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Editor's note: At 58, Marcia Carruthers plays a commanding role in the field of behavioral health. She is CEO of the Disability Management Employer Coalition, a San Diego-based organization that has grown from a handful of members in the early 1990s to 1,500 at present. The organization is expecting 700 attendees at its meeting this July in Boston.

Here, Risk & Insurance^® columnist Peter Rousmaniere conducts a wide-ranging interview with Carruthers about developments in the behavioral-health realm. Carruthers speaks of the growing understanding among providers, suppliers and employers; the lessening of the stigma associated with having a behavioral problem that needs attention; and some of the personal lessons she has learned working in the behavioral health field.

Marcia Carruthers: I've been in the CEO position since the first of this year. My personal duties include strategy planning, fund raising, sponsoring relationship, public relations, speaking, organizational and staff development.

PR: What does DMEC do?

MC: In a nutshell, professional education for disability/absence practitioners. Our goal is to assist employers in developing cost-saving programs, encouraging responsive market products and returning employees to productive employment.

PR: How is DMEC organized?

MC: We have a national board of directors, 13 operating chapters and seven supported chapters. There are also two advisory boards--an executive advisory board and employer advisory board. We have a staff of six full-time positions in our national administrative staff. We might add another staff member to cover membership and marketing. We have to continue to meet the increasing demands of a growing organization.

PR: Were you there at the creation?

MC: Yes, I and others around a table. The very first meeting was March 3, 1992, at the California Self-Insured Conference at the Princess Hotel in San Diego. It was a sunny, warm afternoon, and we met in a small conference room on the hotel grounds where we shared dessert. We discussed universal health care in California and disability management. I was working for Rohr, the manufacturing firm, at the time.

I recall others included Cathy Cather (Intracorp); Sharon Kaleta (also from Rohr); Diana Henderson (Hunt-Wesson); Candace Kilburn (Buck Knives); and someone from what is now SRS Services (a part of The Hartford).

PR: From small beginnings, what next?

MC: Within a year we received two sponsorships that made growth possible. They were from Intracorp and VPA. In 1997, Sharon Kaleta and I became part-time contracted employees, making a formal administrative structure possible.

PR: What do you really know well?

MC: Behavioral risk management, long-term disability administration, conference planning and Sea Ranch.

PR: Sea Ranch?

MC: The Sea Ranch, where my husband and I have lived for the last seven years. One of the most incredibly beautiful places on earth. It inspires me and keeps me grounded in the beauty of a very dramatic Mother Nature environment.

PR: When you were a teenager, what did you want to do when you grew up?

MC: Medical illustrator. My undergraduate degree was a B.A. in visual arts.

PR: Other degrees?

MC: An M.B.A. from the University of San Diego, 1986. Also, two designations: Certified Professional Disability Manager in 1997, and Associate in Risk Management in 1990.

PR: How do you manage difficult people?

MC: Using behavioral approaches and patience.

PR: Is today the same world as 10 years ago? What about 10 years hence?

MC: In the past 10 years, we've seen integration of treatment of nonoccupational conditions and occupational conditions; breaking down silos; moving toward prevention; broadening of the concept to include absence, health promotion and productivity.

In the next 10 years--I expect that behavioral risk management will pervade all aspects of claims and human capital management. National health-care insurance reforms will change the way integration is managed. Also, voluntary benefits will challenge the concept of employer control.

PR: Who has been the most influential person for your professional life?

MC: Sharon Kaleta, DMEC's board chairwoman and one of the founders.

PR: How do your professional colleagues describe you?

MC: Approachable, caring, perfectionist.

PR: What has been driving the increased interest in behavioral aspects of disability in recent years?

MC: The three key stakeholders are all moving in the same direction. Providers--as evidenced by the American Psychiatric Association and the American Medical Association support of the idea that "work is curative." Suppliers--as evidenced by a number of innovative cooperative models, increased use of EAPs, coaching methods, and interest in presenteeism and productivity.

Employers get it and want to dig deeper, find underlying causes--comorbidities to get highly skilled employees back to work and to optimal productivity. They are moving beyond the basic concepts of integration.

Stigma has been lessened by education and the pharmaceutical ads on TV, radio, in magazines. I also see a demographic factor. Greater interest in human capital management is partly a result of the retirement of the baby boomer generation and lack of infill on the part of Gen Xs and Ys. And perhaps, to some extent, there's been an impact of Sept. 11, 2001, making more visible the fragile nature of life.

PR: The July 2007 DMEC conference in Boston--what are you especially looking forward to?

MC: We're eager to increase the DMEC reach to the East Coast based on our successful conference in 2005 in Orlando. We're looking forward to a record attendance breaking 700 attendees. And lobster!

June 1, 2007

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