Assembly Election

Al Herzog, M.D.

"The greatest thing in this world is not where we stand, but in what direction we are moving."

-Oliver Wendall Holmes, M.D.

BIOGRAPHICAL STATEMENT: Some of us may feel that both where we stand and our direction matter a lot. They probably do. But, for me, Dr. Holmes's dictum has always had a special meaning. Although I was born in Germany during World War II (1941), I was fortunate to escape the war's worst ravages. By 1952 my parents initiated plans to leave Germany and immigrate to the U.S. "so our children could have a better life." Permission was eventually granted, and we arrived in America in September 1953.

Whatever the many complex family reasons that determine such a decision, the above reason is the one that has "stuck." It has given me both a sense of personal responsibility and a strong sense of forward direction.

I feel proud to be an American citizen, feel blessed to be living in this country, and deeply value our democratic principles and processes. To be sure, there was "no free lunch," but I feel fortunate in having been able to attend some of our finest schools and practice psychiatry in a setting that values our specialty as an important part of medicine.

Prior to 1992 I earned most of my income from private practice. Since then, I am vice president for medical affairs at Hartford Hospital but still spend about 20 percent of my time in clinical practice. Throughout my professional career, I have always found myself involved in collateral advocacy activities-as cofounder of a family-support group that later evolved into a mental health center, as part of the leadership of a private-public coalition to improve mental health services in Connecticut and now as a member of the CSMS Committee, which assists with independent reviews of managed care complaints.

I have been married to Kathy for almost 32 years. She is generous with her love, both to me and to our two daughters, Trina and Anne, both of whom are in their 20's and doing well with life.

Candidacy Statement: My Assembly travels this past year have been accompanied by a wide range of informative experiences. A few months ago, I had dinner with a child psychiatrist colleague who practices in a western mountain state. He travels 200 miles east and west on one particular day each month to provide the only child psychiatry services available in those areas. On the other side of the country, I played a round of golf with a colleague who practices in a large Eastern metropolitan area and treats only self-pay patients. In between, I talked with many of you who, like me, treat patients who belong to a great variety of restrictive managed care plans.

We are, to be sure, a diverse group. However, it is my sense that we share in common an APA and an Assembly that must:

• Advocate for our patients for access to psychiatric care and advocate for us as well so we can deliver good care.



• Demonstrate to our members the value of APA membership as directly as possible.



• Augment and enrich the educational opportunities available to us.

I would like to address each area briefly in terms of the way I envision that the Assembly can play an important role.

Advocacy for Our Patients and Our Profession

The Assembly has already played an important part in changing the direction of managed care. We need to continue with these efforts and specifically:

1. Push for the development at our local levels of delivery systems that emphasize carve--ins. I am involved in such an effort in our health care system, which, I hope, will put psychiatrists into key administrative and delivery positions. On this item, a lot of us need to make use of our Assembly expertise and translate it into action "back home."


2. In our state capitols, we need to push for managed care reform legislation that mandates the option of an external, independent review process of care denials. Many of us physicians in Connecticut, working closely with the state medical society and state legislators, were able to push through such a bill last year-in spite of fierce opposition from the managed care industry.


3. Perhaps most important, and most difficult of all, we need to push for actions and legislation that will make "administrative" managed care practices (which unduly deny care) a part of medical practice subject to all of the liabilities that go with practicing medicine. This effort will take lots of energy, persistence, patience, and, ultimately perhaps, even litigation.

Demonstrating Value of APA Membership

We need to reverse the present trend of an annual net loss of dues-paying members by demonstrating direct value to our members from APA membership. Two areas are of immediate importance: (1) APA needs to help district branches and state associations with resources (both human and $'s) to limit the scope of practice of non-M.D.'s and (2) to help all of us at the state level to push for the passage of mental health/psychiatric (including substance abuse) parity legislation.

Again, we in the Assembly need to make use of our knowledge of "best practice" from our national network and work with the district branches to move us all from ideas to reality.

We in the Assembly need to demonstrate value in other ways. I, like all of you, value the importance of the Assembly-its energy, vitality, and ideas. However, we need to redouble our efforts to be focused and clear in the actions we pass on to the Board of Trustees. Furthermore, we need to make better use of our deputy reps. Suggestions might be to have them be our legislative reps or be "official" district branch liaisons. I look forward to other suggestions from the Strategic Planning Task Force.

Enriching CME

The CME programs at the annual meeting and at the fall institute are excellent. However, APA needs a more distributive CME program-bring the "best of the best" closer to home and at other times of the year and/or make available to us an excellent abstracting service for advances in psychopharmacology and clinical research.

It is an honor to be running for speaker-elect. If elected, I promise you a leadership style that will be inclusive, energetic, and collaborative.