AMA honor
for Inouye
turns to snub

Psychiatrists upset at his support
for psychologists force the group
to withdraw the award

By Helen Altonn
Star-Bulletin

The American Medical Association has declined to give an award it was to present to U.S. Sen. Daniel Inouye at a dinner Sept. 23 in Washington, D.C.

The organization's psychiatric members had threatened to boycott the event if the award weren't withdrawn because of a controversy over whether psychologists should be allowed to prescribe medication.

Boycotting the dinner now will be the two doctors who nominated Inouye for the award: Jerrold Michael, former dean of the University of Hawaii School of Public Health, and Satoru Izutsu, UH associate dean of public health and psychiatry.

"It's very painful," Michael said in a telephone interview from Maryland, where he now lives. But Inouye didn't want any action to reverse the award cancellation, he said. "He's a gentleman of the first order."

Inouye was notified June 4 that he and Arizona Sen. John McCain had been selected for the Nathan Davis Award because of significant legislative contributions to health and medicine.

On June 16 former U.S. Rep. Norman Mineta of California visited Inouye as an AMA emissary and told him his award was being pulled back because of opposition by psychiatrist members.

Inouye's administrative assistant, Patrick DeLeon, is a psychologist who has just finished nine years on the American Psychological Association's board of directors. He is a candidate for the National Psychological Association president.

"Across the country, psychiatrists are facing the issue of psychologists seeking prescription privileges," DeLeon said. "They don't like that."

Inouye said he was "a bit surprised" when invited to accept the AMA award because "some psychiatrists have been quite incensed with my support of psychologists in general."

He said he has supported psychologists, optometrists, podiatrists, nurses and other medical professionals because "that's the way to cut down medical costs."

When Mineta, his "good friend," talked to him about the award, he said: "They wanted to suggest maybe I delay it.... I said: 'I am grateful for the award, but no thank you. I don't want to be a party to any activity that would mar the dignity of the convention.'

"But I insisted that they present it to John McCain," Inouye added. "I don't want John McCain to be denied just because they don't like me."

Michael and Izutsu said the AMA hasn't notified them of their decision. They learned about it from Inouye's office.

"I was shocked. I just couldn't believe it," Izutsu said. "I cannot believe that a large, prestigious organization like the AMA would do that."

Michael said he was told "the senator was most gracious in understanding there was a scope-of-practice issue, and he certainly understood the position of the AMA."

But he said he and Izutsu "would like people to know just how influential Sen. Inouye has been in health affairs."

This was the second year Inouye was nominated for the award, Izutsu said, "His fantastic involvement and backing of health care for minorities in Hawaii and the Pacific and the American Indians is legendary in Congress."

Dr. Len Howard, Hawaii Medical Association president, and Jonathan Won, executive director, expressed regret about the award cancellation but said they had to support the American Psychiatric Association.

They and two AMA staff members were asked to attend a meeting of psychiatrists at the AMA's annual meeting in June in Chicago, they said. The psychiatrists wanted to know who nominated Inouye for the award and why, Won said.

He said he and Howard tried to suggest other ways to deal with the situation, but the psychiatrists were so upset they threatened to take it to the floor of the AMA's House of Delegates and make it a public issue if it weren't resolved.

Howard said: "We were put into a position that was sort of between a rock and a hard place. I've known Dan 22 years and I respect him highly. He has done so much for Hawaii and Hawaiian medicine."

But prescriptive authority and scope of practice for optometrists, nurse practitioners and clinical psychologists are key issues, Howard added.

Since the HMA represents doctors, he said, "I had to put my personal opinion aside and say the doctors of Hawaii oppose prescriptive authority for clinical psychologists."

Howard and Won said they hope to meet with Inouye to explain the HMA's position and convey their appreciation for his contributions to health and medicine.

"We continue to hold him in the highest respect, but we have to represent what our membership tells us to do," Howard said.

Inouye's ambition was to be a doctor, Michael and Izutsu pointed out. He decided as a child, after treatment at Shriners Hospital for a compound fracture, that he wanted to be an orthopedic surgeon.

That was impossible after he lost his right arm in World War II combat, the doctors pointed out.

They cited Inouye's continuing concern and support for changes to improve the health of Pacific islanders, native Hawaiians and American and Alaskan natives, his support for the military medical system and contributions to Tripler Medical Center's modernization.