As we approach the final year of the Decade of the Brain, our understanding of neural networks has converged with the idea of complex configurations that are constantly influencing and being influenced as the medium (the brain) and the message (the content of our brain, i.e., thoughts, emotions, and behaviors) interact. As applied brain scientists, we have come to understand that neural networks function in the context of genetic expression, the internal bio environment of the brain, socioeconomic influence, and physical factors. We now know that, through a complex and biodynamic dance, these networks respond by influencing the very factors that shaped them. The notion that there is a linear relationship between cause and effect is long dead in the primary biophysical sciences. Advances in our understanding of neurobiology, the effects of environmental stress, substance use, and biological vulnerabilities have shown us that improvements in mental health must address factors that were traditionally seen as “biological” and “environmental” It is now time to fully recognize that the notion of “biology versus environment” and the ontological dualism of “mind” and “matter” are paradigms that are outdated and ineffective in advancing the wellness of our patients, our colleagues, and ourselves.
Why am I writing about this as the 2016-2017 President of the OPPA? Let me tell you why: we cannot be isolated from the changes in health care occurring all around us because these changes are influencing how we practice psychiatry. Our understanding of this model of complex, interrelated networks I the means by which we, as organized psychiatrists, can advanced the practice of modern psychiatry. As an organization, we must continue our work in creating our own form of an advanced “neural network,” a network that extends its reach to elected officials, law enforcement, state and federally regulated health care organizations, social services, education, and other entities. Congruent with this model, we also must be willing to be influenced within this network. At times, the influence does not feel welcome. Some influences that are a special challenge to psychiatrists are Meaningful Use/MACRA, mental health and criminal justice laws that create barriers to emergency care, laws allowing the practice of medicine without a medical degree, and pharmacy benefits coverage rules and practices that fly in the face of standards of care and expedience. But this influence is not unidirectional if we are willing to use the power of our organization’s complex network. For example, the OPPA cannot call a judge and ask him to change a law that he did not write, vote for, or sign, but we can influence legislators to make changes in the law, both through our direct relationships with them and our indirect relationships with other organizations that influence lawmakers, such as journalists, allied organizations, and policy makers.
Along with many great leaders within our organization, Dr. Craig Zarling has helped lead a year of expansion of our sphere of influence. In addition, this year we were joined by an excellent lobbyist, Katy King, who tirelessly works to create personal relationships with key lawmakers. Patrick Sieng and Ms. King have both made great advances in ensuring that our presence is felt at national and local meetings. In the coming year, I plan to extend outreach efforts to our rural members, strengthen relationships with policy makers, public health leaders, and other key entities. Now is the time to further enhance our network, both within our organization and with the larger community that bears so much influence upon us, so that we may, in turn, improve our larger community of care.
In closing, I want the membership to know that I am very proud to be affiliated with the OPPA. During my 8 years with the organization, I have been inspired by many of our members who have shown extraordinary dedication to good patient care, public advocacy, and collegiality. I wish to extend special recognition to Dr. Henry Grass, who has devoted his entire career making the lives of other psychiatrists better. I have deep gratitude for his many contributions to psychiatry in Oregon. When you see him, please take a moment to thank him for his service. I will never be the giant that he is, but I can try to further things along. I want to hear your ideas about actions to take for the coming year. You can email me at email@example.com.
Thank you for being an OPPA member. Your participation is appreciated and if I have not met you in person yet, I hope to meet you at one of our upcoming meetings.
Stephanie Maya Lopez, MD, FAPA