Atlanta psychiatrist Patrice A. Harris, MD, MA, made quite the imprint during her term as AMA president, which concluded June 7 as the reins were handed over to the AMA’s third consecutive woman president, Susan R. Bailey, MD.
Dr. Harris traveled widely and has popped up frequently on TV news, sought out to contribute the AMA’s viewpoint on pressing issues such as the shortage of personal protective equipment and the importance of reopening in the safest way possible.
As the AMA’s first African American woman president, she also has added her sharp insights on the alarming health inequities of the pandemic and police brutality in communities of color. Dr. Harris took some time this week to talk about what she sees for the year ahead—for her work, the AMA, and for the nation’s health system.
AMA: In your farewell address as AMA president at the 2020 AMA Special Meeting of the House of Delegates, you mentioned some of the big issues that you plan to continue focusing on in your work and advocacy as immediate past president and beyond. Tell our physician readers more about that.
Dr. Harris: Each AMA president brings to the office their many years of experience and expertise with which to do the work. And for me, as a child and adolescent psychiatrist and of course an African American woman, there were three things that I said in my inaugural address that I’d like to amplify.
One of those is the importance of the integration of mental health in overall health. For far too long, mental health has been seen as external to health or not an important component of health. Fortunately, more and more people are recognizing the importance of mental health and how it contributes to overall health. I will continue to work towards the goal of a well-funded, well-resourced, integrated mental health infrastructure in this country.
Of course, the AMA has been a leader in advocacy for mental health parity and that work has been particularly important during the opioid epidemic. I have chaired the AMA Opioid Task Force and I will continue to be engaged and involved in work on the opioid epidemic to ensure that stigma is addressed, parity laws are enforced, and that treatment for substance-use disorders is equitably available.
In my address, I also mentioned the importance of a diverse physician workforce in the service of health equity. We have some data that, for instance, Black men are more likely to take advice from a Black physician. We have to make sure that the faces of the physicians in this country match the faces of our patients with a special emphasis on the number of Black men entering our profession.
This links to my passion for working with children. We have to start very early to build the pipeline from preschool to med school, and that includes a focus on socio-emotional development and learning.
AMA: Another area that you’ve really made a priority is the impact of trauma. It seems to many as though we’re living through a kind of nationwide trauma right now if you just look at what’s making headlines in America. Will your work continue in this area?
Yes. The third area I said I wanted to amplify was the importance of understanding—and building infrastructure for those who have experienced—childhood trauma. Again, the data is ever-increasing that trauma impacts health. And not just mental health, but also heart disease, stroke and diabetes. Never would I have imagined that we would have a pandemic, of course; nor would I have wished for this pandemic to amplify these issues. But certainly the COVID-19 pandemic is bringing into stark relief issues related to mental health, inequities and trauma.
Add to that the recent acts of police violence, and we have further amplification of the importance of mental health, the importance of equity and the importance of racism, discrimination, bias, and of course trauma. And it is important to note that you don’t have to have direct experience; police brutality and violence against Black men and women also has an impact on those witnessing these acts of violence.
AMA: Do you think these two big issues that have dominated headlines this year—the pandemic and police violence—and the anxiety and stress that they have caused for so many, will help to make headway in fight for mental health parity and integrating behavioral health into care delivery?
Dr. Harris: I hope so. This is certainly a learning opportunity. But it’s not enough just to learn about or to just be aware of these issues. We need to convert knowledge into action.
There is no one-size-fits-all approach to improving the infrastructure for the delivery of care to those who have mental health or substance-use disorders. But we must have an infrastructure in place, and make sure we have new delivery systems that are trauma-informed and understand systemic and structural drives of health inequities, including structural racism.
AMA: Another major development during your term as president has been the rapid adoption of telehealth as payers and regulators have—at least temporarily—done away with many barriers to implementation by physicians and health care organizations. What do you see as the next steps in this area?
Dr. Harris: I’ve been using telehealth in my practice for years, and I’ve continued to see some patients using telehealth during my time as AMA president. It’s not new to my specialty, nor to other specialties. Many physicians, in many different specialties, have been using telehealth services, particularly to bring health care to rural and underserved areas. So telehealth is not new, but the path forward has been accelerated for many during this period.
What will be required is a thoughtful, evidence-based conversation about the best use of this method for delivering care. The ultimate goal has to be better patient outcomes, and we will certainly need to have pay parity for these services. Also, telehealth should not further fragment health care, and patient choice must be respected. Some of my patients don’t prefer to see me via telehealth.
What we always say is: “Right patient, right time.” We should avoid knee-jerk decisions on the path forward. Delivery of care via telehealth should be an important piece of our future, but should not be seen as a panacea to solve all problems regarding health care delivery.
AMA: So you must be looking forward to a schedule as immediate past president that’s a little less hectic. What’s your advice for Dr. Bailey as she takes the helm as AMA president?
Dr. Harris: For me, this has been the privilege of a lifetime. I have so much gratitude for the opportunities I’ve had, and now for the opportunity to do even more.
As for Dr. Bailey, she is an experienced leader. She has all the skills and expertise necessary to lead us in the next year. My advice to her is: enjoy the ride.