Having served for the past 14 years as executive director for professional practice, Russ Newman, PhD, JD, is leaving APA to become provost and vice president for academic affairs at Alliant International University in California. The Monitor asked Newman about his work on behalf of professional psychology and his new leadership role at Alliant.
What has changed for practicing psychologists since you became executive director of the Practice Directorate in 1993?
Our health-care system continues to deteriorate. Many health-care professionals find it increasingly difficult to practice, and too many consumers are unable to get the psychological services they need.
Managed care was introduced as nothing more than a cost-saving mechanism that, true to its historical roots, has valued profits over patients. Ironically, it failed to even accomplish real cost containment. When I first became executive director of the Practice Directorate, we specifically focused on obstacles to practice arising from the advent of the managed-care industry. In recent years, we have also focused on cultivating opportunities for practitioners beyond traditional mental health services, particularly in the health arena.
Despite our badly broken system, we've seen some positive developments. Building on a strong foundation of traditional psychotherapy and assessment, practitioners are diversifying their practices by expanding into new practice areas. Licensed psychologists continue to broaden their professional opportunities and roles, for example, by gaining legislative authority to prescribe psychotropic medication, by collaborating with other health-care professionals to provide comprehensive services, and being utilized for their expertise to solve behavior-based problems with individuals, groups, organizations, communities and even nations.
Meanwhile, there is growing public awareness of the link between psychological and physical health and greater understanding that lifestyle and behavior are important factors in health and illness. Employers in particular are recognizing the effects of lifestyle and behavior on both their employees and their bottom lines. People are more willing to seek treatment as the stigma against mental health care has lessened. On the federal legislative front, we're on the threshold of achieving full parity, a decade-in-the-making critical move toward ending discrimination in the health-insurance market against individuals with mental health disorders.
What does the future look like for practitioners?
Problems with the U.S. health-care system seem likely to continue in the short run, while unpredictable health reforms cause continuing flux in the system. During that period of flux and beyond, psychologists will need to emphasize their ability to address lifestyle and behavior issues, health promotion and prevention, as well as the importance of dealing with disease management. This is particularly true in our nation, where the six leading causes of death are related to behavior.
Psychologists who continue to diversify their practices and provide culturally competent services to underserved individuals and communities are likely to find the greatest professional opportunities.
What were some of the Practice Directorate's greatest successes during your tenure?
Several of these achievements include:
Creation of the American Psychological Association Practice Organization. APA faces limitations in advocating for practitioners given its tax status as a 501(c)3 organization. In 2001, we launched the APA Practice Organization (APAPO), a 501(c)6 affiliate of APA, to enable us to engage in advocacy and political activity that the 501(c)3 APA is unable to do.
Managed-care litigation. For more than 10 years, we've joined with state psychological associations to successfully wage battle in the courts against abusive managed-care practices, such as fee cuts in breach of psychologists' contracts, no-cause termination, and "phantom panels" that harm psychologists and their patients. The APAPO remains involved in a nationwide class action lawsuit that has yielded $15 million in settlement payments so far, along with substantial managed-care company policy changes.
Gaining the health and behavior codes. The implementation of these new billing codes in 2002 represented a milestone in recognizing and reimbursing psychologists for their services delivered to individuals with a physical health diagnosis but no mental health diagnosis. It has also enabled psychologists to get reimbursed on an 80/20 co-payment basis rather than the 50/50 co-payment for mental health services.
Public education about the value of psychology and psychological services. Our ongoing public education campaign, launched in 1996, has helped inform the public about timely issues including the warning signs of youth violence, resilience, dealing with war and other sources of stress, and the mind-body connection. The campaign reach has been impressive. Millions of people have seen and heard our messages in newspapers, magazines, brochures, on television and radio.
Outreach to the corporate sector. Given the importance of employers in the health-care system, the directorate has incorporated a focus on the employer community during my tenure as executive director. Our Psychologically Healthy Workplace Program is one of our most successful ventures in this area.
What has been your greatest disappointment?
One disappointment involves recognizing the reality of the limited influence any single health profession has in seeking to "fix" a badly broken health-care system. We need to guard against having unrealistic expectations about how much leverage even the health professions together have in dealing with the likes of the insurance and employer communities. It took close to 10 years with parity to convince Congress that the needs of people with mental health problems should take priority over the interests of insurance companies and employers. I am disappointed that change has not been faster and more visible.
What will you miss about working at APA?
Psychology has a rich heritage in its diversity of professional orientations and interests. I will miss working with the many constituencies that comprise the practice community, including leaders in our state, provincial and territorial associations and practice divisions. It has been difficult work at times when groups have differing priorities that need either to be reconciled or reprioritized, but it is gratifying to see what we have been able to accomplish by pulling together.
What will you do at Alliant?
Having practiced psychology and worked with practitioners for more than two decades, it is clear to me that the education and training needs of practitioners are changing. Not only are marketplace changes requiring new kinds of training, but shifting demographics and increasing globalization are significantly affecting training needs for future professionals.
I'll be working at Alliant to help ensure that psychologists and other professionals are well equipped to provide contemporary, culturally competent services in an increasingly international environment. I also expect to cultivate opportunities for collaboration between disciplines--for example, the psychology and business schools--to help prepare students fully for successful practice of their profession, whether it be psychology, forensics, business or education.