State Leadership Conference

Executive Director of APA’s Practice Directorate Dr. Kathrine C. Nordal (credit: APA photo)With the Patient Protection and Affordable Care Act and other factors transforming the nation’s health-care system, it’s more important than ever for psychologists to become leaders, according to Katherine C. Nordal, PhD, executive director for professional practice at APA and the APA Practice Organization (APAPO).

“If we want to be valued as health-care professionals and included as partners with other disciplines, we must be visible in the broader health-care arena and willing to assume leadership positions,” Nordal told the opening session of the 2011 State Leadership Conference. “If we abdicate leadership roles, we give others power over our future.”

Dr. Cathy McDaniels Wilson of Ohio (credit: APA photo)Sponsored by the Practice Directorate and APAPO, the March 12–15 event in Washington, D.C., brought together about 500 representatives from state, provincial and territorial psychological associations, APA divisions, APA governance and the American Psychological Association of Graduate Students, as well as diversity and early career delegates. In addition to attending educational and networking sessions, participants also headed to Capitol Hill to meet with members of Congress and their staffs. In Nordal’s call for psychologists to take more leadership roles, she offered what she called “three mantras” to guide them on the road ahead:

  • Performance matters. Health-care reform has brought new attention to patient outcomes. “Many of our colleagues view with skepticism insurers’ and managed-care companies’ use of performance measures, which are often seen as instruments to restrict care,” said Nordal. Psychologists themselves are quick to point to methodological problems in such data, she said. “We need to be part of the solution and ensure performance data is psychometrically sound and used for the right purposes,” she said.
  • “Value” is not a bad word. Some insurance companies are already incorporating cost and quality indicators into the plans they offer, said Nordal. Patients in these plans have to pay more — or may not be covered at all — if they seek care from providers who are more expensive, less efficient or in lower-quality practices, she said. “We make purchasing decisions every day and expect value,” she pointed out. “Should our patients expect less from us?”
  • Improving performance requires teamwork. Collaborating with other professionals is key to improving outcomes, said Nordal, but teamwork doesn’t come easily for many psychologists. “We’ve been trained for independent practice and believe autonomy is critical for providing quality care,” she said. “We need to understand that we’re more likely to thrive in integrated practices that embrace teamwork, and that teamwork will help us provide better patient care.”

Dr. David Satcher at the State Leadership Conference opening session (credit: APA photo)Former U.S. Surgeon General David Satcher, MD, PhD, director of the Satcher Health Leadership Institute, echoed Nordal’s call for leadership by psychologists. As health-care reform and mental health parity change the health-care system, he said, “we need leadership from your ranks.”

As many as one-quarter of all Americans have a diagnosable mental disorder, said Satcher. The good news is that most of these disorders can be treated effectively. The bad news is that fewer than half of adults and a third of children get the help they need, he said.

“That’s a challenge for leadership,” said Satcher. “We believe this is an area where we can make tremendous progress.”

Leadership is needed beyond the health-care realm as well, he added, citing the impact that social conditions have on people’s health.

Dr. Douglas Marlow of Oregon (credit: APA photo)Health-care reform will help solve many problems, including high health-care costs, inadequate access and health disparities, said Satcher, citing the law’s emphasis on prevention and its elimination of pre-existing conditions as a reason to exclude people from coverage. He urged psychologists to get involved in such areas as the integration of mental health and primary care.

Making the most of health-care reform will take perseverance, said Satcher. He pointed out that his 1999 surgeon general’s report on mental health recommended parity, yet it took until 2008 to get the federal law passed.

“Life is filled with golden opportunities carefully disguised as irresolvable problems,” Satcher concluded. “Together we can solve those problems.”

Rebecca A. Clay is a writer in Washington, D.C.