play - Richard III (Tickets Required)

Saturday, September 208:00am-9:45am Face Time: Doing Therapy in an Age of Digital Attachment - Doreen Dod gen-McGee, PsyD

10:00am-12:00pm Actors Panel: Richard III

12:00pm-1:30pm Lunch on your own or OPPA Members Business Lunch (Tickets Required)

1:30pm-2:30pm Tackling Insomnia - Jon Emens, MD

2:30pm-3:30pm Good Girls & Wicked Women: Iconic Images in Cinderella & Snow White - Cecile Bassen, MD

3:45pm-4:45pm Necessary Enchantments: Poetry & the Creative Process - Jed Myers, MD; Lily Myers

4:45pm-5:45pm Pre-Play Discussion: Into the Woods - Daniel Pollack-Pelzner, PhD

8:00pm Play - Into the Woods (Tickets Required)

Sunday, September 218:00am-9:45am Treatment of Antisocial Personality Disorders & Psychopaths: Hopeful or Hopeless? - Charles Scott, MD

10:00am-12:00pm Actors Panel: Into the Woods

FACULTY

Candice Barr chief executive officer, Lane Co. Medical Society

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

David Conant-Norville; MD child & family psychiatrist in private prac-tice, Beaverton; affiliated clinical professor of psychiatry, Oregon Health & Science Univ.

Doreen Dodgen-McGee, PsyD psychologist in private practice, Lake Oswego

Jon Emens, MDassistant professor, Oregon Health & Sci-ence University; staff physician, Portland Veteran Affairs Medical Center

Tom Fauria, PhD principal clinician, Lane Co. Physician Well-ness Program

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

Thomas Hansen, MD associate professor of psychiatry at Oregon Health & Science Univ.; supervising psychia-trist, Oregon State Hospital

Mark Kleiman, PhDprofessor of public policy, Univ. of California Los Angeles Luskin School of Public Affairs

Christopher Lockey, MD assistant professor of psychiatry, Oregon Health & Science Univ.; supervising psychia-trist, Oregon State Hospital

Jed Myers, MD clinical professor, University of Washington Dept. of Psychiatry

Lily Myers writer; student, Wesleyan Univ.

Daniel Pollack-Pelzner, PhD assistant professor of english, Linfield College

Charles Scott, MDprofessor of clinical psychiatry, Univ. of California Davis Health System

sponsored by

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

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

Enchantment: Natural & Unnatural

6

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

Kyle Johnson, MD (right) was presented with the Child Psychiatrist of the Year Award at OCCAP’s 4th Annual Children’s Men-tal Health Conference in Portland. He is pictured with then-OCCAP President Grant Godbey, MD.

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

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