Candidates for Secretary: Fred Gottlieb, M.D.

APA Must Better Mobilize Members' Input: (1) I believe the March 2009 Board decision to unselectively terminate about 75 APA committees, councils, and other components, composed of about 800 APA member volunteers, was an unfortunate mistake, too driven by a budget panic, throwing out the baby with the bathwater; (2) APA's Political Action Committee, like all PACs, focuses on a single domain. But the PAC's contributions then help some legislators who, on broader balance, a member might not want to support. It's said that “you must pay to play,” i.e., to gain access. Fortunately, there are other routes too. I think that part of an expanded APA secretary's job should be to utilize contemporary technology to reach beyond the PAC to activate many more members' inputs to their legislators.

Increase Information and Openness: (1) APA's secretary reviews potential conflicts of interest. I believe the secretary should be vigilant re both individual and organizational potential conflicts of interest; (2) Although not necessarily enemies, it's a mistake to think of the pharmaceutical industry as our friend. It is not. Like health insurers, pharmaceutical companies sometimes have done awful things, embarrassing the medical profession as well as itself, deviating from standards that distinguish ethical pharmaceutical practice from patent medicine. Whatever his flaws, Sen. Grassley has helped alert medicine to personal and organizational potential conflicts of interest that we, understandably, have tended to minimize; So, (3) Assuring presenters' and authors' transparency is only a first step in helping mark a clearer boundary between us as healers and pharma as promoters. We psychiatrists shouldn't need to depend on subscriptions to publications like The Carlat Report for timely, critical, objective reviews of pharmaceuticals. I think APA should provide such updated information for our members routinely, frequently, and cost-free; (4) I disagree with Roger's proposal to submit minutes for approval immediately at the end of each Board meeting. Those often are hectic moments, and I think it's better to be able to review thoughtfully, better right than fast; (5) Moreover, I believe it's much more significant for the secretary to insure that adequate material from executive sessions is reported to the whole Board and then carefully appears within the Board's minutes. That has not always occurred, and it should.

Emphasize Patient Access and Patient Care: (1) In today's world we must be both patient caregivers and patient advocates, so (2) Although neither single-payer (government funded, privately provided care) nor “public-option” insurance is a panacea, I strongly support APA's stance against the folly of letting health insurance companies continue their virtually free and generally uncompetitive reign; (3) I do not agree with Roger's suggestion that DSM-V would be better if NOS diagnoses approach 0 percent. I think at times the DSM describes more and more about less and less, with some of the checklists and criteria sets a bean-counter's paradise. They may gratify insurers and have potential research currency, but rarely help us to be humane healers. I think honest NOS diagnoses help reflect the complex and ambiguous clinical realities of our patients. More on training and treatment at <http://home.rr.com/fredgottliebmd>.