Candidate for President-Elect
About the Candidate
Fellow, 1971
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Clinical/Academic Program Systems Analyst; Consultant, Homeless Issues; VISN 12, VA, 2000- ; Faculty, Institute for Psychoanalysis, 1999- ; Professor of Clinical Psychiatry, Northwestern, 2001- ; Private Practice, 1971-
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President-elect, American Society for Adolescent Psychiatry, 2001-02; President, American Association of Directors of Psychiatric Residency Training, 1991-92
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NAMI Illinois: Outstanding Psychiatrist, 1999; Faculty of the Year, Loyola Psychiatry, 1998, 1999
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President, Illinois Psychiatric Society, 1998-99; Assembly Representative, 1999-
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Scientific Program Chair, APA Annual Meeting, 1997
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Representative to AAMC, 1992
Candidate’s Views
APA is in need of renewal. There are 45,000 psychiatrists practicing in the U.S. but only 32,000 are APA members (down from 35,800 in 1998). Clearly many members feel that APA is ineffective in advocating for their needs. In a decade only half of America’s psychiatrists may be APA members. Only after stabilizing membership can APA effectively speak to the issues that confront psychiatry and advocate for our patients and the profession.
The Issues
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APA: APA is often seen as an outdated and costly bureaucracy. Consider the alphabet soup of APA committees, task forces, and commissions, 155 by one count. Which are useful? Do they identify and solve problems? Are they cost-effective?
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Psychotherapy and Pharmacotherapy: APA must address how to integrate pharmacotherapy and psychotherapy into practice.
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Public Policy: APA must be a visible participant in deliberation on mental health policy. It is often seen as silent or unclear in advocating for the abolition of mental health carveouts or in addressing managed care companies when they insist that psychiatrists can only prescribe medications.
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Relationship With District Branches: APA must be more effective in supporting its branches and in aiding members as they deal with hospital budgetary decisions that harm practice.
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Public Perception of Psychiatry: APA must school the American public that our unique skills are critical. Policymakers often believe that others are as qualified as we are to either prescribe medication and/or psychotherapy. APA must clarify our relationship with drug companies; often we look like their agents.
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Education and Training: APA must ensure that psychiatrists are current in their knowledge and skills and must work to revitalize medical student education in psychiatry.
The Needed Actions
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APA: APA must be reshaped to respond to our new environment. We must study the cost, structure, and tasks of the central office to determine where essential efficiencies can be made. A similar review must be made of all APA elements.
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Psychotherapy and Pharmacotherapy: APA must develop and promulgate a consensus on our core competencies. It must address when a psychiatrist provides both psychotherapy and pharmacotherapy and when they can be split. Psychiatrists, not administrators, must determine treatment.
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Public Policy: APA must develop a focused, prioritized public policy agenda. While we oppose psychologists prescribing, we must assert, “Education not legislation must determine the scope of each mental health discipline’s practice.”
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Relationship With District Branches: APA must develop new ways to govern this relationship. Revenue sharing between APA and its branches must be enhanced.
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Public Perception of Psychiatry: APA needs new strategies to communicate the differences between psychiatrists and other mental health providers. APA must cap its reliance upon drug companies and assure the public that we are not their agents.
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Education and Training: APA must assure psychiatry adequate time in medical school. In residency pharmacotherapy and psychotherapy as well as knowledge of cultural diversity and its impact upon behavior must be taught as the basis of our field. New programs to enable noncertified psychiatrists to obtain certification must be developed.
This is only a preliminary outline of actions. We must remember, business as usual may mean no business at all.
I welcome your support.
Primary Loci of Work and Sources of Income
Work: 25%—VISN 12 at Hines VA Hospital
40%—West Suburban Hospital, Oak Park, Ill.
35%—Office in downtown Chicago (30 North Michigan Avenue)
Income: 30%—Veterans Administration
70%—Private practice
Information & Authors
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History
Published online: 7 December 2001
Published in print: December 7, 2001
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