The value of getting involved politically speaking
By Paula Hartman-Stein, Ph.D.
Advocacy breakfast, Public Policy Directorate
American Psychological Association Convention
August 5, 2000
For the first 10 years in my professional career I was the typical apathetic, politically uninformed psychologist who did my basic civic duty by voting in general elections and paying dues to several professional associations. I basically viewed politics as a necessary evil in life that had nothing to do with me personally. Then in January 1992 I received a wake-up call. My income as a private practitioner specializing in geropsychology took a nose dive. Why? Because the Medicare allowed rates for psychological testing plummeted to about a 50 percent drop in the government determined fee. I did not accept this lowering of income lying down. I was determined to find out the reasons and then advocate for any possible change. This mission became my first professional political endeavor.
I discovered that the new Resource Based Relative Value Scale (RBRVS) method of determining fees had been implemented, and no values had been assigned to psychological testing services. What could an individual practitioner like myself do about this injustice? The first step was to gather information. So I began by calling Senator Jay Rockefellers office and thereby began a relationship with his political staffers. Then through serendipity, timing, and willingness to speak out publicly, I got a chance to make a small difference. While attending a geropsychology training conference in the spring of 1992, I decided to inform the mainly academic based attendees of the real-life problems of providing services to older adult clientele. Dr. George Taylor, an influential member of APA, apparently liked my outspokenness because he nominated me to possibly be chosen to a panel of psychologists to study the value of psychological services by working with the economist, Dr. Hsiao from Harvard University.
The Harvard researchers chose me to be on the panel. I was chosen partly by my age, specialty area, and where I lived. From 1993 to 1994 I served as one of seven psychologists involved with the study of the RBRVS method of determining payment as it applies to clinical psychological services. Our panel was able to influence recommendations that the Harvard research team made to the Health Care Finance Administration, and these recommendations continue to influence decisions about fees today.
As a result of another bit of serendipity and geography, Dr. Nina Levitt invited me to attend a dinner at the APA convention in Toronto six years ago to honor Ohio Congressman Tom Sawyer. Another Ohio psychologist could not attend at the last moment, so I was invited to pinch hit! This was my introduction to the meaning of the word constituent. My husband and I were quite happy to attend a free dinner and meet a Congressman. We figured that we would blend in to a crowd of 50 to 100 people. Were we ever wrong? Instead we were in a "crowd" of 10 to 12 people, and we spent about three hours getting to know the Congressman, even sitting next to him in the cab ride back to the hotel.
The adage that "there are no free lunches" applies here. In a few weeks after the Toronto dinner, the public policy people at APA asked me to host a fund-raiser for the Congressman. Until that time I knew nothing about fund-raisers. I was a fairly quick study learning how to organize a small gathering of health and mental healthcare professionals to support the continued efforts of Congressman Sawyer. I also learned about the incredible stinginess and widespread apathy among some of my fellow Ohio psychologists. This is also how I learned about the concept of "chits" or making deposits in the political relationship bank.
Because I had raised a small amount of money for the Congressman, I was empowered to later be bold enough to ask the Congressman for a small personal favor. I had heard that he had been an English major and enjoyed writing. I asked him to write the foreword in a book I was then editing, Innovative behavioral health care for older adults. To my surprise he agreed to do so, and he did a wonderful job of introducing my book in both a poetic and political fashion.
Last year Nina asked me to go to Washington as a constituent to have an audience with Senator Michael Dewine. The purpose of this was to convince the senator of the value of training psychologists and other mental health professionals to work with older adults through new wording in the Older Americans Act. This is where geography comes into play once more because Ohio Sen. Dewine happened to be the chair of the Senate subcommittee on aging. My home address gave me an opportunity once more to be politically involved.
From this event I learned about the arduous process of crafting the language of our laws. I take personal pride in influencing the senator to include one specific word in the bill, post doctoral. I advocated for providing funding not only for doctoral training but also for those of us old timers in the trenches who would like to sharpen our skills in working with older adults.
Then last May Nina asked me to be a panelist for a congressional briefing. This was truly a memorable highlight of my career. I spoke about the major ways that psychology has contributed to healthcare for older adults. Much to my surprise there was a crowded room for the event, and people actually listened. This was a far cry from my usual lectures to an internal medicine audience. The audience who was primarily comprised of congressional staffers were there to listen and learn, and they seemed to appreciate all of our panelists efforts.
To summarize, these are my lessons learned about the value of political involvement as a psychologist: