APA at A Glance - Missouri Psychiatric Association

Transcription

Vol 36 No 1 1st Quarter, 2010
Eastern
n
hiatric
Missouri Psychiatry
Newsletter of the Eastern Missouri Psychiatric Society (EMPS)
* * * A District Branch of the American Psychiatric Association * * *
District Branch
of the
ty AAssembly
Reorganization
Means Changes for Missouri
American
Association
By Psychiatric
Garry M. Vickar
MD, FRCPC, DLFAPA and Jo-Ellyn M. Ryall MD, DFAPA
T
he year 2009 was difficult for
APA, especially after the Board
of Trustees mandated a $200,000+
reduction to the Assembly’s 2010 budget.
Deciding what to cut and by how much
fell to the representatives and deputy
representatives. It was the “big elephant in
the room” during the Nov. 20-22 Assembly
meeting, in Washington, D.C.
Because of the need, in fact, demand, to
slash expenses, numerous debates occurred
in Area Council meetings and, ultimately,
on the Assembly floor. The biggest issue
dealt with representation in smaller
areas. After hearing all the resolutions
and amendments, the Assembly voted to
reorganize by changing the formula for
representation to one based on membership
size per state, not district branch.
Effective January 1 (with the new
budget year), the Assembly will apportion
Area Council representatives on a sliding
basis of 450 members for the first rep and
400 members thereafter for subsequent
reps. In addition, states with one rep will
have a deputy rep and states with more than
one rep will have no deputy reps attending
the Assembly.
The Assembly will apply the formula
across the board, with the changes to occur
at the May meeting. The 13 district branches
in New York and five in California took a
beating, as did the three DBs in Missouri.
With a combined state membership of
approximately 550 members, the bottom
line is that Missouri loses one of its three
reps and all of its three deputy reps.
We—all three District Branches—have
been proactive on this issue since it first
arose several months ago. Arshad Husain
MD (CMPS) and David Hunter MD from
Central Missouri, Sherman Cole MD and
Bob Batterson MD from Western Missouri,
and Garry Vickar MD and Larry Kuhn MD
from EMPS, reps and dep reps respectively,
have participated in conference calls with
the state’s DB presidents and executive
staff. The discussions have focused on how
to select two reps for the entire state—
where no state structure exists, and whether
to unite our independent district branches
into a single state association.
Regardless of the discussions, one thing
is clear: Missouri will lose more with its
current fragmented organizational structure.
In its zeal for continued downsizing, APA
decided to award future grants only to
states, not individual DBs. This will have
a serious economic impact at the district
branch level because APA grants are an
important supplemental funding source that
enables DBs like EMPS to support special
projects, advocacy initiatives, litigation,
and infrastructure expenses. For example,
in 2009, we received funds to support a
membership recruitment and retention
campaign. We would not have been able to
initiate the project without the APA grant.
The decision of the three DB presidents
is to conduct a simultaneous election by the
entire Missouri membership to determine
which two representatives to send to the
Assembly. As for whether or not to merge
the district branches, that decision is for
members, as well.
“Whether or not I am the rep who will
continue to serve,” Dr. Vickar said recently,
“I want to express my gratitude for the
opportunity of having been able to serve
[EMPS] for these many years. It has been
an honor and a privilege to represent my
colleagues with the dignity and respect that
their positions have demanded on the floor
of the Assembly.”
We invite the entire Missouri
membership to join us Saturday, March 27,
2-4 p.m., during the Missouri State Medical
Association convention at Renaissance St.
Louis Hotel Airport on Natural Bridge
Road. The membership meeting will
immediately follow a special luncheon
program on psychiatry at 11:30 a.m.–1:30
p.m., when Jothika N. Manepalli MD
will present “Geriatric Mood and Anxiety
as Comorbid Problems in Primary Care
Settings: Evaluation and Management.”
The details are in the works.
Dr. Garry M. Vickar has served as the EMPS
Representative to the APA Area 4 Council
since 2005. Dr. Jo-Ellyn M. Ryall is Chair
of the Area 4 Council. Both also serve on
the EMPS Executive Council.
Content
President’s Column.........................2
MO Psychiatrists Advocate.............3
Legislative Report...........................4
CME: Life After Residency...............4
The Lawsuit Psychosis......................5
Roth Conversion...............................6
APA at a Glance..............................8
Visiting Africa................................13
The Great Russian Escapade..........14
Membership Update......................16
Obituaries......................................18
Committees...................................19
Member Notes................................19
Upcoming Events..........................20
Eastern Missouri Psychiatry
g{x cÜxá|wxÇàËá VÉÄâÅÇ
1st Quarter, 2010
1321 Montevale Court
Fenton MO 63026-3016
(636) 343-8555
RDefilippo@aol.com
www.emopsych.org
Forming the Missouri
Psychiatric Association
Daniel Mamah, MD, MPE
EMPS President
EXECUTIVE COUNCIL
OFFICERS 2008-2010
President
Daniel T. Mamah MD, MPE
President-Elect
Jack L. Croughan MD
Secretary/Treasurer
Susan A. Minchin MD, PhD
APA Assembly Representative
Garry M. Vickar MD
A
Deputy APA Assembly
Representative
F. Kuhn MD
merican Psychiatric Association
which involved sharingLawrenceresources
and
Immediate Past President
(APA)—a
powerful
advocate
publishing a statewide newsletter,
failed;
Jack L. Croughan MD
for psychiatry—works in close
the DBs eventually abandoned
the effort in
COMMITTEE CHAIRS
Bylaws
collaboration with its 74 district branches in
2004.
Jo-Ellyn M. Ryall MD
the U.S., Canada and Puerto Rico. A unified
This year, the need to revisit
thePsychiatry
“merger”
Child & Adolescent
Judith H. McKelvey MD
organizational structure and geographically
issue takes on greater emphasis.
Merger is
Community & Public Psychiatry
Christopher Loynd DO
diverse membership with representation on
now a more viable option for
several reasons.
Education
Arturo C. Taca Jr. MD
various components enables APA to consider
First, the recent Assembly
reorganization
Ethics
Lawrence F. Kuhn MD
issues that affect all
reduced Missouri’s
number
Forensic Psychiatry
psychiatrists and, thus,
of representatives
Jose Mathews MD from three
Legislative
Affairs
speak with a strong voice
to two and
eliminated
the
Paul B. Simon DO
for the profession.
three deputy
representatives.
Membership
A similar need for
Second, Members-in-Training
APA and the
Tabe Ambilichu MD
unification at the state
AssemblyMoses
recognize
Ben W.will
Holt MD
Newsletter
level could apply. For
our three Daniel
DBs
collectively,
T. Mamah MD, MPE
example, Missouri joins
i.e., only Public
asAffairsa Psychiatry
state entity,
Collins E. Lewis MD
California and New York
regardless of whether a state
EXECUTIVE DIRECTOR
as the only states with more
entity exists
(see page 3).
Rebecca DeFilippo MBA, CMP
GOVERNMENTAL CONSULTANT
than one independently
Beyond
Assembly
Richard “Mo” McCullough
run APA district branch
reorganization, the reality
(DB).
The
difference
is that merger makes sense
is that New York and
financially and politically.
California have umbrellaIn a depressed economy,
like state associations that
it is essential to conserve
coordinate legislative and
operational
resources
advocacy activities within
otherwise duplicated by
their borders. Missouri
three separate organizations
does not. The three district
doing essentially the same
branches of EMPS, Central
thing. In addition, APA will
Missouri
Psychiatric Working MPA Logo: The logo award any future grants for
Society
and
Western depicts a modified medical caduceus. special projects, advocacy,
Missouri
Psychiatric The “White Hawthorne Bossom” litigation and infrastructure
Society comprise the most is the Missouri State flower, and to states, not DBs within the
fragmented
psychiatric represents general mental and same state.
organizational structure in physical health. Three filaments per
Our advocacy efforts
petal symbolize the three comprising
APA.
would also benefit from
psychiatric societies. The thorny stem
Discussions
about
merger.
Forming
the
is a representation of psychiatric
merging Missouri’s DBs distress.
Missouri
Psychiatric
into one organization have
Physicians Political Action
occurred for years. The lack of a cohesive
Committee, or MoPPPAC, a little more than a
statewide entity is most apparent in the
year ago, was an important first step. Formally
legislative arena, where activities to influence
joining operations to speak on behalf of
the Legislature require financial resource
the approximately 550 APA members in
sharing and an engaged grassroots advocacy
Missouri would further strengthen our voice
effort. Previous attempts in the early 2000s,
Continued on page 11
2
Eastern
Missouri
sychiatric
PSociety
A District Branch of the
American Psychiatric Association
Fenton MO 63026-3016
(636) 343-8555
RDefilippo@aol.com
www.emopsych.org
EXECUTIVE COUNCIL
OFFICERS 2008-2010
President
President-Elect
Jack L. Croughan MD
Secretary/Treasurer
Susan A. Minchin MD, PhD
APA Assembly Representative
Garry M. Vickar MD
APA Assembly Deputy Representative
Lawrence F. Kuhn MD
Immediate Past President
Jack L. Croughan MD
COMMITTEE CHAIRS
Bylaws
Child & Adolescent Psychiatry
Judith H. McKelvey MD
Community & Public Psychiatry
Christopher Loynd DO
Education
Arturo C. Taca Jr. MD
Ethics
Lawrence F. Kuhn MD
Forensic Psychiatry
Jose Mathews MD
Legislative Aff airs
Paul B. Simon DO
Membership
Members-in-Training
Moses Tabe Ambilichu MD
Ben W. Holt MD
Newsletter
Public Aff airs Psychiatry
Collins E. Lewis MD
EXECUTIVE DIRECTOR
Rebecca DeFilippo MBA, CMP
NEWSLETTER EDITORIAL DIRECTOR
Jessica Simon
GOVERNMENTAL CONSULTANT
Richard “Mo” McCullough
1st Quarter, 2010
Missouri Psychiatrists Advocate to Increase
Community Mental Health Services
By Rebecca DeFilippo CMP, CMMM
I
nclement weather did not deter
psychiatrists representing Missouri
Psychiatric
Association
from
attending an early morning legislative
breakfast reception Jan. 21, in Jefferson
City.
Missouri
Psychiatric
Association
(MPA), an informal organization comprised
of Central Missouri Psychiatric Society,
Western Missouri Psychiatric Society and
EMPS, sponsored the event.
MPA members from St. Louis and
Kansas City met with more than 60 state
legislators and their staff during the third
annual Legislative Breakfast and Mental
Health Advocacy Day at the State Capitol.
Joining WMPS president Subbu Sarma
MD, EMPS president Daniel Mamah MD,
EMPS members Jo-Ellyn M. Ryall MD,
Paul Simon DO and David Berland MD
and the author were MPA lobbyist Mo
McCullough, his McCullough Schlosser
Consulting partners, Nick McCullough
and Lynne Schlosser, and Missouri State
Medical Association Government Relations
Director Tom Holloway and Legal Affairs
Director Jeffrey Howell.
Missouri Gov. Jay Nixon has stated
plans to “rein in . . . overused Medicaid
services” by targeting “heavy users of . .
. psychotropic drugs.” He projects saving
$121 million in fiscal 2011, starting July 1,
by reducing outpatient services provided
through the Department of Mental Health
and limiting the availability of some
community based mental health services
to participants of Missouri HealthNet, the
Medicaid-funded health care program for
the poor.
During talks with state lawmakers,
psychiatrists discussed the impact proposed
service cuts would have on individuals with
mental illness. “Approximately 20 percent
of Missourians has a psychiatric condition
and half of those have severe illness,” Dr.
Mamah told legislators. “A large number
do not receive adequate psychiatric care.”
Many patients lack access to vital
community services and programs. “When
people need help, they often go to hospital
emergency rooms—the most expensive
level of care,” Dr. Ryall said. “This only
adds a heavier burden to already limited
Medicaid dollars for law enforcement,
corrections and state hospitals. No one
wins with these budget cuts.”
Dr. Ryall cited the dramatic changes
that can occur when mental health centers
such as St. Louis-based Places for People
provide patients with Assertive Community
Treatment. “It makes a big difference in
outcomes when patients get the care they
need before they crash and burn.”
The psychiatrists also discussed two
proposals outlined in the MPA 2010
Legislative Agenda. The first proposal
encourages the Legislature to develop an
integrated delivery system of psychiatric
care to ensure accessible and safe treatment
in Missouri’s underserved areas. The fourpronged approach includes expanding the
current network of telepsychiatry services,
enhancing the education of primary care
physicians in psychiatric care, recruiting
psychiatrists to practice in underserved
areas, and improving coverage of psychiatric
services provided by MO HealthNet.
The second proposal would create a state
advisory council on psychiatric care to
study and develop ways to implement an
integrated delivery system.
MPA members also urged lawmakers to
reject bills to expand the scope of practice
for healthcare professionals beyond their
level of education and training. As of
Feb. 5, there is no Missouri bill to allow
psychologists to prescribe medications
(RxP). “We may have short circuited the
RxP bill already this session,” lobbyist Mo
McCullough said. “So far, no one wants
to sponsor it this year.” March 1 is the last
day to file a bill in the Senate and April 1
in the House. “Anything could happen,” he
cautioned, before the Legislature adjourns
May 14 at 6 p.m.
District 87 Rep. John Diehl, R-Town
and Country, discussed with MPA members
how the state allocates monies; education
and state-funded Medicaid consume the
largest share of resources. “Given the severe
budget deficit in Missouri, it is unlikely the
Legislature will support program growth,”
said Rep. Diehl, who represents the cities
of Brentwood, Creve Coeur, Crystal Lake
Park, Des Peres, Frontenac, Huntleigh,
Ladue, Rock Hill, Town and Country,
WMPS President Subbu Sarma MD and EMPS
President Daniel Mamah MD with Rep. Kevin
Wilson, R-Neosho (center), at the Jan. 21 legislative breakfast in Jefferson City.
EMPS Executive Director Rebecca DeFilippo
and EMPS member David I. Berland from St.
Louis with Rep. Stacey Newman, D-St. Louis
County (center), outside the Missouri House of
Representatives chamber Jan. 21.
EMPS members Jo-Ellyn M. Ryall MD and
David I. Berland MD from St. Louis with Rep.
Dwight Scharnhorst, R-Valley Park (center),
Jan. 21 at the State Capitol Building in Jefferson
City.
Continued on page 9
3
1st Quarter, 2010
2010 Missouri Legislative Report
By Richard “Mo” McCullough
T
he 2010 legislative session
in Missouri began at noon on
Wednesday, January 6. This should
be a wild one. Once again, the main issue
will be the state budget and, if you think
last year was tough, this year will be worse.
With an estimated 10% to 12% decrease
over last year’s revenues, everything will
be on the chopping block; nothing will be
safe.
Because 2010 is an election year with
major turnover coming due to term limits,
state legislators are going to be walking a
tight rope between raising taxes and cutting
expenses. Nothing is certain and nothing is
off the table.
Other issues likely to draw attention
this year will be economic development
and ethics reform. The General Assembly
will spend a great deal of time on both, with
an emphasis on job creation and economic
development in an attempt to increase state
revenues.
Obviously, other things will be going on
as witnessed by the more than 400 bills prefiled in December. As of February 5, there
was nothing on psychologist prescribing
but I expect a bill or two to come out soon.
We will be ready with strategic lobbying,
educational information for legislators, and
proactive access legislation of our own.
We will need everyone’s help in
fighting this onerous legislation, so be
prepared to contact your legislator when
asked to do so. Also, now is when we need
to grow our membership numbers in the
Eastern, Central and Western Missouri
Psychiatric Societies and our political
action committee, MoPPPAC. So, please
join, bring in a colleague and get active. By
working together, we succeed.
Richard “Mo” McCullough, a registered
lobbyist in the State of Missouri, represents
psychiatric physicians, their patients and
the profession before the Missouri General
Assembly. He is a frequent contributor to
Eastern Missouri Psychiatry.
Free Suicide
Risk Training
DVD Available
By Rebecca DeFilippo, MS,
MBA, CMP, CMMM
I
n 2009, the American Association
of Suicidology (AAS) developed a
training DVD to educate psychiatrists
about suicide risk and its formulation,
with a goal to help psychiatrists better
recognize and treat those at risk for suicide.
“Suicide Risk Formulation: A Guide for
Psychiatrists” was funded by a grant from
Noven Therapeutics LLC.
For 42 years, AAS has led the nation
in the advancement of scientific and
programmatic efforts in suicide prevention
through research, education and training,
the development of standards and resources,
and survivor support services.
EMPS has a limited supply of the DVD
available for free distribution. If you would
like to receive a complimentary copy,
please contact EMPS at (636) 343-8555 or
RDefilippo@aol.com.
Recap of CME Program on Life After Residency
By Ben Holt MD, PGY 3 Psychiatry Resident, Washington University in St. Louis
S
t. Louis is fortunate to be home to two
excellent medical schools. Annually,
nearly 70 psychiatry residents and
fellows along with a significant number of
medical students with a strong interest in
psychiatry train at these two sites. Although
the programs do a fantastic job preparing
the next generation of psychiatrists, it is
often difficult to appreciate the breadth of
psychiatric practice opportunities while
engrossed in an academic milieu.
In an effort to reach out to medical
students and residents alike, Eastern
Missouri Psychiatric Society hosted
a CME dinner program entitled “Life
After Residency: Options for Psychiatric
Practice” on October 20. The program
brought together a panel of eight outstanding
psychiatrists working in eastern Missouri to
showcase different practice opportunities
available after the completion of residency.
Jaron Asher MD began the program
by outlining his experience working with
4
the underserved in St. Louis at a federally
funded community health center. Robert
Brady MD talked about his experience as a
Child and Adolescent psychiatrist, helping
his patients during the most influential
years of their lives. James Cannon MD,
Acting Lead Psychiatrist for the St. Louis
VA Hospital, related the challenges and
rewards of working with our nation’s
veterans. John Crane MD, of Washington,
Mo., recounted leaving the big city behind
and his experience living and working
in a rural community for the past several
decades.
Jothika Manepalli MD, Geriatric
fellowship director at St. Louis University,
shared her passion for working with older
patients. Dehra Glueck MD described how
she turned a dream of working from home
into a successful telepsychiatry service,
providing much needed care to rural areas
from the comfort of her home office. Jose
Mathews MD spoke about forensics and
its importance in the practice of psychiatry.
Arturo Taca Jr. MD, with many years
of treating chemical dependency issues,
discussed the treatment of patients with
substance use disorders.
The program was well received by the
64 health care professionals in attendance.
The panel did a great job presenting on their
psychiatric specialties and providing insight
to medical students and fellows about
various practice options after residency. The
program also highlighted the talent of local
psychiatrists and their diversity of interests.
The EMPS hopes to offer more programs
like this along with other resources to help
foster mentorship of Members-in-Training
by established psychiatrists throughout the
district branch.
Dr. Ben Holt co-chairs the Members-inTraining Committee on the EMPS Executive
Council. He is a frequent contributor to
Eastern Missouri Psychiatry.
1st Quarter, 2010
The Lawsuit Psychosis
By Moses Tabe Ambilichu MD, PGY 2 Psychiatry Resident, St. Louis University
P
hysicians across all specialties
spend a tremendous amount of
time and investment to coronate
the rigorous, tortuous and complicated
training required to earn a license as a
competent medical professional. This
process requires discipline, assiduity,
endurance and, ultimately, sacrifice. As top
priority, adequately seasoned health care
professionals strive to deliver good quality
treatment to their patients at all times.
This is the reason for enduring so much
sacrifice, both in financial as well as time
commitments, in the steep climb towards
becoming a health care provider.
Owing to the litigious atmosphere
surrounding the practice of medicine,
however, there lingers in the back of
most physicians’ minds a persistent and
significantly
distress-provoking
fear,
even paranoia. As they execute their
mission of patient care, they anticipate
that an unfortunate event might occur
leading to them or a colleague being cited
in a malpractice case. This fear can be
enormous and, at times, overwhelming.
It can reflexively lead physicians to adopt
maladaptive and defensive patterns of
practice detrimental to the same patient
they are trying to help. This situation
negatively impacts the health care system,
by wasting resources in a desperate effort to
do everything that will make a hypothetical
malpractice case defensible. This is a
serious issue, which I have termed “Lawsuit
Psychosis.”
I recall talking with a patient from
Illinois who confessed that she and her
family seek health care in the St. Louis area
or Missouri, at large, because most of the
physicians near them have left the area or
are ostracized by the heavy burden of an
extremely hostile legal climate. As a result,
she said wait times to see a consultant
could be several months. This underscores
how a physician-unfriendly environment is
causing a dangerous hemorrhage of health
care professionals out of this community,
leading to extreme hardship for the same
patients it was intended to protect. This
scenario is easily replicated in many areas
of the country.
Take, for example, an ER doctor who
assesses a patient with symptoms suggestive
of a common migraine headache. The
patient reports a past medical history of
migraines; there are no alarming signs
with this presentation. In spite of all this,
the physician focuses his microscope on
the possibility of a lawsuit and fails to find
comfort in the pure science of the matter.
His mind is pandemonium; within it an
intense fear rages as a perturbing voice
keeps up a running commentary: “What
if I miss something and get sued? I would
rather get a Neurology consult and a CT
scan of the head just to cover my...” The
head CT is normal and the Neurology
resident confirms that the patient has a
common migraine headache.
This kind of approach to patient care
negatively impacts both the patient (higher
copay, unnecessary exposure to ionizing
radiation, waste of time...) and the health
care system (increased deficit). This is
one of many scenarios in which ordering
multiple, irrelevant diagnostic tests is not
done to improve the quality of care rendered
to a patient but to defend oneself against a
lawsuit.
A recent lecture I attended focused on
malpractice lawsuits and how to avoid
them. One of several ways to do this
is to document objectively, accurately,
completely, thoroughly and, above all,
defensibly. My observation is that there is a
huge discrepancy between how much time
is actually dedicated to direct patient care
versus that allotted to documentation.
In this sea of troubles, a hostile
legal atmosphere has generated gigantic
negative waves that have steered the boat
of the sailing physician towards the port of
documentation, away from an interactive
and priceless doctor-patient relationship—
the gold standard of medical practice. On
the average, if a doctor has an outpatient
appointment of 30min with a client, he or
she may spend, at most, 10 minutes talking
to the patient and the rest on documentation.
The rule of thumb is that it is better to spend
most of the time on documentation, rather
than on the patient, because it is the key tool
that may be helpful in extricating oneself in
case a lawsuit ensues in the future. This is
defensive practice and precarious patient
care.
In conclusion, it is critical to appreciate
the effect that “lawsuit psychosis” has on
individual patient care as well as the health
care system at large. Physicians will often
order an excessive number of tests or obtain
supplementary consults just to be sure
their actions are defensible. Furthermore,
the exaggerated use of consults even for
minor issues severely undermines the need
for residents and physicians to exercise
minimal proficiency in areas of medicine
other than their specialty. Defensive
medicine has a huge impact on the health
care crisis. Therefore, any health care
reform that does not seek to overhaul
malpractice laws is defective and below
expectations. Tort reform may be a cure for
“lawsuit psychosis.”
Dr. Moses Tabe Ambilichu co-chairs
the Members-in-Training Committee on
the EMPS Executive Council. He is a
frequent contributor to Eastern Missouri
Psychiatry.
Do We Have Your E-mail?
Have you missed receiving late-breaking news from EMPS? Send your e-mail address to RDefilippo@aol.com and hear quickly about
upcoming events and news that affects you, your patients and the profession. EMPS will never share your address.
5
1st Quarter, 2010
Roth Conversion Season Begins; Income Limits
Lifted January 1
A
s of January 1, high net worth
individuals can convert a traditional
IRA to a Roth IRA. Income limits
that once prohibited individuals with income
in excess of $100,000 from converting to a
Roth have been eliminated (as part of the
Tax Increase Prevention and Reconciliation
Act of 2005).
In theory, everyone can now convert
his or her traditional IRA to a Roth. But in
reality, it is not as simple.
Time to Explore the Possibilities
Just because a medication is reclassified
from a prescription to over-the-counter
doesn’t mean everyone starts taking it once
it arrives on store shelves. The question
individuals should ask first: Is this right for
me?
While there are no strings attached
with the elimination of the income limits,
there is a resulting tax bill. In general,
an individual should only convert if it is
possible to pay the taxes generated from
the Roth conversion with outside dollars,
not from inside the Roth.
One of Many Silver Linings
One of the “silver linings” associated
with Roth conversions is the ability for
individuals to reverse a conversion. Noted
Roth IRA expert Robert S. Keebler, CPA,
MST, AEP explained the unwind feature in
a December 2009 article in Taxes—The Tax
Magazine.
“It appears right now, because of current
volatility in the stock market, that the most
important reason why a taxpayer may want
to consider converting to a Roth IRA is
the ability for him/her to ‘recharacterize’ a
prior Roth conversion,” Keebler said.
Why would someone want to
recharacterize? If an investor converts
a traditional IRA to a Roth and then
experiences a drop in the account’s value,
it may make sense to recharacterize the
account, then convert at a later date and
pay less tax.
With questions galore, investors have
been connecting with their tax advisors.
The specifics of Roth conversions can
be complicated, so having some basic
6
By Aaron Vickar
information can be useful. Following are
some basics on Roth conversions.
Five Questions on Roth Conversions
1. Which IRAs qualify? Will qualified
plans such as 401(k)s and 403(b)s qualify?
Investors’ personal IRAs and IRAs inherited
from spouses are eligible for conversion.
Other inherited IRAs are not eligible.
Qualified plans such as 401(k)s and 403(b)
s also qualify.
2. Does this mean that anyone can open
a Roth IRA? The rules for opening a Roth
are different from the rules for converting
a traditional IRA to a Roth. Investors who
are over the income limits cannot open a
Roth. If these investors want to contribute
to a Roth each year, they would have to
do so by contributing to and converting a
traditional IRA.
3. Can nondeductible contributions to an
Continued on page 7
Focused on individual needs with a
foundation built from scientic research.
Our process exactly.
Buckingham is proud to be a network provider
for the Eastern Missouri Psychiatric Society.
Buckingham supports EMPS and its goal to remain patient focused.
1st Quarter, 2010
EMPS Offered 10 CME Hours in 2009
By Rebecca DeFilippo, MS, MBA, CMP, CMMM
E
EMPS sponsored five Continuing
Medical Education dinner programs
in 2009, each of which offered
attendees a maximum of 2.0 Category
1 CME credit hours. The programs are
available free to members, non-member
psychiatry residents and fellows, and
medical students interested in psychiatry.
Non-member but eligible psychiatrists are
able to attend up to two programs at no
charge before being asked to join the APA.
The
2009
programs
included
“The Assessment of Dangerousness
in Clinical Practice” with Angeline
Stanislaus MD on April 7, “Ethnicity and
Psychopharmacology: Recent Clinical
Advances” with former APA President
Pedro Ruiz MD June 4, “Preventive Health
Care, A Psychiatric Perspective: The Role of
Fitness in Mental and Physical Health” with
”Edwin D. Wolfgram MD on September
22, and “Life after Residency: Options for
Psychiatric Practice” with a panel of eight
psychiatrists on October 20. The panel
included Jaron Asher MD, Robert Brady
MD, James Cannon MD, John Crane MD,
Dehra Glueck MD, Jothika Manepalli MD,
Jose Mathews MD and Art Taca Jr. MD.
Ben Holt MD and Moses Tabe Ambilichu
MD emceed the program. (See “Recap of
CME Program on Life After Residency” on
page 4)
Roth Conversion
as income. If the total of the IRA accounts
would increase earnings enough to move an
individual into a higher tax bracket, partial
conversions may be more sensible.
Continued from Page 6
IRA made on an after-tax basis be converted
(thus avoiding taxes)? For investors who
own both deductible and nondeductible
IRAs, the taxable portion of the IRA or
portion of the IRA they convert will be
determined based on the proportion of
taxable money in all IRAs combined. The
IRS does not allow taxpayers to designate
that their conversions derive strictly from
nondeductible contributions.
4. Do I have to convert the entire balance
of my traditional IRA? No. In some cases,
even if someone is a good candidate for a
conversion, there may be reasons that make
it impossible or impractical to convert all of
his or her IRA funds. A partial conversion
may make more sense if an individual does
not have money to comfortably pay the
taxes, as partial conversions over a set time
period would soften the tax impact. Even
if an individual has sufficient assets to pay
the taxes, it still may not make sense to
convert all at once. When money converts
from a traditional IRA to a Roth, it counts
Expect the Unexpected
April 2009 had the highest return for
the S&P 500 Index in a single month
since March 2000.
March 2000 ~ 9.78 percent
April 2009 ~ 9.57 percent
5. How much time is given to pay the tax
bill resulting from a conversion? Only
for 2010, investors converting their IRAs
during this year have the option to stretch
the tax on the amount converted (all pretax
contributions and earnings) over two years
— paying half on their 2011 tax return
(due by April 15, 2012) and the other half
on their 2012 tax return (due by April 15,
2013). Any conversions occurring after
2010 will see the resulting amount owed in
the same tax year.
This information is meant to raise
awareness on the topic addressed and
should not be considered tax advice. Please
consult a tax planner before engaging in
actions that may have tax consequences.
________
This column is the first in a series on investment
management provided as a new membership
benefit to EMPS members by Buckingham
Asset Management. Buckingham offers feeonly investment management for individuals,
businesses,
trusts,
not-for-profits
and
retirement plans. Members now have access
to complimentary portfolio analysis and other
planning tools as well as the ability to work with a
Registered Investment Advisory firm at a reduced
rate. For more information on Buckingham,
please visit www.investmentadvisornow.com or
call 800-711-2027 X 241 for more information.
Aaron Vickar is an investment advisor with the
St. Louis-based company.
The final educational activity of the year
occurred December 8 when EMPS sponsored
“A Science-Based Medicine Approach to
the Treatment of Refractory Depression”
with Chris D. Bojrab MD. Thirty-eight
healthcare professionals attended the
program including 28 Physicians, five
Medical Students, one Pharmacist, and one
other healthcare professional. Pamlab LLC
provided an unrestricted educational grant
in partial support of the program. Exhibitors
also included AstraZeneca, Bristol-Myers
Squibb, Janssen, Jazz Pharmaceuticals,
Lilly USA, and Merck.
At press time, EMPS will sponsor its first
CME program in 2010 on Saturday, March
27, during the 152nd Annual Missouri
State Medical Association Convention at
the Renaissance St. Louis Hotel Airport,
9801 Natural Bridge Road, St. Louis, MO
63110. The luncheon program, to be held
from 11:30am to 1:30pm, will feature
Jothika Manepalli MD on “Geriatric Mood
and Anxiety as Comorbid Problems in
Primary Care Settings: Evaluation and
Management.” Dr. Manepalli is a Professor
in the Department of Neurology and
Psychiatry at St. Louis University School
of Medicine, where she also is residency
director of the Geriatric Psychiatry
Fellowship Program, and medical director
of the Inpatient Geriatric Psychiatry Unit
and Electroconvulsive Therapy Services.
There is no fee to participate in MSMA’s
annual convention, but attendees must
register because many convention events,
including access to the exhibit hall, require
badges. Contact MSMA at 800-869-6762,
register online at http://www.msma.org/
mx/hm.asp?id=conferencesignup, or visit
the Web site at http://www.msma.org/mx/
hm.asp?id=AnnualConvention. EMPS also
will post information about this program on
its Web site at http://www.emopsych.org/
upcomingprograms.php.
We encourage members to suggest
future CME topics and/or speakers. In
addition, if you attended a program in
2009 and submitted an evaluation form but
did not receive a CME certificate, please
telephone EMPS at (636) 343-8555 or
e-mail RDefilippo@aol.com.
7
1st Quarter, 2010
APA at A Glance
By Rebecca DeFilippo CMP
G
o paperless with APA
Feb. 5 was the last day to
vote in the APA 2010 election.
Members who would like to receive an
electronic ballot in future elections and
forego the clutter of receiving a paper
ballot should log in to <www.psych.org/
options> and opt-in to only receive an
electronic ballot. Members can also go
online to choose the information they
want to receive from APA by e-mail. Visit
<www.psych.org/optinoptout.Default.
aspx>, log in as an APA member, confirm
or update your contact information, and
then, under “E-mail options,” choose the
e-mail newsletter, offers and updates you
would like to receive.
Meeting in New Orleans. Those DBs will
each win a prize of three free member
registrations to the 2011 Annual Meeting
in Honolulu, Hawaii. The winning DBs
will decide how to award the registrations.
EMPS members will be competing for
the registration prizes against the 13
other district branches in Area 4, which
includes Central Missouri Psychiatric
Society, Western Missouri Psychiatric
Society, and the 11 mid-western states of
Illinois, Indiana, Iowa, Kansas, Michigan,
Minnesota, Nebraska, North Dakota, Ohio,
South Dakota and Wisconsin. Head to New
Orleans this May for a terrific scientific
program, huge exhibit hall and networking
It’s not too late to renew your membership
for 2009
The 2009 dues payment deadline was
October 31, but if you missed the deadline
and pay your dues immediately, APA will
reinstate your membership. Call (888) 3577924 to provide your payment information
or to learn how to pay your dues in monthly
installments with automatic charges to
your credit card. Call today to continue to
receive full member benefits.
Register online for 2010 annual meeting
in New Orleans
APA members can now register and
make hotel reservations for the 2010 annual
meeting in New Orleans, May 22-26. APA
will no longer mail the annual meeting
advance registration packet. Instead, it
will post information about registration,
housing, the preliminary program, courses,
and other topics online at <www.psych.org/
MainMenu/EducationCareerDevelopment/
Meetings/AnnualMeeting.aspx>. For more
information, contact Vernetta Copeland at
(703) 907-7382 or vcopeland@psych.org.
7 DBs will win free registrations to the
2011 Annual Meeting in Hawaii
If thoughts of leis, luaus and sandy
beaches come to mind, EMPS may be able
to help. APA will sponsor a contest among
District Branches to determine the DB in
each Area with the highest percentage
of members attending the 2010 Annual
8
opportunities with your colleagues. Enjoy
some seafood gumbo and fresh oysters
along the way.
APA moves DSM-5 publication date to
May 2013
APA has revised the timeline for
publishing the fifth edition of the Diagnostic
and Statistical Manual of Mental Disorders,
moving the anticipated release date to May
2013. Draft changes to the DSM were to be
posted on the DSM-5 Web site in January.
Comments will be accepted for two months
and reviewed by the relevant DSM-5 Work
Groups in each diagnostic category. Field
trials for testing proposed changes will be
conducted in three phases. Information
about the revision process is available
online at <www.DSM5.org>.
EHR incentives for physicians
APA has posted important information
regarding physician adoption of electronic
health records (EHR) on its Web site at
<www.psych.org/ehrincentive>. Physicians
who treat outpatient Medicare patients and
demonstrate that they are using a “certified”
EHR in a “meaningful” way will be eligible
for incentive payments distributed through
Medicare for up to $44,000 per physician
over five years. Details of the incentive
program will be established through
regulations that started in December.
Discriminatory copay begins phase out
Effective January 1, Medicare began
reimbursing providers for outpatient
psychiatric services at 55 percent, while
the patient copay dropped to 45 percent
from the 50 percent copay. Mandated by
the Medicare Improvements for Patients
and Providers Act of 2008, the new rates
are the first step in the gradual elimination
of the discriminatory copayment rate for
outpatient mental health treatment. In
2012, the reimbursement rate to providers
will increase to 60 percent; in 2013, it will
be 65 percent; and in 2014, it will be 80
percent—the same as for all other medical
services.
The Lifers want you!
APA Lifers are seeking new members.
Lifers are APA members who have achieved
Life, Life Fellow or Distinguished Life
Fellow status. Annual dues are $50 and
provide membership benefits that include
events at APA’s annual meeting in May,
a chance to have their voices heard by
APA leadership, representation at the APA
Assembly, volunteer opportunities at the
Lifers display at the annual meeting, and a
subscription to LifersLine newsletter. The
Executive Committee would be pleased
to hear from other Lifers with ideas for
projects, programs and ways that Lifers can
continue to be of assistance to and impact
APA. Membership information is available
from Captane Thomson MD at cpthomson@
comcast.net or (530) 753-7223.
MO Psychiatrists
Advocate
Warson Woods, Webster Groves and
Westwood in St. Louis County.
Rep. Rick Stream, R-Kirkwood, has
sponsored House Bill 1733, to require
health insurance coverage for eating
disorders. “There is no support whatsoever
to raise taxes,” said Rep. Stream of District
94, which includes Kirkwood and Des
Peres in St. Louis County.
District 93 Rep. Dwight Scharnhorst,
R-Valley Park, said there is bipartisan
support for this year’s autism bills; four in
the House and two in the Senate at press
time. He has filed HB1311 to require
health insurance coverage for the diagnosis
and treatment of autism, which he said is
“close to my heart.” He represents part
of St. Louis County and chairs the House
Interim Committee on Autism Spectrum
1st Quarter, 2010
Disorders.
There are 34 state senators and 163
representatives this session. To read the
full text of a Senate or House bill and track
its progress through the Legislature, visit
<http://www.senate.mo.gov/> and use the
Search for a Bill tab at the left.
Postscript: Just before press time, Rep.
David Sater, R-Cassville, filed HB1918,
which opponents allege targets “heavy
users of . . . psychotropic drugs.” The bill
would establish a psychotropic medication
review subcommittee of the MO HealthNet
Drug Prior Authorization Committee in
an attempt to further reduce access to
atypical antipsychotic monotherapy for
individuals with schizophrenia, bipolar
disorder or psychosis associated with
severe depression. One psychiatrist and
one pediatrician or child psychiatrist would
sit on the 8-member subcommittee. The
House Health Care Policy Committee, of
which Rep. Sater is a member, will hear the
bill.
(L-R): EMPS Legislative Affairs Chair Paul Simon DO, EMPS President Daniel Mamah MD, Sen.
Yvonne Wilson, D-Kansas City, Rep. Tom McDonald, D-Independence, and WMPS President Subbu Sarma MD at the Jan. 21 legislative breakfast in Jefferson City.
9
10
1st Quarter, 2010
1st Quarter, 2010
Missouri Psychiatric
Association
7 District Branches Will Win Free
Registrations to the 2011 Annual
Meeting in Hawaii
and visibility in Jefferson City, especially
on legislative issues that affect our patients
and the profession.
After much discussion between
Missouri’s Assembly reps, dep reps,
presidents and executive staff, we decided
to bring merger to the membership. On
January 19 and 20, each of the state’s three
DBs mailed an election ballot to their
eligible voting members. The ballot offers
members a voice on three key items: (1)
Elect two candidates to represent Missouri
in the APA Assembly, (2) Whether to form a
unified, statewide district branch known as
the Missouri Psychiatric Association, and
(3) Whether to accept a draft constitution
and bylaws for a new statewide district
branch, if formed.
A geographically diverse psychiatric
physician membership would guide the
Missouri Psychiatric Association (MPA).
A new statewide executive council would
seat members from the three former
district branches and ensure an equal voice
at the table regardless of membership
size. Finally, cooperation and a sense of
combined mission would help ensure that
the two newly elected representatives to the
Assembly would share psychiatric issues
affecting the entire state.
Merger would maintain the identity of
the existing district branches and allow
them to focus on regional CME programs
and other events; MPA would facilitate
statewide educational and networking
events. A newsletter and Web site would
inform members of statewide and regional
psychiatric news, as well as employment
and research opportunities.
We encourage your participation in this
election. If you have returned your ballot,
thank you. If you haven’t, please complete
and sign the ballot and return it in the self
addressed stamped envelope included with
the mailing. Ballots must be postmarked by
March 12.
T
he APA will sponsor a contest among district branches to determine the
district branches in each Area with the highest percentage of members attending the 2010 Annual Meeting in New Orleans. Those district branches
will each win a prize of THREE FREE MEMBER REGISTRATIONS to the 2011
Annual Meeting in Hawaii. The winning district branches may decide how to award
the registrations.
Do!you!have!a!Sixth!Sense!and!are!you!Shy?
A!study!at!Washington!University,!conducted!by!
Dr.!Daniel!Mamah,!seeks!people!who:
•
•
• Are!between!18"30!years!old
Believe!they!have!ESP,!telepathy,!or!a!“sixth!sense”
• Often!mistake!noises!for!voices
• Sense!the!presence!of!others!when!alone
Have!extreme!social!anxiety!(or!discomfort)!in!social!
situations!involving!unfamiliar!people
• Have!(very)!few!friends
The goal of the study is to use
computerized imaging methods to
evaluate gray and white matter structure
in the brain
Participation will involve a no cost MRI
scan, plus 3-6 hours of interviews and
cognitive testing. Every participant will be
compensated for their time.
Earn up to $150
Call!Melissa!at!(314)!286"1707
or
melissa@conte.wustl.edu
11
Lakeland Regional
Hospital
440 S. Market
Springfield, Mo. 65806
800-432-1210
www.lakeland-hospital.com
CHILD AND
ADOLESCENT
BEHAVIORAL
HEALTH SERVICES
RESIDENTIAL
24-HOUR
ASSESSMENT
AND REFERRAL
1st Quarter, 2010
As the premier child and adolescent psychiatric
hospital in southwest Missouri, we currently have openings for Staff Psychiatrists and are seeking candidates
who wish to establish both a short and long-term relationship with the hospital.
Reporting to the Medical Director, physicians are
responsible for providing psychiatric care on an inpatient and residential basis, primarily in the Acute Hospital setting.
Broad areas of responsibility include medical management, treatment planning, providing on-going
treatment of patients, communicating with parents
and/or guardian, timely response to patient and hospital needs.
With an established patient base, our facility operates a 60 bed acute psychiatric program, a 60 bed adolescent residential program and offers on-site school
services.
Located in the beautiful Ozarks Region, Springfield
offers a quality of life environment, with public, private
or parochial schooling options, several universities and
colleges, a cost of living below national average, a variety of the four seasons recreational experiences for the
entire family including some of the best hunting and
fishing in the Midwest, outstanding shopping, excellent
churches, and a St. Louis Cardinal minor league AA
team.
We offer a competitive benefits package including
medical, dental, vision, life insurance, long-term disability, vacation, holidays, sick-days and 401K.
CALL 800-432-1210
DRUG FREE WORKPLACE/BACKGROUND SCREENING/EOE
12
1st Quarter, 2010
Visiting Africa for a WPA Meeting
A
buja, the capital city of the West
African country Nigeria, was the
venue of the World Psychiatric
Association (WPA) Regional meeting held
October 22-24, 2009. Attending the meeting
and visiting Africa was an exciting and
memorable experience. I had spent a large
part of my youth living between my father’s
homeland Nigeria and my mother’s native
Hungary, but hadn’t been back to Africa
for 12 years. It was particularly humbling
to be able to return in some professional
capacity, and I had hoped to learn about the
state of psychiatry in the continent with the
potential of contributing to its advancement.
Nigeria, Africa’s most populous nation with
over a 150 million people, has only about
130 practicing psychiatrists (in contrast,
the U.S. has 137 psychiatrists per million
people). As is the case in many developing
countries, mental health services are very
limited and largely underdeveloped. The
stigma of mental illness is pervasive, and
traditional healing approaches are often
utilized by those with mental distress.
The WPA meeting attracted 286 visitors
from 19 countries. Held in collaboration
with the African Association of Psychiatrists
and Allied Professionals (AAPAP) and the
World Health Organization (WHO) and
hosted by the Association of Psychiatrists
in Nigeria (APN), the theme of the meeting,
“Scaling up and reaching down – addressing
unmet need for service”, was chosen to
reflect a major focus of current attention
among stakeholders in global mental health,
including both the WHO and the WPA. Dr.
Oye Gureje, the meeting convener, set the
meeting in the context of several decades
of growth of academic psychiatry in
Nigeria. He reminded participants that the
first formal meeting of psychiatrists from
across the world to be held in Sub-Saharan
Africa was convened in Nigeria by the late
Professor Adeoye Lambo in November
1961.
The meeting had a full complement
of scientific programs including plenary
lectures, key lectures, symposia and free
papers reporting new research. Specific
attention was given to several components
of the WPA Action Plan 2008 – 2011.
These included a symposium on successful
experiences in our field, with examples of
mental health reform (Uganda), cultural
therapy (Jamaica), and a mental health/HIV
initiative (in several African countries); and
a forum discussion focusing on the roles
of professional societies in health care
reforms. Two special workshops were held
during the meeting: one on communicating
with children and adults with intellectual
disabilities and the other on the United
Nations Interagency Standing Committee
Guidelines on responding to conflicts and
disasters. A formal change of leadership of
the AAPAP was also witnessed at the dinner
when Dr Frank Njenga, the out-going
President, handed over the ceremonial
chain of office to Professor Oye Gureje as
the new President.
It was inspiring to hear from those
continuing to be involved in mental health
care and psychiatric research in a continent
were these could easily be discouraged by
poor funding and other challenges. Social
networking during the WPA meeting has
provided opportunities to collaborate with
psychiatrists and researchers in Africa.
Fortunately, I have since been awarded startup research funds through a generous donor
in the U.S. to study prodromal symptoms
of psychotic disorders in Nairobi, Kenya.
Hopefully this will herald more exciting
and productive visits to Africa in future
years.
Dr. Mamah with friends at the opening soccer
game of the FIFA under-17 World Cup tournament, hosted in Abuja
Dr. Mamah with AAPAP Presidents incoming
(left; Dr. Oye Gureje) and outoing (right; Dr.
Frank Njenga)
Ceremonial handing over of the AAPAP Presidency
Social event at the British High Commission in
Abuja. From left: Dr. Jeffrey Geller (APA Vice
President), Dr. Norman Sartorius, Dr. Darrel
Regier (APA), Dr. Jay Scully (APA CEO and
Medical Director), Dr. Daniel Mamah, and Peter West (Acting British High Commmissioner)
13
1st Quarter, 2010
The Great Russian Escapade
T
he “great escapade” began when
Nada Stotland MD, Immediate
Past President of the American
Psychiatric Association, invited me to join
her husband and her on a People to People
Ambassador trip to Russia last August. It
took me a second to sign up and check that
my passport was still valid. The hardest
part was sending in my passport to get a
visa, but all returned in plenty of time. The
following entries are condensed from my
trip diary.
Thursday, August 20, 2009: I fly to
Washington, D.C., and then to New York’s
JFK Airport, where I meet two women from
Texas who are part of the trip. We get our
seats on Lufthansa to Frankfurt, and then on
to Moscow. The flights are long; of course,
two toddlers sit in the row behind me and
kick my seat for much of the overseas trip.
Shortly before my departure, I broke my
collarbone in a bike accident and had to
travel with my left arm in a sling. I get lots
of help in airports.
Friday, August 21: We arrive in Moscow
on a gray day, mid-afternoon their time,
about 3 AM St. Louis time. Several of us
are stuck in a slow moving passport control
line. Finally, I claim my baggage. Several
travelers are not so lucky; their baggage is
lost and doesn’t arrive until Monday. We
meet our fellow travelers and our guide,
People to People Ambassador interpreter Alla
Levitina and Dr. Jo-Ellyn Ryall attend a farewell
dinner in St. Petersburg, Russia. All photos
courtesy of Jo-Ellyn M. Ryall MD.
14
By Jo-Ellyn M. Ryall MD
Alla Levitina, without whom we could
not negotiate Russia. The bus arrives and
takes us to the Marriott Tverskaya Hotel
in downtown Moscow. That evening we
have an introduction to our trip and our first
dinner. This gives us a chance to meet the
28 members of our group, which includes
three psychiatrists from Australia, two from
Canada and one spouse, and 18 from the
U.S. with three spouses.
Saturday, August 22: We tour the
Kremlin, Red Square and GUM, the big
state department store that was famous in
Soviet times for its long bread lines. Now,
GUM (pronounced goom) is a high-end
shopping mall similar to Rodeo Drive or
Plaza Frontenac. We see Lenin’s tomb but
do not enter because of long lines. Lunch
at a floating restaurant called the Viking is
a typical Russian meal, with salad, soup,
Beef Stroganoff, and dessert. Tourist stops
include the State Tretyakov Gallery, a view
of the city from the overlook at Sparrow
Heights, and the stadium from the 1980
Olympics. Then we pass the Novodevichy
Convent, where the Tsars sent their first
wives when they wanted to marry other
women. In the convent park, we see a
bronze sculpture of Momma duck and eight
ducklings, which was presented in 1991
by then U.S. First Lady Barbara Bush to
Russian First Lady Raisa Gorbachev. After
the bus tour, we are on our own. Some
shop; I sleep.
Sunday, August 23: We tour the Kremlin
Armoury Museum and view the treasures of
the Tsars, including Fabergé eggs, Russian
Imperial regalia, gowns of the Tsarinas,
suits of armor, and silver and gold gifts from
other nations. We also visit the Kremlin’s
Cathedral Square, where the centerpiece
is the magnificent gilt-domed Uspensky
(Assumption) Cathedral. It is the home of
the Russian Orthodox Church and formerly
was the place of the coronation of all the
Tsars until the last one in 1918. We enjoy
a great lunch at Dymov #1 Restaurant. In
the afternoon, we tour the Moscow Metro
stations, constructed from 1930 to 1950
and considered works of art. Each station
is decorated differently, some with huge
bronze statues or with colorful icons of
Ukrainian dancers and the harvest festival.
Other stations feature marble floors with
geometric designs or paintings and mosaics
on the walls and ceilings. In the evening,
we attend the ballet and see two magnificent
pieces, Chopiniana and Scheherazade.
Monday, August 24: We have our
first professional meeting, with Dr. Peter
Krasnov at the Moscow Research Institute
of Psychiatry. He is also involved with the
Russian Society of Psychiatrists, which
dates to 1887. With the help of an interpreter,
we listen as Dr. Krasnov describes inpatient
care and the role of psychotherapy in the
treatment of psychiatric patients. After
a break for coffee, tea and chocolates,
we tour the day program for patients
recently released from inpatient care. Dr.
Stotland presents Dr. Krasnov with framed
certificates and several books from the
APPI press. Several other doctors in our
group also give gifts including Dr. Igor
Petroff, who brought macadamia nuts from
his farm in Australia. In the afternoon, we
have free time; several doctors retrieve
their lost luggage. Many of us venture to
the Pushkin Café, a lovely restaurant near
Pushkin Square. The food is delicious, if
not expensive, but you only go to Moscow
once.
Tuesday, August 25: We tour Moscow
Municipal Psychiatric Hospital #1, opened
in 1894 due to a vast fundraising campaign.
The hospital now accommodates over 2800
patients. Dr. Vladimir Kozyrev, who has
served as Chief Physician of the hospital
A patient discusses his artwork at Municipal
Hospital #1 in Moscow, Russia.
Russia
since 1987, is also the Chief Psychiatrist of
Moscow and a distinguished member of the
Moscow Medical Academy faculty.
There are administrative districts for
general psychiatric patients (similar to
catchment areas), specialized services
including forensic and alcohol abuse
(mainly detox and stabilization), and a
geriatric unit. Patients are voluntary, court
ordered or forensic for evaluation. Students
at the Russian State Medical University
and the Russian Medical Academy of
Postgraduate Education complete their
residency here. The patients and families
publish a newspaper. One of the reporters
joins our group and plans to feature our
visit in the next issue. (Once back home, I
donate my copies to St. Louis psychiatrist
Dr. Tamara Frishberg, who can read
Russian.) We tour the hospital and return to
the main room where we are given coffee
and tea, and medallions commemorating
the 100-year anniversary. Dr. Stotland
again presents books and plaques.
We dine at Taras Bulba Restaurant,
which serves Ukrainian food. I know my
Grandma Paraszczuk has come back! Then
we are off to the Sheremetyevo Airport for
our flight to St. Petersburg. We walk to the
bus, ride to the plane, and climb the steps
to board. The seats are very close together
and the poor fellow in front of me suffers
my knees in his back. The flight attendants
serve sandwiches and juice. We meet our
St. Petersburg guide and go by bus to the
Novotel Hotel. That evening, we go to the
bar and sample vodka and caviar. You only
live once.
Wednesday, August 26: We tour the
Dr. Jo-Ellyn Ryall with a Russian health minister
during a visit in Moscow.
1st Quarter, 2010
Catherine Palace at Tsarskoye Selo, now
called Pushkin after the famous poet. We
see the completely restored Amber Room.
When I visited in 1996, the Amber Room
was only partially restored and the road had
potholes big enough to swallow buses. All
is better now and the Russians welcome
tourists.
In the afternoon, we visit the Bekhterev
Psychoneurological Institute, founded in
1907 by V. M. Bekhterev. Institute Director
Dr. Nikolay G. Neznanov and several other
staff meet with us. The institute works
with the World Psychiatric Association.
It covers the entire spectrum of medical
education including treatment of adults,
children, adolescents, geriatric, narcology
(addictions), neurosurgery, psychology,
and experimental methods. It has some
grants to study electronic medical records,
and pharmaceutical company grants to
study safety and efficacy of medications. It
also works with NIH and NIDA on several
international projects. The Institute on the
Human Brain has PET and also uses EEG
and polysomnographs. There is a lot of
teamwork and cross-fertilization between
specialties.
Chemical
dependency,
especially
alcoholism, is a major problem in Russia.
Once they detoxify a patient, there is little
treatment. The 12-step program does not
work because the patients do not share.
Instead, clinicians use stress psychotherapy,
i.e., “If you drink another drop, you will
die.” Sometimes it works.
Doctors are cautious in treating children
under 10 years old with medications. They
believe in long-term psychotherapy for
the neurosis, and “Borderline” means less
psychotic. Sleep disorders and seasonal
affective disorder are hard to treat or even
determine the frequency since patients tend
to self-medicate until the end. Unfortunately,
they do not have a veterans service like in
the U.S., so they cannot measure depression
or PTSD in veterans.
Thursday, August 27: We visit the
Childhood Psychiatric Rehabilitation
Center. Dr. Dimitry Shigahov and his
associates discuss how they treat children for
epilepsy, psychosis, and acute conditions.
The center has three wards for boys and one
for girls, a school for 100 children, inpatient
and outpatient wards, a separate 60-bed
ward for retarded children or those with
severe psychosis, and a unit for very young
children. There is no charge or insurance.
A social program for parents provides peer
support on how to handle their children.
The program for autistic children tries to
prepare them for regular classrooms. Our
hosts treat us to a morning snack of coffee,
vodka, and caviar and salmon on rye bread.
Delicious!
Then we drive to the new hospital,
which is being renovated from a building
built before the 1917 Revolution. They keep
the original architecture but modernize the
buildings. The grounds are beautiful. We
stop for lunch and shop before our final
tour of the Hermitage. This is a marvelous
group of buildings of art and culture that
includes the Winter Palace and several
other buildings. We race through the rooms,
just sampling the art and magnificent
decorations.
In the evening, we have a farewell dinner
and recap our experiences. Following a 2:30
AM wake-up call, we go to St. Petersburg
(Pulkovo-2) Airport for our 6 AM flight to
Frankfurt, and then the flight to JFK and
home.
The trip gave me new perspectives on
the state of psychiatry in Russia. They are
very aware of patients’ rights and trying
hard to erase the horrors of psychiatry under
the Soviets. The doctors were welcoming
and eager to share. I would recommend a
People to People tour to all our members.
The People to People Ambassador
Program, based in Spokane, Wash.,
organizes and promotes global, educational
travel opportunities to bridge cultural and
political borders through education and
exchange. For information, call (509)
568-7000 or toll free (866) 794-8309,
or visit the Web site at <http://www.
ambassadorsgroup.com>.
Several Russia tour members enjoy a typical
ethnic dinner (clockwise from left): Jeffrey
Bennett MD, Jo-Ellyn M. Ryall MD, Harold
Stotland, tour leader Nada Stotland MD, Lauren
Wagner MD, and Christine Bennett.
15
1st Quarter, 2010
EMPS Membership Update
By Rebecca DeFilippo, MS, MBA, CMP. CMMM
New General Member (1)
In October, Asad Qalbani MD joined
APA as a General Member. He is a staff
psychiatrist in the emergency room at John
Cochran VA Medical Center in St. Louis.
He graduated from University of MissouriKansas City School of Medicine (1997)
and completed a psychiatry residency at
University of Illinois-Chicago (2008).
New Members-in-Training (4)
EMPS welcomes four new MITs from
St. Louis University. Psychiatry resident
Sharmistha Barai MD completed a MBBS
degree (medical degree equivalent) at Lady
Hardings Medical College, in New Delhi,
India (2002). Psychiatry resident Subhash
Bashyal MD completed a MBBS degree at
BP Koirala Institute of Health Sciences in
Dharan, Nepal (2007). Psychiatry resident
Sumera Salamat MD completed a MBBS
degree at Jinnah Medical and Dental
College, Karachi, Pakistan (2005). Pooja
Sharma MD graduated with a medical
degree from Terna Medical College in Navi
Mumbai, India (1999) and completed a
general psychiatry residency at Lokmanya
Tilak Municipal Medical College in
Mumbai, India (2002). Dr. Sharma began
a fellowship in geriatric psychiatry at St.
Louis University in July 2008.
Reinstatements (1)
In August, General Member Miggie
L. Greenberg MD reinstated her APA
membership. She is the Residency Program
Training Director at St. Louis University.
She graduated from medical school at Case
Western Reserve University (1990) and
completed a psychiatry residency at the
Institute of Pennsylvania Hospital at the
University of Pennsylvania (1994).
Transfers In (7)
EMPS welcomes seven General
Members as transfers from other APA
District Branches.
Zinia S. Thomas MD resides in St. Louis,
Mo. She received her medical degree from
American University of the Caribbean
School of Medicine (1999) in Montserrat.
She served a general psychiatry residency
at New Jersey Medical School and a child
psychiatry residency at Yale UniversityNew Haven Medical Center. She has been
an APA member since 2000 and previously
was a member of the Connecticut
Psychiatric Society.
Vivek Agnihotri MD resides in
St. Louis, Mo. He completed a general
psychiatry residency at New Jersey Medical
School (2003) and a residency in addiction
medicine at Yale University New Haven
Medical Center (2004). He has been an APA
member since 2001 and previously was
a member of the Connecticut Psychiatric
Society.
Katarzyna
Derlukiewicz
MD
resides in Hannibal, Mo. She graduated
from Medical University of Gdansk, in
Gdansk, Poland (1996). She completed a
general psychiatry residency (2005) and
a two-year fellowship in child psychiatry
(2007) at SUNY Health Science Center.
She also completed a one-year residency in
consultation at Albert Einstein College of
Medicine (2008). She joined APA in 2002
and was a former member of the Greater
Long Island Psychiatric Society.
Justin A. Esses MD works in the
Department of Psychiatry at Jefferson
Barracks VA Medical Center in St. Louis.
He joined APA in 2004 and was a former
member of the Massachusetts Psychiatric
Society. He received his medical degree
from Vanderbilt University School of
Medicine (2003). He completed a general
psychiatry residency at Boston University
Medical Center and a psychiatry fellowship
at Massachusetts General Hospital/McLean
Hospital.
Lara Rymarquis Fuchs MD is an
emergency room attending physician at
Metropolitan Psychiatric Center and a staff
physician for outpatient services at BJC
Behavioral Health. “The balance between
the ER work and the long-term relationships
with patients is a nice one,” Dr. Fuchs said.
She has been an APA member for nine
years and was a former member of the
New York County District Branch. She
graduated from Washington University
in St. Louis School of Medicine (2001)
New York University School of Medicine
(2006). “My husband and I met here at a
concert at the old Mississippi Nights, and
we both loved the area so much that we
wanted to come back,” she said. “It just
feels like home to us.”
Tracy D. Gunter MD is an Associate
Professor of Psychiatry at St. Louis
University School of Medicine in the
Department of Neurology and Psychiatry.
She has a secondary appointment as an
associate professor in the Center for Health
Law Studies of the SLU School of Law.
She also participates in the education of
trainees and conducts research in forensic
populations. She joined APA 18 years
ago and was a former member of the
Iowa Psychiatric Society. She received
her medical degree from University of
South Carolina School of Medicine (1990)
Palmetto Health Alliance/USC School of
Medicine (1995). She is board certified in
general and forensic psychiatry.
Raymund R. Tan MD resides in Cape
Girardeau, Mo. He completed a psychiatry
residency at University of South Dakota.
He has been an APA member for two years
and is a former member of the South Dakota
Psychiatric Association.
Transfers Out (2)
Member-in-Training
Rangsun
Sitthichai MD moved to Boston, where
he is a fellow in the Child and Adolescent
Psychiatry program at Children’s Hospital,
part of Harvard Medical School. He received
his medical degree at Chulalongkorn
University (1999), in Bangkok, Thailand,
and completed three years of residency at
St. Louis University School of Medicine.
He has been an APA member since July
2006 and is now with the Massachusetts
Psychiatric Society.
General Member Ramasubba R.
Tatini MD has relocated to Garden City
(Boise), Idaho, following completion of a
one-year geriatric psychiatry fellowship at
16
1st Quarter, 2010
Member Update
St. Louis University School of Medicine. He is now a member of
the Idaho Psychiatric Association.
Advancements (5)
In December, the APA Board of Trustees approved for advancement
five new Fellows from EMPS. They are Bun Tee Co MD, Abhilash
K. Desai MD, Linda Sue Horne MD, Kimberli Etta McCallum
MD, and Thomas F. Richardson MD.
Drops (21)
As of Jan. 31, APA dropped 21 EMPS members for nonpayment of
2009 dues. They include Mina Charepoo MD, Marcie B. Epstein
MD, Lauren E. Flynn MD, Luis A. Giuffra MD, Rakhshanda
B. Hassan MD, Delaina M. Jewkes MD, Julie E. Lafferty MD,
Philip J. LeFevre MD, Phillip McDaniel DO, Sudha Mogali
MD, Bharat Raj Nakra MD, Rashmi Nakra MD, Vasileios
Panagopoulos MD, Cynthia E. Rogers MD, Luzviminda R.
Santos MD, Marcie L. Shea (Orlowski) MD, Hiten P. Soni MD,
Emel Aktan Sumer MD, Nazmul K. Talukdar MD, Ying-Ying
Grace Wu MD and Layla Ziaee MD.
Deaths (4)
EMPS reports the following deaths: Donald F. Bandle MD, Dec.
27, 2009; Silvana Y. Menendez MD, Dec. 18, 2009; Terry A.
Fuller MD, Oct. 5, 2009; and Robert B. Reynolds MD, Nov. 4,
2006 (death reported to EMPS in August 2009). See Obituaries on
page XX.
TOTAL MEMBERS: 345 (includes 17 permanent Inactive
members)
Local AACAP Chapter
Reorganizes
By David I. Berland MD
T
he Greater St. Louis Council of Child and Adolescent
Psychiatry has reorganized under new bylaws. The
council elected new officers last spring. David I. Berland
MD is president, Mini Tandon DO is vice president and Assembly
representative, Ginger Nicol MD is secretary, and Suzanne
L’Ecuyer MD is treasurer. Renuka N. Patel MD, Scott Trail MD
and Cristiana Teodorescu MD serve as directors on the council.
Consistent with the priorities of the American Academy
of Child and Adolescent Psychiatry, the council is working to
improve access to psychiatric care for children, adolescents and
their families. Currently, the council is exploring working with
St. Louis Children’s Hospital and Cardinal Glennon Children’s
Hospital. The next meeting will be held January 26 at 6:30 pm.
All area AACAP members or eligible members are invited.
Please contact Dr. Ginger Nicol at nicolg@wustl.edu for further
information and to be added to the e-mail list.
Membership Form
Please type or print clearly.
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Name*
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Employer*
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Street*
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City*
State*
ZIP*
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Phone
Fax
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E-Mail
* State law requires that we use our best efforts to collectand report the
name, mailing address and employer of individuals who contribute to
MoPPPAC.
Enclosed is my check or money order for:
$250 Capitol Club
$365 Dollar-a-Day Club
$500 Speaker’s Club
$1,000 Senator’s Club
$2,500 Congress Club
$5,000 President’s Club
Other $_______ MoPPPAC Club
The amounts recommended are suggestions only. An individual or medical practice may donate more or less than the suggested amount. The
amount donated by a contributor, or the refusal to donate, will not benefit
or disadvantage you. Only U.S. Citizens or Green Card holders may
contribute. Contributions to the PAC are not tax deductible.
Make checks payable to: MoPPPAC
Return to: 1321 Montevale Court, Fenton, MO 63026
17
1st Quarter, 2010
OBITUARIES
Donald Francis Bandle MD, 89, of
Shawneetown (Gallatin County), Ill., died
December 27, 2009, at the Oakview Heights
Center in Mt. Carmel, Ill. He was born
September 29, 1920, in St. Louis, Mo. In
1970, he married Thomasine Logsdon, who
preceded him in death in 2004. His daughter,
Thomasina Jon White and Eric Turpin of
Mt. Carmel, Ill, and a brother survive him.
His parents; a wife, Betty Bandle; and his
son, Gary Bandle, preceded him in death.
During World War II, Dr. Bandle was a first
lieutenant in the Navy, where his duties
included being captain of a sub chaser in the
South Pacific. After the war, he resumed his
college studies, receiving a master’s degree
in clinical psychology from Washington
University in 1948 and a medical degree
from St. Louis University in 1953. He
served a one-year rotating internship at
Evangelical Deaconess Hospital in St. Louis
and a psychiatry residency at the former St.
Louis State Hospital, where he later served
on the medical staff for nine years. He later
engaged in private practice for fifty years in
St. Louis. He was a 54-year member of the
American Psychiatric Association, which
recognized him as a Distinguished Life
Fellow of Psychiatry. He was also a member
of the American Medical Association. Dr.
Bandle was a consummate sportsman,
and played on the football, basketball and
baseball teams in high school and college.
He also owned and raced thoroughbred
racehorses for forty years. Burial was at
Westwood Cemetery with military rites
by Ridgway American Legion Post #596.
Memorials in Dr. Bandle’s memory may
be made to the new project with Wabash
County Animal Shelter Buddies (WCASB),
11336 North 1550 Boulevard, Mt. Carmel,
IL 62863; telephone (618) 262-7109; Web
site at wcasb_furryfriends@yahoo.com. Go
to http://www.vickeryfuneralchapel.com to
make Internet condolences.
Silvana Yolanda Menendez MD
(nee Lee) died December 18, 2009, in
Chesterfield, Mo. She was the wife of the
late Manuel F. Menendez MD, mother
of Manuel J. (Michele) Menendez DDS,
Yolanda M. Menendez, Michael F. (Marcia)
Menendez and Robert Lee Menendez;
and grandmother of three grandchildren.
18
held December 22. Contributions may be
made to the American Heart Association or
Behavioral Healthcare, c/o Friends of St.
Elizabeth Hospital, 11 South Third Street,
Belleville, IL 62220.
Silvana Yolanda Menendez MD
Dr. Menendez was born in Cuba, and
completed medical school at Universidad
de la Habana, in Havana, Cuba. She served
a rotating internship at Christian Hospital of
St. Louis and a psychiatry residency at the
Child Guidance Clinic of Jewish Hospital
and at the former St. Louis State Hospital
(now, St. Louis Psychiatric Rehabilitation
Center), where she later worked as a staff
psychiatrist. She was a member of the
American Psychiatric Association for
46 years, having joined as an Associate
Member in 1963. She advanced to
Distinguished Life Fellow in 1996.
“I always admired Yolanda as a person,
mother and professional. She loved her
career and her family,” reminisced Dr.
Ofelia E. Gallardo, who worked with Dr.
Menendez at State Hospital. “She was a
source of pride among her fellow Cubans
here in St. Louis.”
Dr. Menendez also was the first
woman president of Memorial Hospital
in Belleville, Ill., first woman president
of St. Clair County (Ill.) Medical Society
and second vice president of the Illinois
State Medical Society. Dr. Menendez was
a staff psychiatrist at Belleville Memorial
Hospital and St. Elizabeth Hospital in
Belleville, Ill. The funeral service was
Terry A. Fuller MD
Terry A. Fuller MD died October
5, 2009. Dr. Fuller graduated from
Washington University School of Medicine
in 1974 and completed his residency in
psychiatry in 1977. Dr. Fuller was a trainee
in pathology through the National Institute
of Environmental Health Sciences and a
research scientist development awardee
through the National Institutes of Mental
Health. He received his board certification
in psychiatry and neurology in 1979. After
conducting research for many years, he
began private practice in 1987. He was
a member of the American Academy of
Organizational and Occupational Psychiatry,
and the Society for Neuroscience. He
also was a former General Member of
the American Psychiatric Association.
Dr. Fuller was an assistant professor of
psychiatry at Washington University and
was on staff at Barnes-Jewish Hospital
until his death. Donations may be made
in memory of Dr. Fuller to Youth in
Need, Attention: Development Office,
1815 Boone’s Lick Road, St. Charles,
MO 63301, or to Washington University
in St. Louis, Attention: Medical Alumni
and Development Program, 7425 Forsyth
Blvd., Suite 2100, Campus Box 1247, St
Louis, MO 63105-2161.
Robert B. Reynolds MD died November
4, 2006, in Glenwood Springs, Colorado.
He was born November 8, 1922, in China.
He completed his pre-medical education at
Carleton College in Northfield, Minnesota
in 1944, and graduated with a medical
degree from Harvard Medical School in
1947. He served a one-year general hospital
internship at the University of Chicago
Clinics and residencies in psychiatry at St.
Louis City Hospital (Malcolm Bliss) and
the Veterans Administration Hospital at
Jefferson Barracks in St. Louis. He joined
the American Psychiatric Association in
1951 and was named a Life Fellow in 1985.
He achieved 50-Year Life Fellow status in
2001.
1st Quarter, 2010
EMPS Committee Membership
BYLAWS
Jo-Ellyn M Ryall MD (chair)
EDUCATION
Arturo C. Taca Jr. MD (chair)
CHILD and ADOLESCENT
PSYCHIATRY
Judith McKelvey MD (chair)
Meg Corrigan MD
David Duesenberg MD
Dehra Glueck MD
Adelita Segovia MD
Duru Sakhrani MD
Moisy Shopper MD
Natasha Marrus MD
ETHICS
Lawrence Kuhn MD (chair)
Aviva Raskas MD
Moisy Shopper MD
COMMUNITY and PUBLIC
PSYCHIATRY
Chris Loynd DO (chair)
Malik Ahmed MD
Jay Engelhart MD
Asif Habib MD
Duru Sakhrani MD
Melissa West MD
Member Notes
Compiled by Rebecca DeFilippo CMP,
CMMM
 Abhilash Desai MD, George T.
Grossberg MD and Jothika N. Manepalli
MD will present a continuing medical
education course on “Pain and Palliative
Care in Psychogeriatrics” on May 24,
during the APA Annual Meeting in New
Orleans. Drs. Grossberg and Desai also
will present on “Psychiatric Consultation
in Long-term Care: Advanced Course.”
 Parkland Health Center, a part of
BJC HealthCare in Farmington, Mo.,
has appointed Vikrant Mittal MD,
MHS director of geriatric psychiatry. Dr.
Mittal authored two chapters in Clinical
Assessments in Psychiatry: Mastering Skills
and Passing Exams, edited by Rajesh Tampi
MD, due out this year from Lippincott, and
published articles in Psychiatric Services
and Case Reports in Medicine in 2009.
He will serve a teaching assistantship at
Johns Hopkins University, in Baltimore,
Md., for their online Health Information
Management Systems course. He plans
to pursue a fellowship in health services
administration with the American College
of Healthcare Executives (ACHE).

Garry M. Vickar MD will present
FORENSIC PSYCHIATRY
Jose Mathews MD (chair)
Angeline Stanislaus MD
LEGISLATIVE AFFAIRS
Paul Simon DO (chair)
Jack L. Croughan MD
Alan Felthous MD
Asif Habib MD
Azfar Malik MD
Jay Meyer MD
“How to Help Your Patients: Adding
Vitamins and Minerals” at the Nevada
Psychiatric Association’s 15th Annual
Psychopharmacology Update, Feb. 11-13,
at South Point Hotel & Casino, Las Vegas,
Nev.
 Collins E. Lewis MD has a role in
Casualties of the State, a feature-length
film from Corner Film Productions, directed
by St. Louis independent filmmaker Jeremy
Cropf and slated for release in 2011. Dr.
Lewis plays FBI Deputy Director Robert
MEMBERS-IN-TRAINING
Ben Holt MD (co-chair)
Moses Tabe Ambilichu MD (co-chair)
Ujjwal Ramtekkar MD, MPE
Paul Simon DO
MEMBERSHIP
Jo-Ellyn M Ryall MD (chair)
Bharat Nakra MD
Edwin D. Wolfgram MD
NEWSLETTER
Daniel Mamah MD, MPE (chair)
Azfar Malik MD
Ujjwal Ramtekkar MD, MPE
PUBLIC AFFAIRS
Collins Lewis MD (chair)
David Duesenberg MD
Herb Rosenbaum MD
Angeline Stanislaus MD
Radhika Rao MD
Abrams in a thriller about the mysterious
deaths of high-level, federal officials who
are profiting from a war between the U.S.
and a Middle Eastern country. Filming took
place in St. Louis and included Kirkwood
City Hall and the Old Post Office Building.
Dr. Lewis’s previous acting credits include
Seamstress of St. Francis Street (2008) and
Room at the Inn (2008) for First Run
Theatre and An Evening with Harold Pinter
(2007) and The Rimers of Eldritch (2006)
for Soundstage Productions.
 Two EMPS members traveled abroad
this year and agreed to write about
their experiences for Eastern Missouri
Psychiatry. Jo-Ellyn M. Ryall MD penned
“Great Russian Escapade” (page 15) during
a People to People Ambassador trip when
she visited psychiatric hospitals in Moscow
and St. Petersburg. Daniel T. Mamah
MD, MPE recollects his memorable trip to
Nigeria to attend a regional meeting of the
World Psychiatric Association in “Visiting
Africa” on page 13.
Dr. Collins E. Lewis (right) as FBI Deputy Director Richard Abrams with Neal McCluggage
as Assistant Director Neal Geller in Casualties
of the State, scheduled for release in 2011.
EMPS encourages members to share news
about their professional accomplishments
in “Member Notes.” Please submit entries
to <RDefilippo@aol.com> or mail to
EMPS Newsletter, 1321 Montevale Court,
Fenton MO 63026
19
Eastern
Missouri
sychiatric
PSociety
A District Branch of the
American Psychiatric Association
PRESORTED
FIRST-CLASS MAIL
U.S. POSTAGE PAID
ST. LOUIS, MO
PERMIT #4400
Fenton, MO 63026-3016
RETURN SERVICE REQUESTED
Upcoming Events
Friday, March 26 – Sunday, March 28
152nd Annual Missouri State Medical Association Convention
Renaissance St. Louis Hotel Airport
There is no fee to participate, but attendees must register.
Contact MSMA at 800-869-6762 or visit www.msma.org
Saturday, March 27, 11:30am – 1:30pm (buffet lunch will be served)
EMPS Specialty Session on Psychiatry: “Geriatric Mood and Anxiety
as Comorbid Problems in Primary Care Settings: Evaluation and
Management,” Jothika N. Manepalli MD
EMPS has requested 2 Category 1 CME credits for this activity. There is
no fee to participate in MSMA’s Annual Convention, but attendees must
register.
Contact MSMA at 800-869-6762, register online at www.msma.org
Saturday, March 27, 2-4pm
EMPS Organizational Meeting,
There is no fee to participate in this meeting and no CME credit is available.
To register, please contact EMPS at Rdefilippo@aol.com or 636-343-8555.
Register online at www.emopsych.org
Saturday, May 22 – Wednesday, May 26
APA 163rd Annual Meeting, “Pride & Promise: Toward a New Psychiatry,”
New Orleans, La.
For registration information, go to www.psych.org
We strive to make content in future issues of
Eastern Missouri Psychiatry representative of
our membership and encourage our members’
participation in its creation.
For communications regarding the newsletter,
or to include articles, events or advertisements
in future publications contact:
Editor, Eastern Missouri Psychiatry
Dept. of Psychiatry, Washington University
660 South Euclid Avenue
St. Louis, Missouri 63110
or
mamahd@psychiatry.wustl.edu
Copyright © 2010 by Eastern Missouri Psychiatric Society.
All rights reserved. No part of this document may be
reproduced or used in any form or by any means, electronic,
mechanical, or otherwise, including photocopy, recording,
or by an information or retrieval system, without the prior
written permission of the publisher.

APA at A Glance - Missouri Psychiatric Association

Transcription

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