APA President Calls on APA Members to ‘Protect the Heartbeat of Our Field’
“Be there” for your patients.
That is the heart of what psychiatry is about, said outgoing APA President John Oldham, M.D., in his presidential address today at APA’s 2012 annual meeting in Philadelphia.
The capacity to “be there” for patients—if psychiatrists make it the soul of their practice—is what will ensure the survival of psychiatry and make it indispensable to the wider field of medicine as the American health care system moves, slowly, toward integrated systems of care.
“As we wrestle with changes in health care, battle to sustain parity for our patients, fight to improve reimbursement rates, educate about the effectiveness of psychiatric treatment . . . work tirelessly to combat stigma, and pursue all of the values so carefully articulated a decade ago in the APA’s Vision for the Mental Health System, and as we embrace integrated care in partnership with the rest of medicine, we need to remember . . . to be there for our patients,” Oldham told psychiatrists at the meeting. “Actually, it takes more than remembering—we need to insist on the essential healing nature of the therapeutic relationship.”
He continued, “I call upon all of us to stay the course, and to protect the heartbeat of our field—our healing partnerships with our patients, which can and must define how we collaborate with our colleagues as we develop new models of integrated care.”
That heartbeat will continue to be what attracts young people to psychiatry, he said. “I’m told that medical students these days say that ‘the road to happiness’ is to choose any one of four specialties: anesthesiology, dermatology, ophthalmology, or radiology,” Oldham said. “You are guaranteed plenty of business, a good income, controllable hours, and minimal night call. But students who do choose to go into psychiatry say they want to have time to spend with patients, to understand what goes wrong (and why) when thoughts, feelings, and self-control get out of balance. And most of all, they want to connect with their future patients in human relationships of healing.
“I, for one, believe that the fundamentals of the therapeutic relationship define our profession at its best and are the heart and soul of whole-person-centered medicine—this is the real road to happiness,” Oldham said.
“Integrated Care” has been the theme of Oldham’s presidential year and of this year’s annual meeting, and Oldham noted that the wider field of medicine has come to regard treatment of mental illness as crucial to a truly integrated system of care. He cited a document on the Patient-Centered Medical Home being developed jointly by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association that reads as follows:
“Science has rendered untenable the implausible and artificial division of people into parts, particularly mental and physical parts. Given that over half of primary care patients have a mental or behavioral diagnosis or symptoms that are significantly disabling, given that every medical problem has a psychosocial dimension, given that most personal care plans require substantial health behavior change—a Patient-Centered Medical Home would be incomplete without behavioral health care expertise and treatment support fully incorporated into its fabric. A whole person orientation simply cannot be imagined without including the behavioral together with the physical.”
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