Oklahoma-Psychiatry-Summer-2018-issue

OKLAHOMA PSYCHIATRIC PHYSICIANS ASSOCIAT ION April, May, June 2018 Attacking the Synthetic Opium Problem – Again ! (updated to mean Fentanyl & Oxycodone) by Harold M Ginzburg, M.D., J.D., M.P.H The Nation, Local, State and Federal Government Agencies and in particular, a number of federal agencies including the Departments of Justice (DOJ), Health and Human Services (HHS) and the Food and Drug Administration (FDA) have come forward with various approaches to addressing the increased mortality and morbidity associated with the ‘Opioid Epidemic’ This is not the first opioid epidemic in this Country Post-Civil War the use and abuse of ‘opium’ was wide spread for traumatic wounds suffered during the civil war The inclusion of opium and alcohol in patent medicines and the addiction of hundreds of thousands in the early part of the 20th century eventually lead to a series of Federal and State laws and regulations The Pure Food and Drugs Act of 1906 required labeling of patent medicines that contained opiates, cocaine, alcohol, cannabis and other intoxicants The opium addicts at that time were considered to be primarily women who used the patent medications and then prescription medications to control menstrual pain The United States’ accession of noncontiguous lands, such as the Philippines and Puerto Rico, and evolving commercial contacts with Central and South America, and Southeast Asia/China lead to increased transportation of opium and other ultimately other controlled substances, including cocaine, into the mainland United States The 1914 Harrison Narcotic Act, which classified cocaine as a narcotic, was a significant Congressional attempt to control access to controlled substances The Harrison Narcotic Act called for the registration of prescribers and authorized the internal revenue authorities to impose a special tax on “all persons who produce, import, manufacture, compound, deal in, dispense, sell, distribute, or give away opium or coca leaves, their salts, derivatives, or preparations, and for other purposes." Challenges to the scope of the law soon occurred and the federal courts held that physicians could prescribe narcotics to patients in the course of normal treatment, but not for the treatment of addiction The Act allowed physicians to prescribe narcotics/ opiates "in the course of his professional practice only." This phrase was interpreted, by the federal courts, to mean that a physician could not prescribe narcotics/opiates to an addict, since addiction was not then considered a disease Once a number of doctors were arrested and some imprisoned, the medical profession understood it was not to supply opiates to addicts The Supreme Court in Webb v United States, 249 U.S 96, 99 (1919) that physicians could not prescribe narcotics solely for maintenance Narcotics were not overtly or publicly used for opioid/narcotic maintenance until Dole and Nyswander, in 1965, reported the use of methadone to control addiction See synthetic opioid problem on Page What’s inside? DEA Diversion Control Benjamin Rush Awards OPPA CME Conference Resident Presentations Membership Update Posters Presented at APA Executive Council Scoop Award Luncheon Highlights 11 Officers 2018-2019 President Jay Lensgraf, MD President-Elect Harold Ginzburg, MD Vice President Jason Beaman, DO Secretary Lauren Schwartz, MD Treasurer Shannon Thomas, DO Parliamentarian Shree Vinekar, MD APA Assembly Delegate Shree Vinekar, MD Harold Ginzburg, MD 1st Councilor Heather Geis, MD 2nd Councilor Bryan Cates, DO 3rd Councilor Ed Hill, MD Councilors V Ray Cordry, DO Vijaya Ekambaram, MD Hashib Faruque, MD Courtney Nixon, MD Britta Ostermeyer, MD Jed Perdue, MD Art Rousseau, MD Haiwang Tang, MD PAGE OKLAHOMA PSYCHIATRY Synthetic opioid problem Soon the use of methadone as pain control medication decreased and then essentially ceased when the National Institute on Drug Abuse was formed and started to fund large scale clinics to provide methadone detoxification and methadone maintenance as a treatment for narcotic/opioid drug abuse A reported treatment goal was to have heroin addicts cease purchasing street heroin and sharing needles and thus decrease their criminal activities and their contracting and communicating hepatitis B and other infectious diseases By the beginning of the 1980s, hepatitis B was replaced by the human immunodeficiency virus (HIV) as the leading cause of morbidity and mortality among heroin addicts The evolution of the availability of synthetic opioid compounds such as oxycodone, hydrocodone and fentanyl increased the ‘at risk’ or vulnerable population for addiction or, in recent decades, called physiological and/or psychological dependence A receptor blocking agent, such as naloxone, provides an immediate life-saving treatment to narcotic/opioid-induced respiratory depression Naltrexone is a longer acting receptor blocking medication that binds and blocks opioid receptors and is reported to reduce narcotic/opioid cravings Naltrexone also prevents respiratory depression continued from page The federal government has provided a treatment model called Medication Assisted Treatment (MAT) MAT involves the use of FDA-approved medications, such as naltrexone, buprenorphine/naloxone (Suboxone) and methadone, in combination with counseling and behavioral therapies, to facilitate the therapeutic management of patients who are abusing heroin, fentanyl, and other narcotic/opioids Health care prescribers are being encouraged to use MAT for the treatment of narcotic/opioid drug dependence either in face-to-face treatment sessions or using telemedicine sessions As noted in the DEA’s Diversion Control Division’s recent publication published on Page 3, alterations in telemedicine statutes allow MAT protocols to be implemented without direct, face-to-face contacts Government’s goal is to stem the ‘opioid epidemic’ of this decade They said the same thing when hundreds to thousands of methadone maintenance programs were established in the 1970’s What have been the lessons learned? Literally, in a century, we have gone from considering narcotic/opioid abuse not a disease and thus not permitted to be treated with narcotic/opioids by physicians to a health care scourge where health care providers are being encouraged to substitute one opiate with another opioid ❖ O c c a p c e l e b r at e s c h i l d f e l l ow s h i p g r a d u at i o n s A dinner party was held the evening of June 9th at the home of Drs Jay Lensgraf and Heather Geis to celebrate the graduation of three Child-Adolescent Fellows from the OU College of Medicine, OKC and the OU College of Community Medicine, Tulsa Honored were graduates William Oliva, MD, OKC (pictured back row in white shirt); Sidharta Seth, MD, OKC and Dreylana (Tori) Taylor, MD, Tulsa (Drs Seth and Taylor were unable to attend.) Colleagues, family and friends joined the evening celebration feasting on an Italian dinner and an assortment of delicious desserts including chocolate mice and cakes inscribed with the names of the graduates! The event was sponsored by the Oklahoma Council of Child and Adolescent Psychiatry ❖ PAGE Under the Ryan Haight Act of 2008, where controlled substances are prescribed by means of the Internet, the general requirement is that the prescribing Practitioner must have conducted at least one in-person medical evaluation of the patient U.S.C § 829(e) However, the Act provides an exception to this requirement 21 USC § 829 (e)(3)(A) Specifically, a DEA-registered Practitioner acting within the United States is exempt from the requirement of an in-person medical evaluation as a prerequisite to prescribing or otherwise dispensing controlled substances by means of the Internet if the Practitioner is engaged in the practice of telemedicine and is acting in accordance with the requirements of 21 U.S.C § 802(54) Under 21 U.S.C § 802(54)(A),(B), for most (DEA-registered) Practitioners in the United States, including Qualifying Practitioners and Qualifying Other Practitioners (“Medication Assisted Treatment Providers”), who are using FDA approved Schedule III-V controlled substances to treat opioid addiction, the term “practice of telemedicine” means the practice of medicine in accordance with applicable Federal and State laws, by a practitioner (other than a pharmacist) who is at a location remote from the patient, and is communicating with the patient, or health care professional who is treating the patient using a telecommunications system referred to in (42 C.F.R § 410.78(a)(3)) which practice is being conducted: A While the patient is being treated by, and physically located in, a DEA-registered hospital or clinic registered under 21 U.S.C § 823(f) of this title; and by a practitioner -who is acting in the usual course of professional practice; -who is acting in accordance with applicable State law; and -is registered under 21 U.S.C § 823 (f) with the DEA in the State in which the patient is located OR B while the patient is being treated by, and in the physical presence of, a DEA-registered practitioner -who is acting in the usual course of professional practice; -who is acting in accordance with applicable State law; and -is registered under 21 U.S.C § 823 (f) with the DEA in the State in which the patient is located Please be advised that the remote Practitioner engaged in the practice of telemedicine must be registered with the DEA in the state where they are physically located and in every state where their patient(s) is (are) physically located 21 U.S.C § 822 (e)(1); 21 C.F.R.§ 1301.12 (a); Notice 69478 Federal Register / Vol 71, No 231 / Friday, December 1, 2006 Also be advised that all records for the prescribing of an FDA approved narcotic for the treatment of opioid addiction need to be kept in accordance with 21 C.F.R § 1304.03(c), 21 C.F.R § 1304.21(b), and with all other requirements of 21 C.F.R Part 1300 to End Please note that while this document reflects DEA’s interpretation of the relevant provisions of the Controlled Substances Act (CSA) and DEA regulations, to the extent it goes beyond merely reiterating the text of law or regulations, it does not have the force of law and is not legally binding on registrants Because this document is not a regulation that has the force of law, it may be rescinded or modified at DEA’s discretion PAGE OKLAHOMA PSYCHIATRY Benjamin rush awards honors students The 2018 Benjamin Rush Awards were announced Saturday, April 7th at the annual meeting and continuing medical education conference of the Oklahoma Psychiatric Physicians Association held at the Laureate Psychiatric Clinic and Hospital Conference Center in Tulsa Named for the father of American Psychiatry, Benjamin Rush, M.D., the awards are presented each year to the outstanding medical student in the field of psychiatry at the Tulsa and Oklahoma City medical schools Honored were Ryan Fightmaster, University of Oklahoma School of Medicine, Oklahoma City campus, and Tyler Jones, University of Oklahoma College of Medicine, Tulsa campus Each received a certificate and $250 check from the OPPA As neither of the award winners were able to attend the luncheon, the awards were presented at a later date Tyler Jones performed exceptionally well and with enthusiasm during his third-year clerkship He knew the criteria, established good therapeutic alliance with patients, and did a good job obtaining information from patients He obtained all the information needed for psychiatric evaluations and picked up on substiles that even some interns not pick up on in their first months of training Tyler is a highly gifted, wellmotivated, hardworking medical student He has impressed our attending faculty with his knowledge Tyler Jones was presented his certificate base, clinical skills, and $250 check at an awards ceremony attitude, and dilihosted by the University of Oklahoma gence He is exCollege of Medicine, Tulsa pected to receive his Doctor of Medicine degree in May from the University of Oklahoma College of Medicine-Tulsa The Department of Psychiatry faculty feels that he will be an excellent physician and are delighted to nominate him for this award Ryan Fightmaster has impressive academic performance, scholarly accomplishments, volunteer work and most of all, dedication to the field of mental health Ryan has completed subinternship elective at Griffin Memorial very successfully as some of the comments for him were: “Ryan has done an excellent job His interviewing skills are very good His critical thinking skills are sharp He is very personable and professional.” Ryan Fightmaster receives his certificate His work and educaand check for $250 from Dr Phebe tion further support Tucker, OPPA Member and Professor and him becoming an Vice Chair, Department of Psychiatry, OU excellent psychiatrist College of Medicine, Oklahoma City His service to his medical school has also been equally strong Ryan is a wellrounded, compassionate and dedicated young man who promises to be an excellent, contributing member of our profession Fifty-one years ago, Dr Jay Shurley told the first recipients of this award: “The Oklahoma District Branch of the American Psychiatric Association deems it highly fitting that such interest and aptitude be tangibly recognized in the form of this award, which carries with it a cash prize, and will be awarded annually beginning this year Capacity for, and talent in the unique skills required by the practice of psychiatry, is a special gift not evenly distributed among the population of our future physicians and not possessed in equal measure by them “Without it, any physician engaged in work with patients is unduly handicapped and limited With it, his practice of any specialty is enriched and enlarged, and with special training he can make that contribution to our society that only a psychiatrist can make, in this day of increasing recognition of the paramount importance of behavioral and social problems as sources of pain, unrest, violence and human misery “Whether the student upon whom this award is bestowed in recognition of his demonstrated excellence and interest in psychiatry chooses eventually to pursue specialization in this field, is of course, his personal decision to make But this award indicates that such a choice would be widely open to him.” ❖ PAGE Current Challenges for Modern Psychiatrists The 2018 Continuing Medical Education Conference of the Oklahoma Psychiatric Physicians Association was held April 67, 2018 at the Conference Center on the beautiful campus of Laureate Psychiatric Clinic and Hospital in Tulsa The program was jointly provided by the American Psychiatric Association and the Oklahoma Psychiatric physicians Association and presented with the Donahue-Shadid Psychiatric Alumni Society and the Oklahoma Council of Child and Adolescent Psychiatry The program began on Friday evening with a presentation by Kristen M Lambert, Esq., MSW, Vice President of Risk Management for professional liability policy holders and specialty programs with the American Professional Agency, Inc Her program, “Risk Management Considerations When Practicing Addiction Psychiatry” discussed liability issues such as federal and state substance use privacy laws, documentation principles, collaborating with other providers and treating patients who may be non-compliant The program continued on a cold, icy and snowy wintery Saturday morning with Swapna Deshpande, M.D presenting Depression and Suicide in Adolescents.” Dr Deshpande is the Director, Child and Adolescent Fellowship Program and Rainboldt Family Chair in Child Psychiatry, University of Oklahoma Health Sciences Center, Oklahoma City Her presentation described epidemiology and discussed a systematic way of assessing risk factors for suicide She also presented a tool for risk assessment called the Suicide Risk Assessment Scale for Adolescents and with the audience worked through a comprehensive assessment Evidence based medications and psychosocial suicide prevention interventions for youth were also described Anand Mehendle, M.D was the keynote speaker of the 2018 CME conference thanks to an educational grant from the Donahue-Shadid Psychiatric Alumni Association Dr Mehendle, who spoke on the “Many Faces of Reward Deficiency Syndrome: The Divine Banquet of the Brain” is a private practice psychiatrist and board certified in neurology and addiction medicine He has been a pioneer and a visionary in Texas regarding physician health issues including Substance Abuse Disorders for over 25 years His presentation focused on the latest concepts of neurobiology addiction, emphasizing the neuroanatomical circuits of addiction Dr Mehendle introduced the Reward Deficiency Syndrome including the interplay of substance and process addictions and their common neurobiological substrate Thanks to an Expedited Grant from the American Psychiatric Association, Jenny Boyer, M.D presented a program on “Advocacy Training: The Importance of Partnering the Profession of Psychiatry with the Psychiatrist to Effect Membership Retention and Legislative Outcomes.” Dr Boyer, who currently serves on the Board of Trustees for the American Psychiatric Association as Area V Trustee, was recently elected to serve as the 111th President of the Tulsa County Medical Society As an OPPA member and Ethics Committee Chair, Dr Boyer discussed how an increased grasp of legislative issues impacting the practice of psychiatry combined with the ability to work with law makers will aid prevention efforts and effective treatments of psychiatric disorders at the local and national levels and how the partnership between the psychiatrist and the organization effects the practice of psychiatry in Oklahoma ❖ Enjoying dinner hosted by the Oklahoma Council of Child and Adolescent Psychiatry upon the conclusion of the annual OPPA CME conference are (from left to right) Dr Shree Vinekar, Mrs Shyamala Vinekar, Dr Saul Puszkin, Dr Britta Ostermeyer, Dr Jenny Boyer, Dr Harold Ginzburg, Conference keynote speaker Dr Anand Mehendale and Mrs Sophia Mehendale PAGE OKLAHOMA PSYCHIATRY residents present research papers Celebrating its 28th year, psychiatric residents from the training programs at the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma State University Center for Health Sciences in Tulsa, Griffin Memorial Hospital in Norman and the University of Oklahoma Health Sciences Center in Tulsa presented research papers at the OPPA continuing education conference held April 6-7th at Laureate Psychiatric Clinic and Hospital in Tulsa OPPA was honored to have as program moderator Britta Ostermeyer, M.D Dr Ostermeyer is Professor and Chairman of the Department of Psychiatry and Behavioral Sciences at the University of Oklahoma College of Medicine in Oklahoma City For their presentations, each resident was presented with a $125 honorarium for their work and willingness to present Pictured at left with Program Moderator Dr Britta Ostermeyer (center) are Ivanshu Jain, M.D (left) and Ambreen Rahman, M.D (right) Ambreen Rahman, M.D., PGY-4 and Ivanshu Jain, M.D., PGY-4, University of Oklahoma Health Sciences Center, Oklahoma City, presented “Million Dollar Diagnosis.” Their project identified the challenges faced in diagnosing Catatonia and summarized the review of literature on treatment strategies in adults Their project also described an algorithm for considering other options when benzodiazepine treatment fails to achieve remission and ECT cannot be used Presenting “Obscurely High Lesser Known Legal Intoxicants.” was Matthew Sharp, D.O., PGY-1, Oklahoma State University Center for Health Sciences, Tulsa His presentation identified lesser known “legal highs” available in America and described their chemical effects and possible influence on a person’s mental health Some substances included calamus root, MexiMatthew Sharp, D.O and Britta can calea, Hawaiian baby Ostermeyer, M.D wood ross, San Pedro cactus, blue Egyptian water lily, Colorado river toad, mug wort, African dream root and kratom “Treatment Challenges with Psychosis Induced Catatonia” was the topic of the presentation by Tarek Kanaa, M.D., PGY2, Griffin Memorial Hospital Dr Kanaa defined catatonia and what conditions can present catatonia including a variety of medical conditions: encephalitis, cerebrovascular disease, neoplasms, head injury and metabolic conditions, diabetic ketoacidosis and hypercalcemia A variety of treatment options including benzodiazepines and ECT were discussed Tarek Kanaa, M.D and Britta Ostermeyer, M.D Eudy Bosley, M.D., PGY-3, University of Oklahoma Health Sciences Center, Tulsa, presented “Chronic Serotonin Syndrome Associated with Deficient CYP2D6 Metabolism.” Dr Bosley identified the mechanism leading to the development of serotonin syndrome and recognized Hunter criteria for diagnosing serotonin syndrome She also discussed a case of chronic serotonin toxicity which was likely the result of interactions between prescribed drugs and over-the-counter agents in the context of biologically plausible pharmacogenetics Treatment strategies for chronic serotonin toxicity were also presented Eudy Bosley, M.D and Britta Ostermeyer, M.D A History of Residents Day The original Psychiatric Residents’ Day was created by Harald Krueger, M.D during his term as chief resident at the University of Oklahoma in 1981 At that time, there was a University Interns and Residents Day However, Dr Krueger believed the work by psychiatric residents in these areas deserved a format in which it could be presented and critiqued Throughout the years a wide variety of material has been presented As more psychiatric residents have conducted their own research or been involved with faculty research projects, these projects have been included In 1990, since the Residents’ Day had evolved into a state-wide event, it became a part of the Oklahoma Psychiatric Physicians Association’s annual meeting and continuing medical education conference By doing so, residents may present their work and engage the community of psychiatry in an intellectually stimulating and informative discourse Congratulations and here’s to many more years of outstanding research by Oklahoma’s psychiatric residents! ❖ PAGE OPPA Membership Update Welcome New Members Jacob Strohl, M.D., Resident Fellow, Oklahoma City Crystal Obiozor, M.D., Resident Fellow, Tulsa Asha Kovelamudi, M.D., Resident Fellow, Tulsa Rosemarie Caskey, M.D., Resident Fellow, Norman Hunter Caskey, M.D., Resident Fellow, Norman Fatima Sheikh, M.D., General Member, Oklahoma City Reinstatements: Welcome Back! William Tankersley, M.D., General Member, Norman (2017 drop) Fei-Ling Yeh, D.O., General Member, Edmond (2017 drop) Shyvonne Brooke Gray, M.D., General Member, Edmond Discontinuation of Membership: Non-payment of 2018 Dues Jonathan Doyle, M.D., Fellow, McAlester Peter Rao, M.D., General Member, Tulsa Xiaohong Hu, M.D., General Member, Edmond John Hennessee, M.D., General Member, Oklahoma City Robert Hensley, D.O., General Member, Tahlequah Bradley McClure, M.D., General Member, Tulsa Celia Posada, M.D., General Member, Tulsa Asma Mudassir, M.D., General Member, Norman Irina Baranskaya, M.D., General Member, Edmond Weixin Lu, M.D., General Member, Oklahoma City Najma Hamdani, M.D., General Member, Norman Sinisa Trbovic, M.D., General Member, Lawton Alzira Vaidya, M.D., Life Fellow, Ponca City Dustin Smith, D.O., Resident Fellow, Jenks Saoda Shuara, M.D., Resident Fellow, Oklahoma City Christopher Snyder, D.O., Resident Fellow, Jenks Ranelle Bracy-Lewis, D.O., Resident Fellow, Broken Arrow Amar Chakra, M.D., Resident Fellow, Tulsa Reshma Motiwala, M.D., Resident Fellow, Norman Seth Migdalski, M.D., Resident Fellow, Tulsa Pranathi Mruthyunjaya, M.D., Resident Fellow, Norman John Laurent, M.D., Resident Fellow, Tulsa Jerrod Spring, M.D., Resident Fellow, Glenpool Gloria Martz, D.O., Resident Fellow, Oklahoma City Aus Aburashed, M.D., Resident Fellow, Tulsa Congratulations Fellows! Linda Lantrip, D.O., Advancement to Life Fellow, Norman Julia Irwin, M.D., Advancement to Fellow, Norman Ayesha Farhan, M.D., Advancement to Fellow, Norman Virginia Heller, M.D., Advancement to Fellow, Tulsa Advancements: Belated Congratulations! Ben Quiambao, M.D., General Member, Norman Sarah Kauble McClanahan, D.O., General Member, Tulsa April 2018 - June 2018 Goodbye and Good Luck: Transfers from Oklahoma Andrew Dentino, M.D., Fellow, (to Texas) Nataliya Polito, M.D., Resident Fellow (to Texas) ❖ In Memoriam Jeff McIlroy, M.D Word has been received of the recent unexpected passing of Jeff McIlroy, M.D., General Member of the Oklahoma Psychiatric Physicians Association and American Psychiatric Association He passed away January 4, 2018 Dr McIlroy was born on May 25, 1962 and graduated with a degree in Medicine from the University of Oklahoma in Oklahoma City in 1987 He entered residency training in July at the University of Oklahoma Tulsa campus graduating in 1991 after having served as Chief Resident in Psychiatry from July 1,1990 to June 30, 1991 He began his practice in Claremore in July, 1991 with Dr Clayton Rogers as his “mentor” in learning the healing art of mental health care within a small community His experience in private practice and as Medical Director of the Geriatric Psychiatry Unit at the Claremore Hospital quickly taught him the need to address treatment in a comprehensive, multidisciplinary fashion This understanding led to the creation and founding of Strength of Mind in 2004 Board Certified in Geriatric Psychiatry, Dr McIlroy was involved with many organizations including the Tulsa Christian Foundation and Every Nation Mission Foundation He was an Oklahoma representative for the Fair Tax and served as President of the River Hill Home Owner’s Association He had been a member of the OPPA and APA since 1990 According to his family, he was a brilliant thinker, wood-smith, and loved tending to his land He was a consummate lumberjack and built a beautiful log cabin on the land behind his home in Catoosa He inspired all who knew him to live life bigger and brighter Dr McIlroy is survived by his wife, two children and their spouses, his father and step-mother, mother and four siblings plus a host of close friends, colleagues and other extended family members ❖ PAGE OKLAHOMA PSYCHIATRY residents present posters in New York city For the sixth year, psychiatric residents from Oklahoma’s training programs were awarded Resident Assistance Fund grants to assist in their travels to the American Psychiatric Association’s 171st Annual Meeting and Scientific Conference held May 5-9 in New York City These residents were among those selected by the APA to present posters during the annual meeting Receiving grants this year were Matthew Sharp, D.O., from the Oklahoma State University Center for Health Sciences, Tulsa; Hunter Caskey, M.D., Griffin Memorial Hospital Residency Training Program, Oklahoma Department of Mental Health and Substance Abuse, Norman; and Ambreen Rahman, M.D., Ivanshu Jain, M.D and Akshay Lokhande, M.D from the University of Oklahoma College of Medicine, Department of Psychiatry and Behavioral Sciences, Oklahoma City The Resident Assistance Fund was originally created in 2012 by the OPPA Executive Council to help residents pay for expenses, including registration, travel and hotel, associated with their participation in the APA annual conference This year each of the four residency programs was allowed $400 to be awarded to residents selected by the program By accepting the grant, each resident must agree to attend the APA conference and present a poster; present the same poster at the annual meeting of the OPPA or quarterly COPS or TPA meeting; attend one OPPA Executive Council meeting during the coming year and be a member in good standing of the APA/OPPA for one year The Resident Assistance Fund is in need of tax deductible donations to help the program grow If you wish to donate, please send a check payable to the OPPA and mail it to PO Box 1328, Norman, OK, 73070 Please be sure to include Resident Assistance Fund on the memo line of the check ❖ Matthew Sharp, D.O., PGY-1, entered a poster in competition at the APA Annual Conference His title is “Kratom Craze, Delirium Haze or Schizophrenic Ways?” Ambreen Rahman, M.D., PGY-4, (left) and Ivanshu Jain, M.D., PGY-4, are pictured with one of their posters entered in competition titled, “Chronic Alcoholism, Traumatic Brain Injury and the Development of Korsakoff Psychosis - A Case Report.” Hunter Caskey, M.D., PGY-3, poses with the poster he entered titled “How Do You Manage the Psychosis of Huntington’s Disease? An Inpatient Challenge from Admission to Discharge.” Akshay Lokhand, M.D PGY-4, is pictured with his poster titled“ Eight-year-old with Rumination Disorder: A Case Report and Literature Review.” PAGE The following information is highlights from the approved minutes of the OPPA Executive Council meeting held February 17, 2018 via Skype between Oklahoma City and Tulsa Treasurer’s Report (Dr Lauren Schwartz) – Treasurer, Dr Lauren Schwartz, presented the year end 2017 budget This year, the Resident Assistance Fund only received a $200 donation with the remaining $1400 of the $1600 budgeted for resident grants came from Operations Other income included an expedited grant from the APA for Advocacy Membership programming and membership dues Revenue from the 2017 annual meeting held in Oklahoma City was down due to lower attendance Resident Assistance Grants (Dr Heather Geis) – An email reminder is being sent to the Residency Training Directors regarding the availability of Resident Assistance Grants The amount is $400 per program Dr Ostermeyer noted this is really a small amount when the costs of attending the meetings has increased Dr Tucker agreed it would beneficial if the amount could be larger Dr Geis reported an idea to raise money was to hold a raffle during the annual meeting and all proceeds be added to the Resident Assistance Fund Dr Rousseau suggested registration to the annual meeting as a raffle item Other items suggested were artwork or donations from businesses Dr Faruque moved to hold a raffle at the annual meeting to increase resources for this fund Dr Schwartz second Mrs Mixon will forward an email to all members announcing the raffle, so members will be prepared to purchase raffle tickets (check, cash or credit card) New Email Address – Please use the new email address: oklapsychiatry@gmail.com to communicate with OPPA 2018-2019 Officer and Councilor Ballot (Dr Bryan Cates) – The Officer and Councilor ballot was presented Vacancies on the ballot include the President-Elect, Treasurer and one Councilor at Large position All proposed officers and councilors accepted inclusion on the ballot Dr Jed Perdue accepted and will be included on the ballot as a Councilor at Large Dr Shannon Thomas accepted the Treasurer position leaving a Councilor at Large vacancy Dr Vijaya Ekambaum accepted this Councilor at Large position Dr Harold Ginzburg accepted the President-Elect position and to stand for election for a 2-year term as APA Delegate Child Psychiatry (Dr Brent Bell) – Dr Bell reported CHIP for children’s Medicaid was extended for seven years President Trump’s proposed budget calls for a 22% cut to Medicaid funding Oklahoma Medicaid is funded through the end of the year The flu crisis has driven up Medicaid expenses by an estimated $30 million Regarding gun safety, it is a gun crisis 44% of the worlds handguns are in the United States and the United States is only 4% of the worlds population Delegate (Dr Harold Ginzburg) – Dr Ginzburg reported the Area V representative from Puerto Rico resigned from the APA out of protest for the lack of response from the APA during their national disaster She felt the response was inadequate and the concept of dues relief for and free membership was not supported at the APA level He also reported the voting percentages were the lowest in the national election Early Career Psychiatry (Dr Shannon Thomas) – The APA has discontinued the self-assessments These had been a drawing card for new memberships Ethics Committee (Dr Jenny Boyer) – The Ethics Committee has forwarded one case to the Oklahoma Board of Medical Licensure and Supervision for investigation Another ethics complaint was received against one member and one nonmember After consultation with the APA Ethics Division, an email was sent to the complainant for detailed information Legislative (Dr Art Rousseau) – Dr Rousseau reported the OSMA has a new director, Matt Robinson The StepUp Oklahoma bill failed so now the agencies are looking at budget cuts HB 1013 is the nurse practitioner bill and Sen Yen has it in committee again this year Sen Griffin introduced another nurse practitioner bill, SB 720 Sen Yen has entered SSP 1027 which is a study regarding the supervision issue raised by nurse practitioner against physicians Some physicians sell their services to nurse practitioners, so Sen Yen has introduced SB 1127 which states physicians cannot accept monetary compensation for supervision Massage Therapists would like to have licensure and regulation in Oklahoma since some parlors are fronts for human trafficking SB 693 and SB 758 address these issues Acupuncturists also would like to have licensure in Oklahoma, so SB 1523 was introduced, putting them under the Osteopathic Board SB 1501 and SB 1119 would create a separate board for acupuncturists Sen Yen has introduced an E-prescribing bill, SB 1128, which is supported, and pain clinic licensure is under SB 1124 which follows legislation in Florida SB 1446 limits opioid prescriptions to only seven days and SB 1367 is the opioid Good Smartian bill which allows the reporting of opioid overdose Sen Griffin has introduced SB 1052 which removes a physician from the involuntary commitment procedure, leaving other healthcare personnel, such as alcohol counselors, with the authority for involuntary commitment SB 1219 creates protection against sexual abuse by mental health professionals Regarding medical marijuana legislation, the bill refers to a “physician” who may subscribe; however, there are seven “physicians” under the law including veterinarians This issue will be up to the voters of the state of Oklahoma so will watch and wait for the election outcome Membership (Dr Heather Geis) – Since the August Council meeting, the OPPA has gained 14 new members and five former members have reinstated One resident fellow member has upgraded to a general member The OPPA lost one member as Dr Jodie Edge passed away in October See Council Scoop on Page 10 PAGE 10 OKLAHOMA PSYCHIATRY Council scoop Veterans Affairs – In a written report, Dr Janssen noted Chaplain Carter Check at the Muskogee VA is now providing Reconciliation Clinics to assist veterans with the healing from moral injury The clinic utilizes a 12-week program with a strong focus on self-forgiveness Resident Programs – Dr Geis and Dr Ostermeyer recently spoke to the OU Residency Training Program regarding the benefits of OPPA membership Resident Program Directors – Dr Chesser reported the OSU Tulsa program filled all slots with OSU graduates COPS – Dr Tucker reported the next COPS meeting will be March 8th, at Johnny Carino’s on Memorial Road in Oklahoma City Drs Rachel Dalthorp and Britta Ostermeyer will be presenting on Ketamine in Psychiatric Practice and Violence: Risk Assessment and Reduction respectively And, in December, Dr Jenny Boyer presented a program on Membership Advocacy which was sponsored by the recent APA grant received by the OPPA this summer COPS is also looking for continued CME sponsorship at a reduced rate Integris Health has been the sponsor the past two years continued from page TPA – Dr Chesser reported the next TPA meeting is set for Thursday, February 22ne at In the Raw on the Hill restaurant The program will discuss the Tulsa Mental Health Plan Speaking will be Dr Gerald Clancy, Courtney Knoblock and Richard Wansley TPA will also host Dr Jenny Boyer presenting the Membership Advocacy program this spring and looking at a program on Forensics in the fall Donahue-Shadid Psychiatric Alumni Society (Dr Jimmie McAdams) – Dr McAdams reported DSPAS has a new President for 2018-2020 It is Vivian Hasbrook, MD who recently served as Vice President for the organization Oklahoma Council of Child & Adolescent Psychiatry (Dr Brent Bell) – After the conclusion of the OPPA conference on Saturday, April 7th, OCCAP will host a social dinner and board meeting at the French Hen Bistro beginning at 5:30 pm Everyone is invited Meeting adjourned ❖ PAGE 11 Annual meeting luncheon events 2018-2019 new officers and councilors New officers and councilors assumed their leadership roles of the Oklahoma Psychiatric Physicians Association during the April annual meeting luncheon held in Tulsa during the CME scientific conference Pictured above (from left to right) are Drs Jay Lensgraf, President; Harold Ginzburg, President-Elect and APA Delegate; Shannon Thomas, Treasurer; Lauren Schwartz, Secretary; Shree Vinekar, APA Delegate; Hashib Faruque, Councilor-at- Large; Heather Geis, Past President and First Councilor; Art Rousseau, Councilor-at-Large; Bryan Cates, Second Councilor; and Jed Perdue, Councilor-at-Large Not pictured are Drs Jason Beaman, Vice President; Ray Cordry, Councilor-at-Large; Vijaya Ekambaram, Councilor-atLarge; Courtney Nixon, Councilor-at-Large; Britta Ostermeyer, Councilor-at-Large; and Haiwang Tang, Councilor-at-Large ❖ Raffle raises funds & fellows honored With donated funds for the Resident Assistance Grants spent, the OPPA Executive Council decided it was time for some creative thinking What about a raffle at the annual meeting? So for a donation of $20 per ticket, one lucky winner would have the chance to receive reimbursement of their conference registration fee plus a $25 gift card to Panera Bread The drawing by OU resident, Dr Ambreen Rahman, (pictured right) took place during the afternoon break and the lucky winner was Dr Heather Geis! Conference participants were generous as the OPPA raised $1,230 through ticket sales and additional donations for resident grants in 2019 Recognized at the annual meeting luncheon was Linda Lantrip, D.O (pictured below right) who, through advancement, became the OPPA’s 6th Life Fellow in January, 2018 Dr Lantrip joined the APA and OPPA during her first year of residency at Griffin Memorial Hospital in 1989 Life Fellowship honors a lifetime of dedication to the work of the APA and OPPA and the psychiatric profession Also honored, but not present at the luncheon, were the organizations new Fellows Honored with an advancement to Fellowship this year are Julia Irwin, M.D., Norman; Ayesha Farhan, M.D., Norman and Virginia Heller, M.D., Tulsa Joining the Golden 80 Club this year is Birgit Jones, M.D., Tulsa As a retired member, Dr Jones was recognized at the luncheon for her dedication to her profession and for reaching her 80th birthday! ❖ PAGE 12 OKLAHOMA PSYCHIATRY Oklahoma Psychiatry PO Box 1328 Norman, OK 73070 405.360.5066 oklapsychiatry@gmail.com Oklahoma Psychiatry is a publication of the Oklahoma Psychiatric Physicians Association Harold Ginzburg, M.D., J.D., M.P.H., Editor Renée Davenport Mixon, Executive Director The Oklahoma Psychiatric Physicians Association, a district branch of the American Psychiatric Association, is a medical specialty society recognized world-wide Our member physicians specialize in the diagnosis and treatment of mental and emotional illnesses and substance abuse disorders I n t e g r at e d c a r e wo r ks h o p h o s t e d at O S U - T u l s a A free training workshop on “Applying the Integrated Care Approach Practical Skills for the Consulting Psychiatrist” was held May 30th at the Oklahoma State University Center for Health Sciences in Tulsa The program was sponsored through a Transforming Clinical Practice initiative offered by the American Psychiatric Association The four-hour CME training program, presented by John Kearn, M.D., (pictured above) included a general history of integrated care models, workflow differences between traditional psychiatry and psychiatric consultation in Collaborative Care, how initiating treatment as a part of a team, how to use a registry to facilitate treating-to-target and how the registry differs from current practice Psychiatrists are in a unique position to help shape mental health delivery in the current rapidly evolving healthcare reform landscape using integrated care approaches, in which mental health is delivered in primary care settings The OPPA wishes to thank Dr Sara Coffey, OSU-Tulsa and the APA for their assistance and hard work coordinating this free model of patient care training opportunity.❖