fall greetings letter from the editor from the apahc president · 2018-05-04 · letter from the...

Letter from the Editor

ASSOCIATION OF PSYCHOLOGISTS IN ACADEMIC HEALTH CENTERS

FALL 2012 Volume 2 No. 1

Autumn and all of its beautiful colors are finally here. And just like the vibrant colors of Fall APAHC has been a vibrant organization from its inception ( for more details about the early years of the organization check out the archives section of our website). Yet, with the Fall sea-son representing maturation I feel it is only fitting to remind APAHC members that our organization is maturing and about to celebrate its 30th year. APAHC turning thirty may have many different meanings to each of us but I envision that our thirties will represent a time period of explosive creativity, new partnerships, and new ventures. Our organization’s maturity now allows us to be positioned firmly as the voice of psychologists in academic health centers at a time when rapid changes in the health care arena, field of education and technology are redefining our culture.

The creativity of APAHC members can be seen through recent initiatives that include creation of this bi-annual newsletter by Dr. Melisa Moore, a user friendly website main-tained by Dr. John Wryobeck, development of a Promotions Primer (now available in the members only section of our website) by Drs. Ed Christophersen and Zeeshan Butt, pulling together spectacular programming for our upcoming national conference, Applying the Science of Psychology in Academic Health Centers: Implications for Practice, Teaching, Research and Policy in Tennessee on January 31-February 2, 2012 by Drs. Cathy Schuman, Laura Schaffer and Amit Shahane, and initiatives by the Research Committee to interface with the AAMC and APA lead by Dr. Jerry Leventhal.

Many examples of new partnerships involving APAHC can be seen. As some of you may already be aware, at the request of APA President, Dr. Suzanne Bennett Johnson, APAHC has two representatives (Drs. Kathryn Sanders and Cathy Schuman) on the Inter-Orga-nizational Work Group on Competencies for Psychological Practice in Primary Care. This special project brought stakeholders from various organizations committed to psy-chology’s role in primary care together to articulate the competencies that are unique and essential elements for psychologists working in primary care settings. The final doc-ument will be vetted by all the stakeholders (including the APAHC board) to produce a final product to be published. When finalized, the project will increase the visibility of psychology as a health profession and underscore psychology’s unique contributions in primary care settings. Additionally, the composition of the Task Forces being lead by Dr. Alfiee Breland Noble (Cultural Diversity and Health Disparities) and Dr. Cheryl Brosig (Behavioral Sciences in Medical Education) demonstrate how partnering with new in-dividuals and organizations can benefit AP-AHC. In her efforts to strengthen APAHCs

Fall Greetings from the APAHC President♦ Barbara Cubic, Ph.D., Eastern Virginia Medical School

♦ Melisa Moore, Ph.D. The Children’s Hospital of Philadelphia

continued on page 10


THE APAHC NEWSLETTER

Fall is in full swing and the end of the cal-endar year is approaching, which means it is a good time to reflect on the accom-plishments of our members. I have been continually impressed by our members’ hard work and ability to get things done and you will read all about it in this issue of Grand rounds! Dr. Wheat will summa-rize APAHC’s involvement at APA. You’ll read about our new ini-tiatives in articles by Dr. Cubic and Dr. Brosig-Soto as well as an im-portant new resource for early career psy-chologists, the APAHC Promotions Primer, written by Drs. Ed Christophersen and Zeeshan Butt. The need for this primer became clear from lively discussions on the listserv and was brought to completion in an incredibly short amount of time. Given all of this hard work, Dr. Clark shares with us her advice for keeping a work life balance and Dr. Novosel interviews Dr. Linton to get his perspective on our changing pro-fession. Dr. Wryobeck highlights another point of discussion on the listserv—the impact of the EMR on psychologists. With regard to APAHC in the future, we hope the conference information will entice you to attend our bi-annual conference in January of 2013.

continued on page 10

1 Fall Greetings from the President / Letter from the Editor2 Reflections on Psychologists in Academic Health Centers3 Tips for Maintaining Wellness Throughout Your Career4-5 APAHC at APA 20126 Free Access to a Primer for Career Development / Congratulations to Dr. William Robiner7 Task Force on Behavioral and Social Science Foundations for Physicians 8 Healthcare Changes in Our Present and Future9 See You in Nashville!—APAHC 2012

Dr. John Linton has made significant con-tributions to defining the role of psycholo-gists within academic medical settings. Through his clinical, research, leadership, and administrative roles and responsibili-ties, he has served as a vital advocate for psychologists. This distinguished career has afforded him a unique perspective from which to share his reflections on how the field has evolved for psycholo-gists in academic health centers and what we can do to remain vibrant team mem-bers for many years to come.

What have you observed as the biggest change in how psychologists are integrat-ed within academic healthcare settings?

While in the 1970s psychologists could be found in academic healthcare settings, they tended to be in departments of psy-chiatry at large institutions. Community hospitals and smaller medical centers were dominated by psychiatrists. Health psychology as a specialty was in its infan-cy. There was one text in health psychol-ogy, and I had the privilege of being one of the “founding parents” of the APA Division of Health Psychology developed in the late 70s. Throughout the ensuing decades the progress was slow but steady. It took years to train fledging health psychologists who then had trainees, and they in turn trained more. Graduate programs began including “medical psychology” and neu-ropsychology into their curricula as rou-tine courses to obtain the doctorate.

Psychologists grew past departments of psychiatry to medicine, surgery, family medicine, dentistry and nursing, as well as research positions in medical school basic sciences. This increased presence allowed pre-doctoral psychology internships and then postdoctoral fellowships to develop and then flourish in health centers. Be-

cause inter-professional prejudice tends to develop later in the career, as psychol-ogy trainees interacted with medical stu-dents, residents, nurses and other health professionals, they developed a mutual respect that often carried into mature practice. Psychologists became faculty invited to train medical and allied health students. The inclusion of psychologists went from atypical to commonplace. But pockets of resistance remain and will need constant vigilance as national trends shrink budgets in academic health centers and payment sources continue to shrivel the purse.

Which approaches have you found to be most and least beneficial when interacting with physician colleagues, and why?

While it’s important to attend to your own and your family’s self-care, it is the physi-cians’ world. Show up early and stay late. Learn their rules, and unless your ethics prohibit it, play by those rules. If offered opportunities to showcase your talents or the science of psychology, take them. Act like an equal professional but understand that kindness and being psychologically minded doesn’t come easily to some phy-sicians. Many don’t know that what you do is worth anything, so expect some to dis-count you. Live with and learn from that. Find powerful friends who will endorse you; build and nurture those relationships carefully over a long time. Accept referrals if you have the training to do so. Agree to serve on committees but avoid interject-ing psychology into everything discussed; if they want a psychological perspective they will ask. Meet at 6:30 AM if neces-sary; medical centers wake up early. Di-versify your contributions. Solve person-nel problems for administrators. Give a talk at someone’s service club luncheon when asked. Be scrupulously responsible.

Answer your pages immediately if pos-sible. Insinuate yourself so deeply that the place can’t imagine what it would be like without you.

To screw it up, polish your PhDeity. Break the chain of command; go over someone’s head with a problem without consulting the next in line. State how wonderful psy-chologists are and their superiority over psychiatrists. Hang out only with other psychologists and be sure to breed an “us vs. them” mentality. If asked to take on an assignment that won’t add to your CV, turn it down. Remain above the fray, clean and pure and distant, avoiding the politi-cal landscape and the realities of practice.

What do you believe are main issues impacting psychologists within academic healthcare settings over the next 10-15 years?

As sources for payment diminish, psychol-ogists will be pressed to prove their worth. Lack of innovation could prove costly as we compete with counselors, social work-ers and nurses for influence in academic health centers. The biggest challenge will be preparing medical and allied health professionals for a new century, with the unknowns of micro-computing technolo-gy, dramatic medical advances, exponen-tially expanding social media and ethical challenges we can’t even fathom looming on the horizon.

Early Career Psychologists

APAHC Grand rounds | Fall 2012 Association of Psychologists in Academic Health Centers | 2


Reflections on Psychologists in Academic Health Centers♦ Interviewer: Rachel Novosel, Ph.D., Children’s Hospital of Philadelphia♦ Interviewee: John Linton, Ph.D., A.B.P.P., West Virginia University Health Sciences Center

Continued on page 10



Tips for Maintaining Wellness Throughout Your Career

While the Accredi-tation Council for Graduate Medical Education (ACGME) requires that physi-cians be educated on impairment and

wellness on a routine basis, no such cur-riculum requirements exist for psychol-ogy trainees or early career psychologists (ECP). One could argue that ethics con-tinuing education (CE) counts toward this, but wellness may not be covered in all ethics CE. However, wellness within the career of a psychologist is a topic that needs to be addressed continually. A survey was conducted with psycholo-gists from various listservs asking what people found most difficult about main-taining wellness and what recommen-dations they might have. The goal of the survey was to provide practical informa-tion on wellness that could not only be applied to early career psychologists, but also throughout one’s career. A total of 38 responses were received with a mean of 15 years of experience (range 1 year to 40 years). While years of experience varied, it seems that the ECPs and the more es-tablished psychologists expressed similar views and provided comparable advice and tips.

What barriers exist in keeping us from exercising wellness? One psychologist wrote that he was threatened with not being promoted if he practiced wellness. Another reported that she was too in-vested in her career track to turn back at this point. Several voiced that it was dif-ficult to separate home from work and vice versa. However, it seemed interesting that most emails contained one word in

their list of barriers…guilt. A number of psychologists expressed a sense of guilt for practicing wellness.

How do we navigate taking care of our-selves and still secure a position that we have always wanted? How do you separate home and work? And how do we not feel a sense of guilt or consider ourselves lazy for practicing wellness? The answers to these questions were varied. Some help-ful tips included developing a one, three, five and ten year plan. Knowing where you want to be in the future and how you de-fine success were key elements in deter-mining how to spend your time. In addi-tion, knowing what you enjoy and makes you personally healthy can facilitate the practice of wellness. Basically, what do you value in your personal life and your career?

Secondly, a number of psychologists sug-gested using one calendar for work and personal time. If you scheduled personal time, it should be treated with the same priority as other appointments and meet-ings. Poignantly, a responder to the survey said that “we tell our patients/clients all the time to make time for themselves or they would not be able to take care of oth-ers. Are we as psychologists too good for our own advice?” It seems this is an im-portant point in addressing guilt or auto-matic thoughts related to taking time for ourselves. We need time to enjoy and rein-vigorate just like others.

Finally, many respondents suggested that we need to learn how and when to say “yes” and “no.” There will be many op-portunities for each of us, but accept only those opportunities that are a part of your short and long term goals. If you say “yes” to every opportunity, you will be more susceptible to burnout, may not perform to the best of your ability, and your time will be limited/off-balanced.

Finally, respondents were asked what they perceived as benefits to promot-ing wellness. It seemed that most agreed that there are both primary and second-ary benefits. For example, you gain per-sonal benefit from engaging in wellness, but your wellness then positively impacts your social support network/family and patients/clients because you are better able to serve when fully charged. Numer-ous research articles have suggested that those who work more than 40 hours per week are no more productive than those who work a 40-hour week. Therefore, we may be fooling ourselves into thinking that we are more productive than we re-ally are.

One memorable quote from a respondent was “I worked many years in the hospice setting. Never once did I hear my dying patients express the regret that they did not work more. They had more regrets for not engaging with family, friends and ful-filling activities that would have brought them joy.” Therefore, I leave you with this question. If your last days were ahead, what would you change, want more of, or what would you do with your time? Please take those answers and start plugging them into your calendar, and I hope you have a “balanced” work and life.

♦ Molly S. Clark, Ph.D., University of Mississippi Medical Center

The Association of Psychologists in Academic Health Centers (APAHC) has established a Tribute Fund to remember or recognize colleagues who have made significant contributions to the Associa-tion or to medical/health psychology. Donations in any amount are welcomed and all contributions will be acknowledged publicly. Individuals who wish to contribute $500 or more to the fund will be recognized as founding members in the APAHC public materials. Contributions received will serve as discretionary funds to be dispersed upon approval of the APAHC Board. It is the hope of the APAHC Board that this fund grows and does honor to our field.

The APAHC Tribute Fund

The 2012 Annual Convention of the Amer-ican Psychological Association (APA) was held in Orlando, FL from August 2nd -5th. APAHC was present and active, hosting a variety of activities to benefit psycholo-gists who work within academic health centers (AHCs). Further, the APAHC Board and some of its committees con-vened during the convention, seizing the opportunity to strengthen or initiate ef-forts to benefit the organization, and ul-timately its current and future members.On Friday, August 3rd, APAHC Board mem-bers met to discuss several exciting proj-ects. For example, updates were given by Drs. Kathryn Sanders and Cathy Schuman on the progress of the Inter-Organiza-tional Work Group on Competencies for Psychological Practice in Primary Care. APAHC chose Dr. Cathy Schuman to rep-resent our organization at the upcoming APA Education Leadership Conference in Washington, D.C The board learned about efforts from the organization’s Task Force on Behavioral Sciences in Medical Edu-cation lead by Dr. Cheryl Brosig Soto to create a repository of innovative educa-tional techniques and resources for psy-chologists who are teaching other health professionals within academic health cen-ters. Dr. Alfiee Breland Noble provided an

update on the Task Force for Multicultural Diversity and Health Disparities that she chairs. She has identified 4 new members to join her on this important initiative and they are working on their mission and vision statements and organizational goals. The task force would like to have a section of the webpage dedicated to the NIH reports on training in the biomedi-cal workforce and disparities in awards for federal funding. The board also heard updates from Dr. Barbara Cubic, APAHC President, on the near finalization of the Promotions Primer, a publication for those pursuing career advancement in AHCs (see article on page 6 by co-authors Drs. Zeeshan Butt and Dr. Ed Christophersen). Dr. Jerry Leventhal, chair of the APAHC Re-search Committee, was present during the board meeting and discussed the commit-tee’s continued efforts, one of which has been working toward inclusion of Psychol-

APAHC at APA, 2012

ogy in the AAMC annual faculty survey. He informed the board that the Research Committee also would convene during the conference to discuss this and other im-portant activities. Finally, the board was updated by Dr. Cathy Schuman, APAHC conference committee member, on the exciting and nearly finalized agenda for APAHC’S upcoming meeting, to be held in Nashville, TN from January 31st-February 2nd, 2013. Full details of the conference pro-gram can be found on APAHC’s website.



CongratulationsDr. Nadine Kaslow

was recently elected

as the 2013 APA President-Elect.

Dr. Kaslow will start her term as

President-Elect on January 1,

2013. On January 1, 2014, Dr.

Kaslow will become President.

During the course of the convention, three outstanding and engaging talks were pro-vided by individuals who received APAHC awards during the 2011 APA Convention. Dr. Richard Seime (2011 recipient of the Ivan Mensh Award for Distinguished Achievement in Teaching) and Dr. John Robinson (2011 recipient of the Joseph D. Matarrazo Award for Distinguished Contributions to Academic Health Cen-ters) highlighted some common themes that they have observed to be critical to their success in practicing psychology in AHCs. They emphasized the importance of both receiving and subsequently pro-viding effective mentorship, growing in professionalism within academic health settings through active and meaningful collaborations across disciplines, and an awareness of professional identity devel-opment in the uniquely multidisciplinary setting of AHCs. Further, APAHC hosted a talk by Dr. Dorothy Hatsukami, during which she provided an engaging over-view of her research which earned her the 2011 Bud Orgel Award for Distinguished Achievement in Research at last year’s convention. Dr. Hatsukami’s talk, Future Directions in Disease Prevention: Tobacco Control as a Case Example, highlighted the

use of an epidemiological model to sum-marize and guide research to promote tobacco-associated disease reduction and prevention, through possible pathways such as reducing the attractiveness of to-bacco and regulating the use of toxicants in tobacco products.

APAHC continued its recognition of out-standing accomplishments and service during this year’s APA convention as well, bestowing several awards, as listed below:

John Linton, Ph.D., ABPPIvan Mensh Award for Distinguished Achievement in Teaching

Robert Archer, Ph.D., ABPPJoseph D. Matarrazo Award for Distinguished Contributions to Academic Health Centers

As you can see, APAHC continues to work diligently on behalf of its members and of-fer outstanding APA programming to meet the needs of APAHC members. We look forward to seeing you at our upcoming national conference, Applying the Science of Psychology in Academic Health Centers: Implications for Practice, Teaching, Re-search and Policy in Tennessee on January 31-February 2, 2012, and at APAHC events at the next APA Convention in Honolulu, Hawaii, July 31- August 4, 2012.



APAHC at APA, 2012

The National Register of Health Service Providers in Psychology (National Register) Board of Direc-tors announced the pre-sentation of the Alfred M. Wellner Distinguished Ca-reer Psychologist Award to

William N. Robiner, Ph.D., of Minneapolis, MN.

Upon receiving the award, Dr. Robiner responded, “It is a deeply humbling hon-or to be the recipient of the 2012 Alfred M. Wellner, Ph.D., Distinguished Career Award. Dr. Wellner’s interest and writ-ings about topics ranging from education and credentialing to licensure and regula-tion, as well as his interest in surveying psychologists about such matters, has influenced my own work addressing di-verse aspects of professional affairs. For example, in a Clinical Psychology Review article discussing the doctorate as the ba-sis for psychology licensure, my coauthors and I cited his work. His dedication to en-hancing the profession of Psychology by addressing educational, regulatory, and quality issues, could well have served as a blueprint for my own service to the pro-fession and professional writings. “

The award is named for the National Register’s first Executive Officer, Alfred M. Wellner, Ph.D. The Wellner Award is the National Register’s highest honor be-stowed on a psychologist to commemo-rate numerous and significant contribu-tions to psychology during a distinguished career.

In her nomination letter, Sharon Berry, Ph.D., Director of Training and Psycho-logical Services System Leader at Chil-dren’s Hospitals and Clinics Minnesota wrote, “Dr. Robiner exemplifies the high-est standards in the field and in the ethi-cal practice of Psychology. He is passion-ate about educating the next generation of psychologists, and shares his wealth of knowledge with others at all levels. He is articulate, creative, and a born leader. I am honored to nominate him for the Well-



♦ (L) Ed Christophersen, Ph.D., ABPP, University of Missouri-Kansas City School of Medicine

♦ (R) Zeeshan Butt, Ph.D., Northwestern University Feinberg School of Medicine

The contributions of psychologists can be recognized in the academic health center (AHC) via appointment as faculty mem-bers, promotion in rank, and in some cases tenure. However, psychologists are a unique case within the AHC for several reasons. For one, most psychologists have been trained in colleges of arts and scienc-es (although this is changing as more and more internship and post-doctoral train-ing opportunities are being offered in med-ical settings) and so are more familiar with the norms and mores of that setting, which can be different than those of the medical school or AHC. Also, given that psycholo-gists are not often in a Department of (Health/Medical) Psychology, those indi-viduals who have administrative oversight over their position may be from another discipline. In part due to the differences in training backgrounds, psychologists serve unique roles and responsibilities in the AHC. These differences are especially im-portant as they relate to the appointment, promotion, and tenure process.

Earlier this year, APAHC members Ed Chris-tophersen, Ph.D., ABPP and Zeeshan Butt, Ph.D. participated in a listserv discussion on medical school faculty tracks. Noting a lack of such a resource, they were invited to develop a brief document summarizing the key concepts for career development and promotion for psychologists working in an academic health center. We’re happy to announce that the full version of their primer is available as an APAHC member-ship benefit: http://div12.org/section8/member/wp-login.php. It is also available for a small fee for non-members. In addi-tion, it is a supplement to the December 2012 issue of the Journal of Clinical Psychol-ogy in Medical Settings. The primer comple-

For APAHC Members...

Free Access to a Primer for Career Development

ments other APAHC membership benefits, such as the APAHC Consultation and Men-torship Program, which may be helpful for early career or more seasoned psycholo-gists planning for career transitions.

The complete APAHC Primer includes sec-tions on what to do before you apply or interview for a position, the interview pro-cess, negotiating an offer, starting a new position and planning for promotion. It also includes helpful sections on activities that may support your promotion, with fo-cus on clinical practice, research, teaching and mentorship activities, as well as local, AHC, regional, and national service. We hope that you take the time to read the full primer, which we consider a living docu-ment that will evolve over time. If after re-viewing the document, you have additional topics that you would like to see treated, please contact APAHC or the authors di-rectly. We will try to address these issues in a future update.

Continued on page 10

Congratulationsto Dr. William Robiner!

http://div12.org/section8/member/wp-login.php


ASSOCIATION OF PSYCHOLOGISTS IN ACADEMIC HEALTH CENTERSASSOCIATION OF PSYCHOLOGISTS IN ACADEMIC HEALTH CENTERS

In our last issue of Grand rounds, APAHC President Dr. Barbara Cubic intro-duced several new ini-tiatives, including the development of the Task Force on Behav-

ioral and Social Science Foundations for Physicians. The AAMC recently released a report “Behavioral and Social Science Foundations for Future Physicians” that emphasizes that “a complete medical edu-cation must include, alongside physical and biological science, the perspectives and findings that flow from the behavioral and social sciences”. This report builds on the 2004 Institute of Medicine report “Enhancing the Social and Behavioral Sci-ence Content of Medical School Curricu-la”. Academic medicine, in its education of medical students and residents, values the scientific and clinical contributions of psychology/behavioral science, and is recognizing that this needs to be a key component to medical education. Behav-ioral and social sciences are part of the core competencies for interprofessional collaborative practice. Because of the in-creasing emphasis on this area in medi-cal education, for our APAHC member-ship, we would like to provide resources for those who are doing this work. I am honored to be chairing this important endeavor, and excited to be working with a very talented group of people who are committed to ensuring that academic health center psychologists contribute their knowledge and skills in educating future physicians regarding behavioral and social sciences.

Task Force on Behavioral and Social Science Foundations for Physicians♦ Cheryl Brosig Soto, Ph.D., Medical College of Wisconsin

Let me introduce you to our task force members:

Cheryl Brosig Soto, Ph.D., (Chair)Associate Professor, Department of Pediatrics, Medical College of Wisconsin. Dr. Brosig Soto is cur-rently Member-at-Large in APAHC and serves as Section Chief of Psychology in her Department. She is working to increase the integration of behavioral and social science prin-ciples into the training of medical students, residents and fellows.

John Carr, Ph.D., Professor Emeritus Departments of Psychia-try and Behavioral Sciences and Psychology, University of Wash-ington. Dr. Carr has been an active member and former President of AP-AHC and has been a pioneer in devel-oping medical school curriculum for behavioral science courses. He is co-editor of one of the leading behavioral sciences textbooks used in medical student education “Behavioral Sci-ences and Health Care”.

Mark Vogel, Ph.D., Associate Professor Department of Family Medicine, Michigan State Univer-sity. Dr. Vogel is Director of Behav-ioral Science and Psychology and coordinates the behavioral science education of residents within the Family Practice Residency program. He is the former chair of the Group on Behavioral Science in the Society of Teachers of Family Medicine, and has been Executive Director for the Association for the Behavioral Sciences and Medical Education (ABSAME).

Kelly Foran-Tuller, Psy.D., Staff Psychologist, Department of Psychiatry, VA Connecticut Healthcare System. Dr. Foran-Tuller currently serves as Early Career Rep-resentative in APAHC and represents this perspective on the task force. She is currently involved in training of future physicians in integrated primary care.

Barry Hong, Ph.D., Professor & Vice Chairman of Clinical AffairsDepartments of Psychiatry and Internal Medicine, Washington University School of Medicine. Dr. Hong was the previous APAHC President and APAHC representative to the Council of Academic Societies (CAS) of the AAMC, and has served on various AAMC committees. He has been actively involved in revising the behavioral and social science content of the MCAT. Dr. Hong recently received an APA Presiden-tial Citation for his “extraordinary leadership and contributions to the advancement of psychology in aca-demic health centers and to medical education”.

The task force is hard at work compiling resources that would be helpful to APAHC members who are involved in teaching within medical schools. These materials will be available soon on the members only section of the APAHC website.

Articles of less than 1000 wordsfor the Spring Issue of

Grand rounds due February 1, 2013.

Please contact Melisa Moore at [email protected]

Healthcare change is coming; from changes in coverage and pay-ment to electronic re-cords and regulation. My institution’s recent adoption of the elec-tronic health record (EHR) precipitated my exploring what kinds

of changes we psychologists need to know about. I will briefly address four of these: the Health Information Technology for Economic and Clinical Health Act (HI-TECH), the Physicians Quality Reporting System (PQRS); and changes to the Cur-rent Procedural Terminology Codes (CPT); and from the Relative Update Committee (RUC) of the AMA changes.

The HITECH Act is designed to incentiv-ize healthcare providers and hospitals to adopt EHR technology. The act has three stages: 1) show the EHR can capture mean-ingful data and that patients can be given electronic copies of their electronic record (happening now); 2) show that the EHR information can be effectively shared with other health professionals ) AND give pa-tients online access to their personal re-cords (2014); and 3) to expand how mean-ingful use will be defined. During this roll out the U.S. Department of Health and Human Services (HHS) is paying incen-tives to doctors/hospitals for being able to meet the standards in particular ways. These incentives will eventually give way to penalties for those who do not meet the standards under Medicare. During our in-stitution’s rollout I learned that psycholo-gists are not considered healthcare provid-ers under this act. It was another example of psychologists being marginalized within healthcare.

In talking with Stacey Larsen, Psy.D., J.D. Director of Legal and Regulatory Affairs of the American Psychological Association, I came to understand that there is a divide within the psychology community because

to be identified as a provider under this act will require psychologists to use electronic records in a meaningful way or risk lower reimbursement (i.e., a penalty) once the act is in full effect. Many psychologists object to exposing themselves to penalties and have raised concerns about the confiden-tiality of mental health records in an EHR.

The issue of confidentiality goes beyond the scope of this article, but you may want to catch Dr. Jeffrey Younggren’s presentation Electronic Psychological Record Keeping: Meeting the Ethical and Legal Standard of Care at APAHC’s January 2013 conference in Nashville. As psychologists working in health centers we need to think about how healthcare changes affect us and our prac-tice and consider potential risks of being further marginalized within the changing healthcare environment if we do not play active roles in advocating for the profes-sion’s meaningful involvement.

The PQRS is important to know about if you bill under Medicare. Beginning in 2015, psychologists must submit data on PQRS quality measures or receive a 1.5 percent payment adjustment. It is impor-tant to note that to avoid the 2015 penalty, one must report PQRS quality measures during 2013. If one does not participate in 2013, Medicare payments will be reduced in 2015. The reportable measures available for 2013 will be posted on the CMS website: http://www.cms.gov/PQRS.

Revised psychotherapy codes from the RUC have been published and are effective Janu-ary 1, 2013. The diagnostic interview code of 90801 will be replaced with 90791 (non-medical) and 90792 (medical). These codes can be used more than once if the evalu-ation goes beyond one session. Psycho-therapy codes 90804-90829 are deleted and replaced with 90832, 90834 and 90837. The change in coding is in part related to time. CPT code 90832 is for 30 minutes, 90834 for 45 minutes and 90837 is for 60 minutes. It is currently being reported that 90832 is

chosen if time spent is between 16-37 min-utes, 90834 between 38-52 and 90837 when over 53 minutes. There will be a new code for psychotherapy in a crisis, 90839-to be used for a patient in high distress or in a life threatening situation and does not include medical services. The code covers from 30-74 minutes (add-on codes will be available for longer time periods. The codes for psy-chodynamic psychotherapy (90845), group therapy (90853), and family therapy (90846, 90847, 90849) will remain unchanged.

Finally, on the issue of reimbursement, the above CPT codes will have different reim-bursement rates which have not yet been published. The Centers for Medicare and Medicaid Services (CMS) are projecting a 2% reduction in Medicare payments to psy-chologists for 2013. This of course is in ad-dition to the 26.5% cut in Medicare funding to psychologists that is scheduled to take place on January 1, 2013 if congress does not act and the country goes over the “fis-cal cliff ” in accord with the Budget Control Act of 2011. The new CPT codes and reim-bursement rates are scheduled to be pub-lished at about the time this newsletter is published. CMS has not made a final deci-sion about the “relative value unit” (RVU) factored into the calculation of reimburse-ment amounts and so has assigned “in-terim” work RVUs for the codes in 2013, comparable to the current psychotherapy codes.

This is not an easy time for psychologists, in or out of health centers, but it is impor-tant that we collectively stay informed and continue to have psychologists at the vari-ous tables where these critical policy and financial decisions are being made.

I truly appreciate the work of the many psychologists in APAHC who are active in these matters and suggest we maintain an ongoing dialogue to discuss how the changes will impact our services and our patients.


Healthcare Changes in Our Present and Future♦ John Wryobeck, Ph.D., University of Toledo Medical School


SPRING2013



APAHC 2012 Conference Co-Chairs: ♦ Laura Shaffer, Ph.D., Cathy Schuman, Ph.D., and Amit Shahane, Ph.D.

Make your plans now! Our 6th national conference will be here before you know it, and you will not want to miss this professional development and networking event of the year. The con-ference is January 31-February 2, 2013 at the fabulous Hutton Hotel in Nashville, Tennessee. Our theme is as ambitious as our members: Applying the Science of Psychology in Academic Health Centers: Implications for Practice, Teaching, Research and Policy.

We have a star-studded program of our own esteemed APAHC colleagues in addition to our recent research award recipient and leaders from APA. Drs. Norman Anderson and Danny Wedding will open the conference with addresses on national and international efforts to more

firmly establish psychology as a healthcare profession. We will explore current work on interprofessionalism with addresses by Drs. Suzanne Bennett Johnson and Susan McDaniels as well as Regina Russell who was involved in writing the AAMC Report Behavioral & Social Science Foundations for Future Physicians. Dr. Jerry Leventhal and members of the APAHC Research Committee will update us on APAHC’s efforts to collaborate with the AAMC and APA to better understand workforce issues in aca-demic health centers. Those of you who were at APPIC last Spring or who have had the opportunity to hear him elsewhere will be pleased to know that Dr. Kermit Crawford is going to give a talk on multicultural com-petence. Clinical topics for this year include risk-taking behavior in youth (Drs. Velma McBride Murry and Uma Rao), obesity (Drs. Thomas Wadden, Laura Shaffer, and Wendy Ward), motivational interviewing (Dr. John Wryobeck), and working with difficult patients (Dr. William Robiner). As follow up to lively discussion at our last conference in Boston, Dr. Jeffrey Youngrenn is going to give a presentation regarding ethical issues surrounding electronic health records. We will also have presentations on facilitating and funding clinical research (Dr. Roger Kessler) and implications of healthcare reform for psychology training and available funding (Dr. Cynthia Belar). Finally, Janice Stern, Senior Editor of Health and Behavior at Springer Science+Business Media, will give an address to aid in the dis-semination of our good work through publication. Be sure to plan to stay an extra day in Nashville if you want to explore because you will not want to miss a minute of this line-up!

Other exciting activities include the Early Career Boot camp, poster session, and APAHC’s 30th birthday celebration. Representatives from the Commission on Accreditation will again be on hand to provide site visitor training and a Self Study workshop. ABPP examin-ers will also be present for those of you ready to complete your exam in Clinical Health Psychology.

The conference program, registration, and hotel information are all available on the APAHC website:http://www.div12.org/section8/index.html.

See You in Nashville!

President: Barbara Cubic, Ph.D.

Past-President: William N. Robiner, Ph.D., ABPP

President-Elect: Ron Brown, Ph.D., ABPP

Secretary: Kathryn Sanders, Ph.D.

Treasurer: Kim Embleton Dixon, Ph.D., MBA, BSN

Members-at-Large: Alfiee Breland-Noble, Ph.D.Cheryl Brosig Soto, Ph.D.

Division 12 Representative: Barry Hong, Ph.D., ABPP

Membership Chair: John Wryobeck, Ph.D.

Program Chair (APA; 2012-13): Ron Brown, Ph.D.

Conference Committee Co-Chairs: Laura Schaffer, Ph.D.Catherine Schuman, Ph.D.Amit Shahane, Ph.D.

Trainee Representative: Amanda Wheat, Ph.D.

Senior Advisor to the President: Cheryl King, Ph.D., ABPP

AAMC CAS Reps (2010-2012):Patrick Smith, Ph.D., ABPPCynthia Belar, Ph.D., ABPP

Research Chair: Gerald Leventhal, Ph.D.

Communications and Publications Committee:

Melisa Moore Ph.D., Co-Chair, Editor, e-newsletterJohn Wryobeck Ph.D., Co-Chair, Web MasterBarbara Cubic, Ph.D., Editor, JCPMS

Special Projects: Catherine Schuman, Ph.D.

Association of Psychologists in Academic Health Centers (APAHC)

APAHC Board of Directors& Committee Chairs

ner Distinguished Career Award knowing that he lives this life every day, and has had an impact locally, throughout Minne-sota, and nationally. He is a gifted teacher and researcher, is well respected by peers, open to debate, and willing to challenge us to think more broadly about solutions. In summary, Dr. Robiner is a visionary who works tirelessly on behalf of the field. Minnesota is a better place because of Dr. Robiner, and the field of professional psy-chology has a rare gem in his presence and willingness to serve in so many areas.

Dr. Robiner received his Ph.D. from Wash-ington University in St. Louis Missouri in 1981. He completed his fellowship at Hen-nepin County Medical Center, Department of Psychiatry. Since 1985, he has been a faculty member of University of Minne-sota. In 2011, Dr. Robiner was inducted into the University of Minnesota Academic Health Center Academy of Excellence in the Scholarship of Teaching and Learning. Dr. Robiner has been credentialed by the National Register since 1991.

The National Register is the largest cre-dentialing organization for health service psychologists. For more information, see www.nationalregister.org.

How can we, as psychologists, best pre-pare ourselves to successfully meet these challenges?

Become educated, broadly trained and ex-perienced. Be willing to become involved with professional organizations and avoid a “silo” mentality. Pursue continuing pro-fessional development and life-long learn-ing across the life-span. Leave a comfort zone and take risks that might be uncom-fortable.

Describe the challenges and successes you have experienced during interactions with physician colleagues across different professional roles (i.e. clinical, research, administration, etc.)?

The constant challenge is that my train-ing and experience differs from my phy-sician colleagues. We have had to learn each other’s culture constantly. Earning equality takes time but works better than demanding it. Physicians are ultimately responsible for patients in most settings. I am often a consultant for all but my out-patients, and I work with that fact of life. Research is more of a level playing field and administration has been an avenue of success. Over time psychologists got pagers and inclusion in medical staff di-rectories, obtained medical staff parking for psychology faculty and interns, were appointed to important committees and then chaired them, got promoted and tenured. They have the same size offices on the same corridor and have the respect of medical students and residents, as do psychology interns. They are valued by physician colleagues for their clinical and teaching skills and their contribution to the service and research mission of the academic health center. They could live without us; they would rather not.


ASSOCIATION OF PSYCHOLOGISTS IN ACADEMIC HEALTH CENTERSASSOCIATION OF PSYCHOLOGISTS IN ACADEMIC HEALTH CENTERS

In addition to what you’ll read about from our contributing members, there are two honors I’d like to highlight:

First, Dr. Barry Hong, past president of APAHC, received a 2012 APA presidential citation from Suzanne Bennett Johnson. The Citation recognizes “Dr. Hong’s ex-traordinary leadership and contributions to the advancement of psychology in aca-demic health centers and to medical educa-tion.” Since 2008 Dr. Hong has represented medical school clinical faculty on the 5th comprehensive review of the MCAT, and you can read about his work in the Spring 2012 edition of Grand rounds.

Second, a new award was established in honor of Dr. John Robinson. The Society for the Psychological Study of Ethnic Mi-nority Issues, a division of the APA, re-cently established the Asuncion Miteria Austria and John Robinson Distinguished Mentoring Award to be initially awarded at the 2012 APA convention. This award was established because of John’s long and distinguished record of mentoring students and psychologists (especially early career psychologists) into service in the governance structure of APA.

APAHC’s membership is brimming with talent! As you can see, even contributions to the listserv can end up having a lasting impact. We hope that you will bring your talent to one of our new initiatives, to one of our committees, to our exciting upcom-ing conference or to our next newsletter.

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cultural diversity and health disparities initiatives Dr. Breland Noble has encour-aged several early career psychologists to assist her in determining the direction the organization should take. Dr. Cheryl Bro-sig has solicited involvement of many ex-perts in the field on medical education on her task force including partnering with Dr. Mark Vogel who has been a central member of the Association of Behavioral Sciences in Medical Education.

And, new ventures? I think there are likely many and I would love to hear from our membership about how you would like to see our thirties unfold. Please e-mail me at [email protected] with ideas.

fall greetings letter from the editor from the apahc president · 2018-05-04 · letter from the...

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