THE GOOD FIGHT - Robert L. Pyles, MD

But when managed care dies, what will replace it Jim Clark’s original vision of
Healtheon—today’s Web MD, was nothing short of one large conglomeration of
insurers, physicians, and pharmacies—all controlled through the 21 st century tool of the
web.The impact of the web on the issues of privacy and centralized management have
only just begun to emerge. As other iterations of managed care appear, we must be at the
table to add our voice to that debate.
Section VI
Challenges Ahead
It has often been observed that trying to get a group of psychoanalysts to take
collective action is like trying to herd cats. Or that trying to get our Association to change
direction is like trying to turn the Queen Mary around. I am pleased to be able to report
that the cats are marching together (mostly) and the Queen Mary has become positively
nimble and responsive.
It is undeniably true that we are a fractious bunch, with more opinions on any topic
than members. Which makes what we have been able to accomplish even more
astonishing. Consider, for example, the scene in the registration area at our Chicago
meeting in May. On one TV monitor was a continuous showing of a program on privacy,
produced for cable and Congress, featuring psychoanalysts. On a second monitor were
clips of psychoanalysts being interviewed on major news programs, like Jim Lehrer, Tom
Brokaw, and Diane Sawyer. This would have been unthinkable a few short years ago.
This is vivid proof of what we can do in a very short time if we are determined. Even in
this past year we have seen a dramatic upturn in the number of psychoanalysts published
and quoted in the media, thanks in no small measure to the efforts of Leon Hoffman and
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