Insight Matters
Summer, 2002

APA's Mettle Has Been Tested!
by Charles Bensonhaver, M.D., APA Representative

Richard Harding, M.D., our Ohio-bred immediate past president of the APA, could well identify with Dickens when he penned, "It was the best of times, it was the worst of times." His term was threatened with 9-11, with New Mexico prescribing privileges for psychologists, with an APA financial crisis, with attempts by the Bush administration to abridge privacy for psychiatric patients, and with declining APA membership.

Primary among his blessings was the key role played by the APA and knowledgeable psychiatrists in the disaster management following 9-11. Much of Mayor Guliani's performance is credited to such consultation. The importance of the knowledge base about disaster management is now high in the minds of America's psychiatrists. District Branches have re-invigorated their disaster committees.

Other blessings included the immediate benefit of streamlining APA functions, a very successful annual meeting, and President Bush's coming out in favor of a national parity law.

Psychologists and scope of practice

The achieving of prescribing privileges by psychologists in New Mexico has sparked anguished and heated debate among our members. It is my view that there are many red herrings in these discussions such as serving rural communities, the need to appeal to reason, and the supposed ineptitude of the APA from preventing this action.

The overwhelming reason for the passage of this legislation is very simple. We got beaten out at the level of grass roots political activity. We must hold more fundraisers for our local candidates running for the Ohio Legislature. We must personally let them know our views. We must support OPA lobbying efforts and OPPAC!

Prescribing privileges for psychologists is not an issue which will inevitably sweep America. We psychiatrists must shake loose from our usual naiveté and be smart in our politic activity. The APA is well organized to help. They cannot be effective without strong local and state political activity as a base.

Financial crisis

In both 1999 and 2000 the APA lost about 4 million dollars. By mid year 2001 it appeared that the APA would again lose millions. Cuts were made in several areas. Accounting procedures were upgraded. A commitment was made to move into better and cheaper quarters. Sales from the APA press rose. The APA finished the year 2001 slightly in the black.

A successful convention in Philadelphia brought about 2500 more registrants than had been budgeted. The "Components" have been streamlined. A commitment was made not to use earnings from reserves to cover the budget. Plans are afoot to streamline both the Board and Assembly functions. These constitute a basis for hope that we will continue to be living within our means.

Membership

Today about two thirds of all psychiatrists in America are members of the APA. As professional associations go, that is a good record. However, there was a change five years ago from ever-rising membership to a slow decline. This is a major concern to the leadership of the APA at all levels. Several factors are thought to be the cause. The two leading ones are the financial squeeze on psychiatrists largely from managed care and the perception that the APA has not been very helpful to the rank and file.

No immediate solution is apparent. However the APA is working towards more active communication with all psychiatrists and the district branches. Better methods of payment and dues amnesty plans are afoot.

Summary

We psychiatrists live in a time of unparalleled efficacy in the treatment of psychiatric disorders. Nonetheless, managed care, the recession, and terrorism have pushed our needs into the background. Therefore, our beloved and venerable APA is even more our primary vehicle of advocacy for our profession and our patients.

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