Insight Matters
Winter, 2003

Candidate for OPA Treasurer:
Ralph G. Walton, M.D.

POSITION STATEMENT

"It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair..." With apologies to Charles Dickens, his words suggest the circumstances we currently face in American psychiatry.

At a time when we have more effective therapeutic tools than ever before, there are increasing impediments to the implementation and delivery of those tools. For our profession and our patients this could and should be the best of times. If current trends are not reversed, however, this could well prove to be the worst of times.

The current knowledge base of our profession is truly phenomenal. Websters defines wisdom as "knowledge coupled with just judgment as to action." If we do not act effectively on many fronts, despite the breadth and depth of our knowledge we will find ourselves in an age of foolishness rather than wisdom. It is essential that decisions regarding patient care be restored to the most knowledgeable practitioner - the psychiatrist - not relegated to clerks, bureaucrats and accountants at managed care companies. The exponential growth in the neurosciences and psychopharmacology clearly dictates that prescriptive privileges be in the hands of individuals with broad medical training. To argue otherwise would be the height of foolishness. Clinical psychologists should certainly be granted prescriptive privileges provided they receive such training - generally called medical school.

Our profession is beginning to have a real impact on destigmatizing mental illness and making the public aware of the efficacy of our treatment. Just at the time of growing belief in the value of psychiatric care, there is incredulity at the lack of fair and equitable availability of these services. Evidence based medicine clearly demonstrates that psychiatric care is at least as effective as the care rendered by internists for the major clinical problems encountered in their practice, yet this is not reflected in insurance parity. The highly effective treatments for our most seriously mentally ill are less and less available with the downsizing and closing of programs.

I certainly do not suggest that I have quick or easy solutions to these complex issues. I can say though, that after a lengthy career encompassing private practice, public sector psychiatry and academia, I am well aware of the problems, challenges and opportunities facing our profession. It is truly an honor to be a candidate for Treasurer of the OPA. I pledge that if elected I will energetically work with the OPA to pursue solutions. It is my firm belief that with the right people working together we can turn the 'winter of despair" into the "spring of hope."

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