The Role of the Medical Director in Public Mental Health
Jules M. Ranz, M.D. Æ Susan M. Deakins, M.D.
Published online: 7 April 2007
Ó Springer Science+Business Media, LLC 2007
For 26 years the Public Psychiatry Fellowship (PPF) of New York State Psychiatric
Institute and Columbia University College of Physicians and Surgeons has been training
young psychiatrists who wish to exert leadership roles in public psychiatry. In the early
years of the fellowship it was assumed that alumni would naturally ﬁll executive roles in
mental health services. Over the ensuing 25 years, however, such leadership roles have
increasingly been ﬁlled by other mental health professionals and, more recently, by people
with business training with or without mental health experience. This trend is especially
true in community-based organizations and also in hospital-based organizations to a lesser
extent. For medical-legal reasons, however, almost all mental health organizations have
medical directors who fulﬁll clinical and medical leadership roles with line authority over
medical but not necessarily clinical staff. The role of such a medical director is complex.
Many psychiatrists who ﬁll such roles without specialized training end up doing little more
than signing prescriptions and treatment plans.
Over the years PPF has developed a strategy to prepare fellows for facing the challenges
of public sector leadership and to support alumni in this endeavor throughout their careers.
PPF encourages fellows and alumni to focus on speciﬁc problems their organizations are
encountering and to develop appropriate strategies to exert leadership in helping their
organizations deal with these issues.
The series of articles in this section are examples of this approach. In each case the
author describes choosing and carrying out a particular strategy designed to deal with a
pressing challenge he is facing in his management position.
1. Dr. Hellerstein describes how, as clinical director of a NYS psychiatric facility, he
developed a project to assess obesity-related health problems of severely-mentally ill
J. M. Ranz, M.D. (&) Á S. M. Deakins, M.D.
New York State Psychiatric Institute, 1051 Riverside Drive, Box 111, New York, NY 10032, USA
J. M. Ranz, M.D. Á S. M. Deakins, M.D.
Department of Psychiatry, Columbia University Medical Center, New York,
Psychiatr Q (2007) 78:169–170