Winter 1999, Vol. 8, No. 2.

AOOP Member Profile

Red Stick Psychiatry

By Linda Cunning, D.O., M.P.H.,
Madison, WI

For the first member profile, we head to the Deep South to meet two AOOP members who have formed an occupational psychiatry consulting firm. The two members are Larry Wade, MD, and David Post, MD, and their company is Minds @ Work, LLC, in Baton Rouge, Louisiana.

Baton Rouge offers a variety of opportunities for occupational psychiatry. On the banks of the Mississippi River 90 miles north of New Orleans, this city of approximately 250,000 is a major international industrial port. With its many chemical and industrial companies, Baton Rouge is sometimes called Chemical City, but, in addition to industry, it has a variety of other businesses. Service employers in the region include the banking, insurance, and retail sectors. Baton Rouge is also home to a major university, Louisiana State University, and is the capital of Louisiana.

Both native Southerners, Drs. Wade and Post met about three years ago at a Louisiana psychiatric meeting and quickly learned of their mutual interest in forensic psychiatry. Dr. Post had just completed a forensic fellowship at Harvard/Mass Mental Health, and Dr. Wade had been doing independent psychiatric evaluations for social security and personal injury lawsuits for 14 years. Dr. Wade had approached several other Baton Rouge psychiatrists about forming an occupational psychiatry company over the years, but had always been politely turned down until he approached Dr. Post, who was enthusiastically 'on board.' Over the next several months they began to establish their professional identity by choosing the company name, deciding on their corporate structure, and making marketing forays into the community.

One of their first steps was to attend the Seattle AOOP meeting in early 1998, where they were energized by exposure to other like-minded psychiatrists from around the country. Both Dr. Post and Dr. Wade emphasize the value of relationships established through AOOP. They have found the annual meetings stimulating and supportive, filling them with renewed focus as they return home.

They have been promoting their business over the past two years, and in July, they successfully presented the 1st Annual 'Red Stick' Occupational Psychiatry Forum to 40 non-psychiatric professionals working in the field. (For those of us unfamiliar with Cajun lingo, Baton Rouge means 'Red Stick' in French.) The forum was co-sponsored by a local psychiatric hospital, a collaboration with significant benefit for Minds @ Work; the hospital Marketing Director was invaluable in making the conference center arrangements, and the course of discussions with the hospital led to a greater understanding of opportunities for further collaboration.

The day-long forum included an attorney's discussion of the Americans with Disabilities Act, a Cajun comedian providing a lunchtime diversion, and short presentations on the differences between psychiatric illness and disability and the role of psychiatric treatment in returning anxious or depressed employees to work. In addition, Dr. Wade provided an overview of the psychiatric disability evaluation process, and Dr. Post spoke on interventions for workplace violence. The entire forum was enthusiastically received, and they are beginning the planning process for next year.

Minds @ Work was established primarily as a marketing device to generate referrals for consultation for Dr. Post's and Dr. Wade's separate practices. Both doctors focus their occupational work on performing independent evaluations, rather than treatment, believing that a clear differentiation allows greater objectivity. Their business and professional interests are complementary, and they expect to have greater success working collaboratively than they found working alone. As the longer established member of the company, Dr. Wade had already established key connections with attorneys, insurers, and health care providers in the region before the formation of Minds @ Work, while Dr. Post had formal forensic training and an interest in marketing. Despite their strengths, they found the start-up process slow. They note that breaking into occupational psychiatry requires sustained efforts in marketing and relationship building combined with patience.

In addition to making external connections, they needed to build the relationship with each other, which they accomplished by regular discussions about their vision—bringing quality occupational psychiatry services to Baton Rouge—and their definition of the company's core mission and identity. This process took many hours of brainstorming, as well as a commitment to the vision and a willingness to accommodate each other. For instance, they began with rather different views of the need for corporate organization, a conflict they resolved through frank discussion and consultation with separate attorneys. They ultimately decided to organize as a limited liability partnership, a formal arrangement designed to minimize future internal disputes. They are now both pleased with the decision and recognize that the conflict resolution process was beneficial in the long run because of the knowledge gained about each other.

Both partners have work outside Minds @ Work. Dr. Post is a full-time forensic psychiatry Unit Director at the East Louisiana State Hospital in Jackson, Louisiana. He also has a private practice of psychiatry that includes adolescent psychiatry, medication management, brief therapy, and court evaluations. Dr. Wade practices general adult psychiatry in his own office and is associated with a private psychiatric hospital; in the past he has worked with chemical dependency treatment programs and has been the Utilization Management and Quality Management officer for a psychiatric IPA as well as conducting thousands of disability evaluations for Social Security and private insurers.

Drs. Wade and Post offer several words of hard-earned wisdom to others interested in starting an occupational psychiatry practice. Networking is key and relationships take time to develop. For these doctors, written flyers and faxed announcements drew little response; the most important referral sources came through their professional collaborations. They have consciously chosen to provide evaluation services only, rather than including treatment services in their practice. Dr. Post notes that by offering Employee Assistance Programs a resource for independent assessment they can help the EAP maintain a therapeutic relationship that is separate from evaluation. In so doing they offer a service that supports rather than competes with EAPs.

They recommend networking through ASTD (American Society of Training Director) and SHRM (Society of Human Resources Managers), both for individuals on the local level and for AOOP on the national level. They encourage information sharing among AOOP members and would like to see an AOOP speakers bureau established.

Minds @ Work has a web page (www.MindsatWorkLLC.com), which is under development and may be a future marketing resource. Other marketing plans include making video tapes of their recent forum available.

Dr. Post and Dr. Wade are interested in sharing their experience in starting an occupational psychiatry company and in learning from others. They are happy to receive fax or e-mail inquiries about their company. For further information, Dr. Wade may be reached by e-mail at 74157.1004@compuserve.com. Dr. Post may be reached at dpost007@pol.net. Minds @ Work fax number is (225) 928-9724.

 
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