President's Message: First the Good News, and Then the Bad News
by Mark Wright, M.D.

I postponed writing this column until after the American Psychiatric Association Meeting in Philadelphia so that I could report to you what I had learned about two issues of great importance to psychiatrists in Kentucky. The first is the recent issue regarding malpractice insurance coverage. The second is prescriptive privileges for psychologists.

As you are probably aware, in February, Legion Insurance Company, the preferred provider for the American Psychiatric Association Professional Liability company, dropped to a B rated company. Soon thereafter the Insurance Commissioner for the state of Philadelphia (where Legion's home office is located) took over the oversight and management of the company and placed Legion into voluntary rehabilitation. The Psychiatrists' Professional Liability Insurance Program has been working diligently to obtain quality malpractice coverage for members of the APA. While in Philadelphia, I met with the chairman of this program as well as the regional director who is responsible for Kentucky. I am pleased to announce that coverage has been obtained from an A++ program. The National Union Fire Insurance Company will become the new carrier for the state for Kentucky. I have been in touch with the Insurance Commissioner's office to encourage an expeditious processing of this company such that coverage may be continued for psychiatrists in a fluid manner. As policies with Legion come up for renewal, the policyholder will be re-insured by The National Union Fire Insurance Company. It should be noted that Legion is NOT IN RECEIVORSHIP and NOT IN BANKRUPTCY at this time.

In most instances, since the majority of policies are of the claims made type, there will be no need of a tail to cover previous events; that is, the insurer covering at the time of the claim is responsible for the claim even if its occurrence preceded the period of the policy. If you have further questions regarding this issue, The Psychiatrists' Program can be contacted directly at 1-800-245-3333, or visit the company website at apa-plip.com. It should be noted that an increase of 30% in coverage prices is expected.

The second issue that was a hot topic of discussion in Philadelphia is the recent event in New Mexico. Despite the concerted efforts of the American Psychiatric Association and the American Medical Association, psychologists were granted prescriptive authority in the state of New Mexico. It seems that an important development in this occurring was the agreement of family physicians to become supervisors of psychologists wishing to prescribe medications. The law requires 400 hours of supervision of a minimum of 100 patient cases by a physician. After a two-year period, the psychologist may apply for independent prescribing privileges, WITHOUT PHYSICIAN SUPERVISION. Of note is that although psychologists made the issue of receiving prescriptive privileges an issue of access to mental health care in rural areas, attempts to limit psychologists prescribing to rural areas was always met with great opposition by the psychologists.

The APA will continue to monitor this issue in New Mexico as well as in the rest of the United States where this is surely to become an important issue as psychologists push for prescriptive privileges in other states. As a psychiatrist, it will be important that each of us take an active role in talking with elected representatives on both a state and national level about this very important issue in health care. As a psychologist who returned to medical in order to train APPROPRIATELY to prescribe medications, I believe it is imperative that everyone has a the right to have medication prescribed by a physician. To paraphrase an American Medical Association slogan, psychologists prescribing medication is a prescription for disaster.

At the risk of sounding melodramatic, it must be stated that now, more than any time in recent years, the Kentucky Psychiatric Association and the American Psychiatric Association need the participation of every practicing psychiatrist to fight for the rights of those who require competent psychiatric treatment. We owe this to our patients, their families, and our colleagues who rely on our medical expertise in facilitating the mental health of the citizens of Kentucky. If you are not a member of the KPA, I invite you to join your fellow psychiatrists in an organization that is pursuing the best interest of psychiatric patients.

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